Psychological and self-management factors in near-fatal asthma☆
Received 24 July 2008; received in revised form 20 April 2009; accepted 28 April 2009. published online 29 June 2009.
Abstract
Background
Several studies that have analyzed differences in psychological and self-management variables between patients with a near-fatal asthma (NFA) attack and asthmatics without a NFA attack (non-NFA) have shown conflicting results, probably due to the heterogeneity of the events studied and the selection of comparison groups.
Objective
To determine whether NFA patients, in stable situation, have greater psychological morbidity and worse self-management behavior than non-NFA patients with similar sociodemographic and clinical characteristics.
Methods
A sample of 44 NFA patients (mean=5.65 years after the NFA episode) and 44 non-NFA patients matched for age, sex, and asthma severity was assessed. All patients were in clinical stable situation. Information about sociodemographic, clinical, functional, and morbidity variables was collected for each patient, and the Cognitive Depression Inventory, the Trait-Anxiety Scale, the Toronto Alexithymia Scale, the Practical Knowledge of Self-management questionnaire, and the Medication Adherence scale were administered.
Results
In comparison with non-NFA patients, NFA patients showed higher levels of trait-anxiety (23.84 vs. 16.86; P=.001) and more difficulties describing and communicating feelings (11.36 vs. 8.90; P=.002). NFA and non-NFA patients did not differ in self-management variables. After adjustment in multivariate logistic regression analysis for age, sex, and asthma severity, significant differences were observed between NFA and control group patients in marital status [odds ratio (OR)=0.26; P=.017; 95% confidence interval (CI)=0.09–0.78], prescribed dose of inhaled corticoids (OR=4.48; P=.006;95% CI=1.53–13.09), and trait-anxiety (OR=1.071;P=.025;95%CI=1.01–1.14).
Conclusions
NFA patients show higher psychological morbidity than non-NFA, even years after the NFA episode.
aDepartamento de Psicología Clínica y Psicobiología, Facultad de Psicología, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
bServicio de Neumología, Complejo Hospitalario Universitario A Coruña, Spain
cDepartamento de Psicología Social, Básica y Metodología, Facultad de Psicología, Universidad de Santiago de Compostela, Spain
dUnidad de Epidemiología Clínica y Bioestadística, Complejo Hospitalario Universitario A Coruña, Spain
Corresponding author. Departamento de Psicología Clínica y Psicobiología, Facultad de Psicología, Universidad de Santiago de Compostela, 15782 Santiago de Compostela, Spain. Tel.: +34 981563100x13731.
☆ This study was supported by a Formación de Profesorado Universtario (FPU) grant from the Ministerio Español de Educación y Ciencia.
ABSTRACT