Çocukluk Astım Kontrol Testi ve GINA Kriterlerine, Yaşam Kalitesi Alanlarını Eklemenin Zamanı Geldi mi?

Amaç: Astımlı çocuklarda Standart Pediatrik Astım Yaşam Kalitesi Anketi (PAQLQ(S)) kullanılarak yaşam kalitesini ölçmek; Çocukluk Çağı Astım Kontrol Testi (c-ACT) ile Global Initiative for Asthma (GINA) Testinin PAQLQ(S) alanları ile ilişkisini belirlemektir. Yöntemler: Bu çalışma kesitsel olarak planlandı. En az bir yıldır astım tanısı ile izlenen 7-11 yaş arası ardışık tüm çocuklar çalışmaya alındı. Çocuklar PAQLQ(S)'yi doldurdu. Astım kontrol seviyeleri, c-ACT ve GINA kriterleri ile aracılığıyla tanımlandı. Bulgular: Toplam 120 çocuğun medyan(%25-75) PAQLQ(S) ve c-ACT puanları 4.90(1.3) ve 17.9(4.8) idi. Dördü dışında tüm çocukların yaşam kalitesinde bozulma vardı. c-ACT'ye göre çocukların %41,7'si kontrol altındaydı. PAQLQ(S) skorları her iki c-ACT skoru ile korele bulundu(p<0.001, r=0.612). c-ACT skoru, PAQLQ(S)'nin semptom alanı ile daha anlamlı bir şekilde koreleydi (r=0,667, p<0,001). c-ACT ile aktivite ve emosyonel fonksiyon düet skoru arasında daha anlamlı bir pozitif korelasyon bulundu (r=0.930; p<0.001). Sonuç: Astım çocuklarda yaşam kalitesini etkilemektedir. PAQLQ(S) puanları, astım kontrolden çıktığında önemli ölçüde düşer. PAQLQ(S), GINA kriterlerine kıyasla c-ACT ile daha anlamlı bir şekilde ilişkilidir. c-ACT veya GINA kriterleri, yaşam kalitesini kapsayacak şekilde iyileştirilmesi klinik uygulamada yararlı olacaktır.

Anahtar Kelimeler:

Astım Kontrolü, Astım Kontrol Testi, Çocukluk Çağı Astımı, Yaşam Kalitesi

Is It Time to Add Domains of Quality of Life to the Childhood Asthma Control Test and the GINA Criteria?

Objective: To measure the quality of life by using the Standardized Pediatric Asthma Quality of Life Questionnaire(PAQLQ(S)) in children with asthma and to determine the association of the Childhood Asthma Control Test(c-ACT) and Global Initiative for Asthma(GINA) criteria of asthma control with the PAQLQ(S) domains. Methods: This study was planned in a cross-sectional design. All consecutive children between the ages 7-11 years who had been followed up at least one year with a diagnosis of asthma were enrolled. Children filled out PAQLQ(S). The levels of asthma control were defined by c-ACT and GINA criteria of asthma control. Results: Of the total 120 children, the median(%25-75) PAQLQ(S) and c-ACT scores were 4.90(1.3) and 17.9(4.8). All children had quality of life impairments except four. According to c-ACT, 41.7% of children were controlled; 58.3% of them were uncontrolled. PAQLQ(S) scores were found to be correlated with both c-ACT scores(p<0.001, r=0.612). The c-ACT score was more significantly correlated with the symptom domain of PAQLQ(S)(r=0,667, p<0,001). A more significant positive correlation was found between c-ACT and the duet score of activity and emotional function(r=0.930; p<0.001). Conclusion: Asthma affects the quality of life in children. PAQLQ(S) scores decrease significantly when asthma is out of control. PAQLQ(S) is more significantly associated with c-ACT than GINA criteria. It would be useful in clinical practice if c-ACT or GINA criteria can be improved to cover quality of life, at least the part of the quality of life related to the symptoms or the activity limitations and emotional functions.

Keywords:

asthma control, asthma control test, childhood asthma, quality of life,

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ISSN: 1309-3878
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 2009
Yayıncı: Düzce Üniversitesi Tıp Fakültesi Aile Hekimliği AD adına Yrd.Doç.Dr.Cemil Işık Sönmez