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Previous issue date: 2014-08-25 / Objective : Evaluate the impact of asthma on the quality of life in a population of school children in the city of Iju?, which is located in an essentially agricultural region of the state of Rio Grande do Sul, Brazil. As well as the relationships between the comorbidities of atopy and rhinoconjunctivitis.
Methods : Transversal study of children in elementary school from third through eighth grades in the municipality of Iju?, Rio Grande do Sul, Brazil. In November 2012 (phase I), parents or guardians of the school children population answered an initial screening questionnaire. Based on it, asthmatic children were classified and paired with non-asthmatics considering parameters, such as age, gender and school. From May to June 2013 (Phase II), at their residency, parents or guardians and school children were interviewed and answered questions related to asthma, rhinitis and rhinoconjunctivitis of the International Study of Asthma and Allergies in Childhood questionnaire. An additional set of questions related to quality of life and asthma control were included on the questionnaire. A group of children, asthmatic and non- asthmatic (control), were subjected to blood tests to evaluate atopy through IgE levels.
Results: In the first phase of the study, 2,000 initial screening questionnaires were distributed, out of which 1,691 (84.5%) were completed; school children aged on average 11.5 years and 780 (46%) were males. According to the criteria utilized on this study, 324 (19%) of the school children were classified as having active asthma. Questions about asthma, respiratory symptons and questionnaire about quality of life were answered by 480 school children. Out of which, 246 (51,2%) presented rhinoconjunctivitis in the past year. 189 school children were classified as asthmatic and 291 as healthy controls. 185 school children consented to be subjected to blood tests, out of which 127 (68,6%) were considered allergic to at least one of the tested allergens. Assessing the domains of quality of life, the asthmatic group presented the worst scores on the physical domain (p ˂0,001) and on the total quality of life (p=0,025) when compared to the control group. The average scores of quality of life for the group of school children with asthma and rhinoconjunctivitis was significantlly lower on the same domains: physical (p˂0,001) and total quality of life (p= 0,018), when compared to its controls presenting the same symptoms. Considering the group of asthmatic school children with or without rhinoconjunctivitis, the average scores were lower in the physical (p=0,039) and emotional (p=0,025) domains for the group with asthma and rhinoconjunctivitis. Multivariate analysis of health-related quality of life, revelead a significant association between asthma diagnosis and total score (β=-2,59 CI95% -4,82 a -0,37 p=0,022). The asthma control test revealed that 62(50,4%) were not controlling the disease. Evaluating the correlation between the asthma control test and the domains of quality of life, weak statistically significant positive correlations between the physical domain score (r= 0,38; p˂0,001) and total scores(r=0,24; p=0,008) were found.
Conclusion : The health-related quality of life in children with asthma was lower when compared to the control group. The rhinoconjunctivitis as an asthma comorbidity seems to affect health-related quality of life, especially in physical domain, but asthma is the major contribuitor to a decreased quality of life. / Objetivo : avaliar o impacto da asma na qualidade de vida em uma popula??o de escolares na cidade de Iju?, RS, regi?o essencialmente agr?cola do estado, bem como as rela??es entre as comorbidades de atopia e rinoconjuntivite.
M?todos : Estudo transversal com escolares de 3? a 8? s?rie do Ensino Fundamental do munic?pio de Iju?/RS. Em novembro de 2012 (etapa I), foi enviado aos domic?lios um breve question?rio de triagem para ser preenchido pelos respons?veis que possibilitou a classifica??o dos escolares com asma e este grupo foi pareados para sexo e idade com um grupo de colegas da escola, n?o asm?ticos. De maio a junho de 2013(etapa II), os respons?veis e os escolares, em seus domic?lios, foram entrevistados e responderam os question?rios de qualidade de vida relacionada ? sa?de, controle da asma e ?s perguntas do question?rio International Study of Asthma and Allergies in Childhood relacionadas ? asma, rinite e rinoconjuntivite. Um grupo de crian?as com asma e outro de crian?as controles realizaram coleta de sangue para avalia??o de atopia atrav?s de testes de IgE espec?fico.
Resultados : Na primeira fase do estudo, dos 2000 question?rios de triagem distribu?dos obtivemos o retorno de 1691 (84,5%); a m?dia de idade dos escolares foi de 11,5 anos e 780 (46%) eram do sexo masculino. De acordo com os crit?rios utilizados nesse estudo 324 (19%) dos escolares foram classificados com asma ativa. As perguntas sobre asma, sintomas respirat?rios e o question?rio de qualidade de vida foram respondidas por 480 escolares. Destes 246 (51,2%) apresentaram rinoconjuntivite no ?ltimo ano. 189 escolares foram classificados com asma e 291 como controles saud?veis. 185 escolares aceitaram realizar a coleta de sangue e 127 (68,6%) foram considerados at?picos a pelo menos um dos al?rgenos testados. Na avalia??o dos dom?nios de qualidade de vida o grupo com asma apresentou pior escore nos dom?nios bem estar f?sico (p ˂0,001) e no escore total de qualidade de vida (p=0,025) quando comparado ao grupo controle. A m?dia dos escores de qualidade de vida para o grupo de escolares com asma e rinoconjuntivite ? significativamente menor nos mesmos dom?nios bem estar f?sico (p˂0,001) e escore total (p= 0,018) quando comparadas aos controles com os mesmos sintomas. Para os escolares asm?ticos com e sem rinoconjuntivite, as m?dias nos dom?nios bem estar f?sico (p=0,039) e bem estar emocional (p=0,025) apresentam-se menores para os asm?ticos com rinoconjuntivite. Em an?lise multivari?vel da qualidade de vida relacionada ? sa?de, o diagn?stico de asma apresentou associa??o significativa com o escore total (β=-2,59 CI95% -4,82 a -0,37 p=0,022). Na avalia??o do asthma control test, 62(50,4%) apresentou a doen?a n?o controlada. Na correla??o da pontua??o do asthma control test com os dom?nios de qualidade vida, encontramos fraca correla??o positiva em todos os dom?nios, com signific?ncia estat?stica para dom?nio bem estar f?sico (r= 0,38; p˂0,001) e no escore total (r=0,24; p=0,008).
Conclus?o : A qualidade de vida relacionada ? sa?de em escolares com asma ? menor quando comparadas aos escolares controles. A rinoconjuntivite como comorbidade da asma parece influenciar na qualidade de vida relacionada ? sa?de, especialmente no bem estar f?sico, mas a asma aparece mais relacionada com a piora da qualidade de vida.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/1439 |
| Date | 25 August 2014 |
| Creators | Strassburger, Simone Zeni |
| Contributors | Stein, Renato Tetelbom |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Medicina/Pediatria e Sa?de da Crian?a, PUCRS, BR, Faculdade de Medicina |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 3098206005268432148, 500, 600, -8624664729441623247 |
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