Avaliação da qualidade de vida entre adolescentes asmáticos

Abstract

Objectives: The association between quality of life and adolescents with asthma: Paper 1 - Evaluate the association between the severity of asthma, the presence of comorbid chronic diseases, lifestyle and quality of life (QoL); Paper 2 - Evaluate the association between CMD and quality of life in adolescents with asthma. Method: Paper 1 - We undertook a sectional study 210 adolescents between ages 12 and 21, of both sexes with asthma, seen in the adolescent medicine service of public university hospital in the state of Rio de Janeiro. The self-administered Paediatric Asthma Quality of Life Questionnaire (PAQLQ) was used to evaluate QoL. The explanatory variables used included other allergic disease, medication use, passive smoke exposure, employment, asthma severity and lifestyle. The analyses were conducted considering dichotomous outcome definitions of QoL (good-poor) using the mean of the scores. Generalized linear models (log-binomial) were used to calculate the gross and adjusted prevalence ratios; Paper 2 - This transverse study investigated 210 adolescents with asthma between ages 12 and 21, seen at a university outpatient adolescent medicine service in Rio de Janeiro, Brazil. The Paediatric Asthma Quality of Life Questionnaire (PAQLQ) and General Health Questionnaire (GHQ-12) were used to assess QoL and common mental disorders (CMD) respectively. Total quality of life and its various dimensions were treated as dichotomous variables. A binomial log-rithmic model was used to calculate raw and adjusted prevalence ratios. Results: Paper 1 - Forty-six percent of woman, and 57% of men reported poor quality of life. There was no correlation between other chronic disease and poor QoL. Poor QoL was associated with low levels of education, medication use, passive smoke exposure, and employment; the relationship was - The prevalence of asthmatics with CMD was 32.4%. Examining CMD s relation to QoL, the prevalence of poor QoL was associated with low levels of education, medication use, passive smoke exposure, and employment; the relationship was statistically significant (p< 0.05). The adjusted analysis showed that severe asthma (RP=1.53; CI 95%: 1.12-2.11), medication use (RP=1.58; CI 95% 1.09-2.28), asthma diagnosis within the prior five years (RP= 1.30; CI 95%: 0.97-1.86), passive smoke exposure (RP= 1.38; CI 95%: 1.35-2.00) and being employed (RP=1.30; CI 95% 0.97-1.74) are associated with poor quality of life; Paper 2 - The prevalence of asthmatics with CMD was 32.4%. Examining CMD s relation to QoL, the prevalence of poor QoL was 36.6%. The adjusted final models showed an association between CMD and poor total quality of life (PR= 1, 84 IC 95% 1,19-2,86) as for the domains related to emotions (PR =1,77 IC 95% 1,16-2,62) and symptoms (RP=1,75 IC 95% 1,14-2,70). For the domain related to physical activity, the association to CMD was only borderline (RP=1,43 IC 95% 0,97-2,72). We conclude that: Paper 1 -The negative impact on quality of life is directly related to having severe asthma, being exposed to passive smoke, or being recently diagnosed with asthma. The multidisciplinary team faced with the challenge of establishing and maintaining a good quality of life needs a comprehensive approach to the adolescent capable of helping these patients cope with society and their own issues; Paper 2- The results of this study suggest that greater attention be paid to the emotional needs of adolescents with chronic diseases, including more effective initiatives in the area of mental health in order to promote better quality of life and more comprehensive treatment for young patients with asthma.