ArticlePDF Available

Quality of life and activity of children suffering from bronchial asthma

Authors:
Anna Trzcieniecka-Green at Górnośląska Wyższa Szkoła Handlowa im. Wojciecha Korfantego w Katowicach
Anna Trzcieniecka-Green
Kamilla Bargiel-Matusiewicz at University of Warsaw
Kamilla Bargiel-Matusiewicz
Agnieszka Wilczynska at Dolnośląska Szkoła Wyższa
Agnieszka Wilczynska
Download full-text PDFDownload full-text PDF
Read full-text
Download citation

Abstract and Figures

The aim of this article was to analyze the quality of life of children suffering from bronchial asthma and to analyze their everyday activity. The research was conducted in 137 children. The following questionnaires were used in the study: Pediatric Asthma Quality of Life Questionnaire (PAQLQ) and a questionnaire designed by the authors specifically for the purpose of the study. The findings of the study show that illness duration (r = -0.2; P = 0.22) and gender (P = 0.37) do not influence the quality of life. It appears that among children ill with asthma a higher level of quality of life is typical for the children who live in the country side in comparison with those from cities (P <0.05). The comparison was also made in terms of everyday activity of children ill with asthma and non-asthmatic children. The children ill with asthma displayed less social contacts with peers/friends (P <0.05) and they performed less physical activities (P <0.05). The study points to the possible beneficial effects of activating children's social interactions, creating conditions for appropriate development of their social competences, and of stress reduction connected with social interactions. Asthmatic children should also be encouraged to intensify appropriate physical activity.
Figures - available via license: Creative Commons Attribution 4.0 International
Content may be subject to copyright.
2047-783X-14-S4-1
47.pdf
Content uploaded by Kamilla Bargiel-Matusiewicz
Author content
All content in this area was uploaded by Kamilla Bargiel-Matusiewicz on Mar 27, 2015
Content may be subject to copyright.
Quality of life and activity of children suffering from bronchial asth
ma.pdf
Available via license: CC BY 4.0
Content may be subject to copyright.
Abstract
Objectiv e: The aim of this article was to analyze the
quality of life of children suffering from bronchial
asthma and to analyze their everyday activity.
Methods: The research was conducted in 137 children.
The following questionnaires were used in the study:
Pediatric Asthma Quality of Life Questionnaire
(PAQLQ) and a questionnaire designed by the authors
specifically for the purpose of the study.
Results: The findings of the study show that illness
duration (r = -0.2; P = 0.22) and gender (P = 0.37) do
not influence the quality of life. It appears that among
children ill with asthma a higher level of quality of
life is typical for the children who live in the country
side in comparison with those from cities (P <0.05).
The comparison was also made in terms of everyday
activity of children ill with asthma and non-asthmatic
children. The children ill with asthma displayed less
social contacts with peers/friends (P <0.05) and they
performed less physical activities (P <0.05).
Conclusions: The study points to the possible beneficial
effects of activating children’s social interactions, creat-
ing conditions for appropriate development of their so-
cial competences, and of stress reduction connected
with social interactions. Asthmatic children should also
be encouraged to intensify appropriate physical activity.
Key words: bronchial asthma, quality of life
INTRODUCTION
The aim of this article is to analyze the quality of life
and everyday activity of children suffering from
bronchial asthma. Childhood is a period when many
models of behavior – implemented later on in life –
are formed. Therefore, it is worthwhile to consider
how children’s chronic disease influences their evalua-
tion of life quality and social activity [1, 2].
Civilization development and increase in environ-
ment pollution lead to an increase in the occurrence of
allergic diseases, including bronchial asthma. WHO re-
ports that 300 million people suffer from asthma
world wide. The International Study of Asthma and
Allergies in Childhood (ISAAC) carried out in the
1990s show that asthma affects 7.2% of children aged
6-7 and 11.3% of those aged 13–15. Progressive in-
crease in the incidence of asthma makes this condition
the most prevalent chronic disease of the respiratory
system in children [3].
The disease, along its course, evokes varying emo-
tions in children; the negative ones prevailing. Emo-
tional disorders are experienced by 25–40% of asth-
matic children; most often consisting of excessive psy-
chological dependence on the parents and increased
anxiety level [4]. Parents often tend to act incorrectly
in such situations. They are overprotective, assume
rigid attitudes, and get too much involved in other
family members’ lives. Overprotection impedes the
child’s emotional development, disturbs the develop-
ment of self-reliance and independence. Excessive
family concentration on the affected child leads to the
lack of independence, egocentrism, and infantilism.
The child starts to exert pressure on the family, where-
as, when separated from the family, he is not self-con-
fident and new situations trigger anxiety reactions [2].
Reducing everyday duties and permanent supervision
of the child result in difficulties in adoption to living
in the society [5, 6, 7].
The child’s chronic disease also may disturb the
learning process. Difficulties at school may result
from several factors, such as the medicines taken, the
absenteeism due to disease exacerbation or hospital-
izations. Oral glucocorticosteroids may disturb the
cognitive processes or cause sleep disturbances, plain-
tiveness, anxiety, or depression. Beta2-adrenergic ago-
nists, in turn, may cause muscles trembling and may
be the reason for illegible handwriting. Sleepiness, de-
creased concentration, and fatigue are just some of
the other side effects resulting from antihistaminic
medicines.
Incorrectly controlled asthma, in its turn, or more
severe forms of the disease may lead to lasting nightly
complaints which, by disturbing child’s sleeping, have
an impact on both physical and mental functioning.
MATERIAL AND METHODS
The study protocol was approved by an institutional
Ethics Committee. The following questionnaires were
used for the study: Pediatric Asthma Quality of Life
Questionnaire (PAQLQ) and a self-developed ques-
tionnaire addressed to both healthy and asthmatic chil-
dren. The PAQLQ was used for the identification of
negative physical, emotional, and social effects chil-
dren suffering from asthma could be exposed to. The
questionnaire enables to survey children aged 7-17. It
consists of 23 items, including three domains: symp-
toms, emotions, and activity limitation. By summing
EUROPEAN JOURNAL OF MEDICAL RESEARCHDecember 7, 2009 147
Eur J Med Res (2009) 14(Suppl. IV): 147-150 © I. Holzapfel Publishers 2009
QUALITY OF LIFE AND ACTIVITY OF CHILDREN SUFFERING FROM BRONCHIAL
ASTHMA
A. Trzcieniecka-Green1, K. Bargiel-Matusiewicz2, A. Wilczynska-Kwiatek3
1Department of Psychology, Silesian Medical University, Katowice, Poland; 2Faculty of Psychology, Warsaw University, Warsaw, Poland;
3Faculty of Psychology, Silesian University, Katowice, Poland
S. I-X, 1-284:Layout 1 24.11.2009 10:43 Uhr Seite 147
up the score from these domains, a coefficient pertain-
ing to the general quality of life (QL) is obtained [8,
9].
Another tool was a self-developed questionnaire. It
was directed to healthy children and children suffering
from bronchial asthma. It is complementary with the
PAQLQ. The goal is to gain information about every-
day activity of children covered by the survey (con-
tacts with age-mates, watching TV, time spent on using
computer, reading books, physical activity) and to col-
lect demographic data.
The survey was conducted on 137 Polish children
from Katowice, Chorzów, Tarnowskie Góry and
neighboring villages. There were 37 children suffering
from bronchial asthma and 100 healthy children in the
group. Children suffering from bronchial asthma, for
whom at least a year had passed from the moment
they were diagnosed with the condition, were selected
to participate in the survey. There were slightly more
girls in the whole group (52%). However, girls made
up 55% of the healthy children, whereas boys domi-
nated among the asthmatic children (57%). The
youngest children in the survey were 7 and the oldest
were 14 years old. The average age of the whole group
was 10.6; it was 10.7 in the asthmatic children and 10.6
in the healthy ones.
RESULTS
Before calculations regarding the relation between the
Quality of Life (QL) and other parameters were made,
the results of the PAQLQ questionnaire had been ver-
ified. The aim was to define the relation between vari-
ous results of individual sub-scales of this question-
naire (symptoms, emotions, and activity limitation)
and the general result referred to as QL. To this end,
coefficients of linear correlation were calculated be-
tween the results of sub-scales and the general result.
As the correlations proved to be very strong (symp-
toms r = 0.96; emotions r = 0.95; activity limitation r
= 0.94), it was assumed that the variables were actually
univocal with the QL variable.
With reference to the above outlined, in further
analyses, a comparison of the disease duration, place
of living, and gender, on one hand, with the general
result of PAQLQ, on the other hand, was made. Fig. 1
shows that there was a weak, negative correlation be-
tween disease duration and quality of life, which lacks
statistical significance (r = -0.2; P = 0.22). Next, a rela-
tion between the place of living and QL was analyzed.
For this purpose, the significance of differences in QL
assessed by children living in the city and in the coun-
try was statistically verified. The results are presented
in Table 1. It was found that in the case of children
suffering from bronchial asthma, the children living in
the country assessed their QL higher than those living
in the city.
Further, the relation between the gender and QL
was analyzed. These results, presented in Table 2,
show that the differences in QL between girls and
boys suffering from bronchial asthma were statistically
irrelevant.
Finally, everyday functioning of children suffering
from bronchial asthma and their age-mates was evalu-
ated. The comparison encompassed the following:
how much time was spent on different activities -
reading books, watching TV, meeting friends (after
school), time spent for computer games, and physical
activities. The results of this comparison are presented
in Table 3.
EUROPEAN JOURNAL OF MEDICAL RESEARCH
148 December 7, 2009
Tab le 1. Differences in Quality of Life (QL) of children living in the city and in the country.
Sum of ranks – QL in the city Sum of ranks – QL in the country U Statistics Pn
262.5 440.5 72.5 <0.05 City 19
Country 18
QL – quality of life; Mann-Whitney-U test.
Fig. 1. Relation between the duration of disease
and quality of life.
S. I-X, 1-284:Layout 1 24.11.2009 10:43 Uhr Seite 148
The differences concerning the average time devot-
ed for reading books, watching TV, and using comput-
ers in asthmatic vs. healthy children were insignificant.
Yet, remarkable statistical differences were found with
reference to the average time spent with friends after
school and that devoted to physical activities (117 vs.
35 min for social interaction and 144 vs. 81 min for
physical activities in healthy and asthmatic children, re-
spectively). Statistical elaboration of these results is
presented in Tables 4 and 5.
DISCUSSION
The present study failed to substantiate the existence
of significant relationships between gender of chil-
dren suffering from asthma or the duration of disease
and their quality of life. The lack of such relationships
is in accord with other studies on the subject [5]. What
turned out to be significant was the relation between
the place of living and quality of life of asthmatic
children. It was found that children living in the coun-
try assessed their quality of life better than those from
the city. A better assessment of quality of life among
country children may result from a few factors, such as
a slower pace of life, less pressure of time, and there-
fore less associated stress. Children living in the coun-
try spend more time with their parents who give them
more support. They may also be supported by their
grandparents, who live in common households much
more often than in case of cities. Another reason for a
feeling of a better quality of life in these children may
be less polluted natural environment in the country,
which in case of asthma directly translates to the fre-
quency of respiratory symptoms.
Concerning everyday functioning of children, the
analysis shows that both asthmatic and non-asthmatic
children spend a comparable amount of time on read-
ing books, watching TV, and using computer. Yet, a
significant difference appeared concerning the time
spent on socializing with friends after school. Healthy
children tend to spend remarkably more time with
their friends than the asthmatic ones, on average, 117
min vs. 35 min, respectively. Thus, it seems to be im-
portant to encourage children suffering from asthma
to intensify social activity, to engage in contact with
age-mates, and to do so not only at school, but also af-
ter classes. Proper social relations constitute an essen-
tial factor in the process of forming the self-assess-
ment and the sense of self-efficacy, which are of cru-
cial meaning for functioning in many areas of life [1,
7]. Beside, there is a risk that a child who spends little
time with age-mates will experience much more stress
EUROPEAN JOURNAL OF MEDICAL RESEARCHDecember 7, 2009 149
Tab le 3. Comparison of physical activities of healthy children and children suffering from bronchial asthma.
n%Reading books Watching TV Meeting friends Computer Physical activities
(min) (min) (min) (min) (min)
Healthy children 100 73 52 113 117 112 144
Asthmatic children 37 27 62 120 35 100 81
Tab le 2. Significance of differences between Quality of Life (QL) of girls and boys.
Sum of ranks - QL among girls Sum of ranks - QL among boys U Statistics Pn
369.5 333.5 138.5 P = 0.37 girls 21;
boys 16
QL – quality of life; Mann-Whitney-U test.
Tab le 4. Significance of differences concerning the time spent with friends.
Sum of ranks – Asthmatic Children Sum of ranks – Healthy Children U Statistics Pn
1344.5 8108.5 641.5 P<0.05 Asthmatic - 37
Healthy - 100
Mann-Whitney- U test.
Tab le 5. Significance of differences concerning physical activities.
Sum of ranks – Asthmatic Children Sum of ranks – Healthy Children U Statistics Pn
1721.0 7732.0 1018.0 P<0.05 Asthmatic - 37
Healthy - 100
Mann-Whitney- U test.
S. I-X, 1-284:Layout 1 24.11.2009 10:43 Uhr Seite 149
in the situations of social interactions than persons for
whom social contacts are something normal in every-
day functioning. Many authors claim that stress and
negative emotions can trigger and exacerbate the
symptoms of asthma [2, 10, 11]. It is worth mention-
ing that sanatorium treatments have a positive influ-
ence on social skills. Staying in this kind of facilities al-
lows establishing new friendships, and therapeutic
classes not only develop new skills, but also allow
overcoming emotional stresses often accompanying
the disease. Contact with other children suffering from
bronchial asthma allows sharing one’s experiences with
others and to find out about the way others deal with
the condition.
There also was a significant difference concerning
physical activity between asthmatic and healthy chil-
dren to the disadvantage of the sick; on average, 81 vs.
114 min, respectively. Admittedly, it is a detrimental
occurrence and may result from incorrect convictions
of parents or teachers, and passed onto children, that
physical activity should be shunned or disadvised in
asthma, due either to reduced children’s capability or
the possibility of asthma aggravation. Research shows
that doing sports by people suffering from asthma,
under appropriate pharmacological umbrella, reduces
bronchial hyperreactivity and improves physical effi-
ciency. However, not every sport discipline is recom-
mended to children suffering from asthma. Due to
high minute ventilation, they should avoid such sports
as basketball, cycling racing, long-distance races, or
other high-performance sports. Exposure to cold and
dry environment while doing sports is not recom-
mended either. What is recommended are the disci-
plines where effort is spread over time, e.g., swim-
ming, riding a bike, gymnastics, or canoeing. The diag-
nosis of bronchial asthma does not mean at all that a
child should lead sedentary life and resign from the
benefits of physical activity. Activity is not only a per-
fect way to be in a good shape, enjoy good health, but
also to keep good mental condition (12). Previous re-
search shows that what is essentially important con-
cerning physical activity is the perceived competence
at it and attitude toward it (14). Therefore, it is crucial
to help shape positive attitude toward physical activity
in children with asthma.
In summary, the present survey may help shape atti-
tudes toward functioning of children suffering from
asthma. Such children should be encouraged to the in-
teractions on social level, which would create condi-
tions for appropriate development of their social com-
petences and to reduce stress connected with such in-
teractions. They also should be encouraged to intensi-
fy physical activity taking into account recommenda-
tions as to the forms of activity suitable for these chil-
dren.
Conflicts of interest: The authors reported no conflicts of in-
terest in relation to this article.
REFERENCES
[1] Janion E. Zaspokajanie potrzeb psychicznych dzieci
przewlekle chorych. Problemy Opiekunczo –Wychowaw-
cze 2000; 1: 32-35 (Article in Polish).
[2] Lehrer P, Feldman J, Giardino N, Song H, Schmaling K.
Psychological aspects of asthma. J Consul Clin Psychol
2002; 70: 691-711.
[3] Asher MJ, Weiland SK. The international study of asthma
and allergies in childhood. Clin Exp Allergy 1998; Suppl
28: 52-66.
[4] Trojanowska A, Bernat K. Funkcjonowanie emocjonalne a
wiedza o chorobie dzieci chorych na astme oskrzelowa.
Zdrowie Publiczne 2002; 112: 192-194 (Article In Polish).
[5] Adamska R, Drózdz Z, Breborowicz A, Pawlaczyk B.
Zmienne spoleczno – ekonomiczne a jakosc zycia dzieci z
astma oskrzelowa. Pielegniarstwo Polskie 2005; 2: 294 -
299 (Article in Polish).
[6] Bray M, Theodore L, Patwa S, Margiano S, Arlic J, Peck H.
Written emotional expression as an intervention for asth-
ma. Psychol Sch 2003, 40, 193-207.
[7] Bray M, Kehle T, Peck H, Theodore L, Zhou Z. Enhanc-
ing subjective well-being in individuals with asthma. Psy-
chol Sch 2004, 41, 95-100.
[8] Juniper E. Pediatric Asthma Quality of Life Question-
naire. Ontario, McMaster University Medical Center,
1999.
[9] Adamska R, Drózdz Z, Breborowicz A, Pawlaczyk B.
Wykorzystanie kwestionariusza PAQLQ w badaniu
jakosci zycia dzieci z astma oskrzelowa. Pielegniarstwo
Polskie 2005; 19: 22-26 (Article in Polish).
[10] Milton B, Whitehead M, Holland P, Hamilton V. The so-
cial and economic consequences of childhood asthma
cross the life course: a systematic review. Child Care
Health Dev 2004; 30: 711-728.
[11] Ritz T, Steptoe A, DeWilde S, Costa M. Emotions and
stress increase respiratory resistance in asthma. Psycho-
som Med 2000; 62: 401-412.
[12] Welsh L, Kemp J, Roberts R. Effects of physical condi-
tioning on children and adolescents with asthma. Sports
Med 2005; 35: 127-141.
[13] Pianosi P, Davis H. Determinants of physical fitness in
children with asthma. Pediatrics 2004; 113: 225-229.
Corr espo nding a uthor:
Kamilla Bargiel-Matusiewicz
Faculty of Psychology
Warsaw University
Stawki 5/7 St.
00-183 Warsaw, Poland
Phone: +48 22 5549703
E-mail: K.matusiewicz@op.pl
EUROPEAN JOURNAL OF MEDICAL RESEARCH
150 December 7, 2009
S. I-X, 1-284:Layout 1 24.11.2009 10:43 Uhr Seite 150
... Similarly to our study, it was found that the physical fitness of healthy children was higher than that of children with BA (on average, healthy children spent 144 min per day engaged in physical activity, while those with BA spent only 81 min). However, no significant difference was observed when assessing activities that did not require significant physical effort, such as reading books, watching television, or playing computer games [21]. In evaluating the impact of overall children's health on daily activities, the study examined the influence of physical health. ...
... When comparing our results to other authors, similar results were found. In the previously mentioned study in Poland, as in our study, it was statistically significantly determined that healthy children spent more time per day (117 min) interacting with friends than children with BA did (35 min) [21]. Table 6. ...
... However, no significant difference was observed when assessing activities that did not require significant physical effort, such as reading books, watching television, or playing computer games. Also, in this study, as in our study, it was statistically significantly determined that healthy children spent more time per day (117 min) interacting with friends than children with BA (35 min) [21]. It is essential to consider the limitations of this study: the severity of BA was not specified, and the sample of participants with BA was not very large. ...
Quality-of-Life Assessment in Children with Mild to Moderate Bronchial Asthma
Article
Full-text available
  • May 2024
Background and Objectives: Assess the quality of life of children aged 2–10 with mild to moderate bronchial asthma. To evaluate the general health condition of children with mild and moderate severity bronchial asthma. To determine health changes in children with mild- and moderate-severity bronchial asthma as they grow older. To evaluate the impact of mild- and moderate-severity bronchial asthma on children’s daily and social activities, physical health, emotional state, and general well-being. Materials and Methods: A comparative cross-sectional study was conducted in March–June 2020. Parents or guardians of 2–10-year-old children without bronchial asthma and children with mild to moderate bronchial asthma were interviewed after receiving their written informed consent. The questionnaire was based on the standardized quality-of-life quiz SF-36. A total of 248 questionnaires were collected—106 from the parents or guardians of children with bronchial asthma and 142 from parents/guardians of children without bronchial asthma. For further analysis, 106 children without bronchial asthma and with no chronic conditions were selected. Quantitative variables were compared using the Mann–Whitney U test and qualitative data using the chi-square (χ2) criteria. Quantitative data were described by giving means, medians, and standard deviations (SD); qualitative features by giving relative frequencies. Statistical data were analyzed using SPSS and Excel 2020. Results: Children with mild and moderate asthma exhibit poorer health compared to their healthy counterparts. Only 20.7% of respondents with asthma reported excellent or very good health, contrasting with 64.1% of healthy children (p < 0.001). As children with asthma age, their general condition improves, with 46.2% showing improvement in the past year, while 42.5% of healthy children had a stable condition (p < 0.05). In various activities, children with asthma face more constraints than healthy children (p < 0.05), including energetic activities (sick—59.5%; healthy—10.3%), moderate activities (sick—24.5%; healthy—4.7%), climbing stairs (sick—22.7%; healthy—3.8%), and walking over 100 m (sick—9.4%; healthy—0%). Children with asthma are more likely to experience exhaustion, anxiety, tiredness, lack of energy, and restraint in public activities (p < 0.05). Conclusions: Parents/caregivers of children with mild to moderate bronchial asthma rate their health worse than those of healthy children do. As children with mild to moderate bronchial asthma grow, the disease impact on their overall well-being decreases. Children with mild to moderate bronchial asthma, compared to healthy children, experience more limitations in vigorous or moderate activities; face more difficulties climbing stairs or walking more than 100 m; frequently feel exhaustion, anxiety, fatigue, or lack of energy; and encounter restrictions in social activities.
View
... The current study was a cross sectional study that was conducted in pediatric outpatient clinics at Zagazig University Hospitals from July 2018 to June 2019. The study included a total of 176 asthmatic children aged (6)(7)(8)(9)(10)(11)(12) years old. Any comorbid chronic diseases such as (hypertension, congenital heart diseases, handicapping…etc.) ...
... These findings were in the same attitude of the study performed by Varni et al. [10] in United States of America (USA), Trzcieniecka-Green et al. [11], and Reichenberg and Broberg, [12] which reported significantly lower physical score among asthmatic children in comparison to healthy children. ...
View
... In the past 50 years, several studies analyzed the effect of physical activity on childhood asthma [40][41][42][43][44][45][46][47]. Many studies suggested regular physical activity to asthmatic children [48,49], since it could improve both their physical conditions, their social interactions and their development as well [50]. Several studies proved that obesity aggravated the severity of asthma and attenuated the quality of lives [42,[51][52][53] strongly suggesting proper diet and regular physical activity [54]. ...
Assessment of the Physical Activity of Children with Asthma Bronchiale
Preprint
Full-text available
  • Nov 2023
Physical activity is especially important of children's everyday life with chronic disease. The aim of the study was to show whether asthma is a barrier to physical activity in our society. The correlation between the severity of the disease, body mass index, and physical activity were analyzed, and, parents' opinion whether children should participate in active sports was assessed. Physical activity of children with asthma was analyzed by questionnaires and activity-measuring armbands. 93 parents and their children were involved in the survey, while 20 children were wearing the armband. The age of children was 12.6±3.5 years (mean±SD), 69.9% were boys, 30.1% were girls. 93.4% of the respondents participated in physical education program and 56.5% also attended sporting activities on a regular basis. 61.2% of the children had mild, 37.6% moderate, and 1.2% severe asthma. 6.5% of the respondents stated that their illness had been consistently or frequently limiting the performance concerning their school or home duties over the past 4 weeks. Twelve percent of parents felt that physical activity was not appropriate in the context of this disease. We conclude, that fear of the consequences of physical activity depends largely on education which should involve their parents, teachers and coaches.
View
... Dans toutes les recommandations internationales, l'AP régulière est un élément majeur de la prise en charge de l'asthme, quel que soit l'âge [30] . Les effets spécifiques de l'AP sont multiples, par exemple une réduction et une meilleure prise en charge des symptômes [31] , une meilleure qualité de vie [32] et une meilleure fonction pulmonaire [33] . ...
Activité physique et maladie chronique des enfants
Article
  • Mar 2024
Si l'augmentation de la prévalence des maladies chroniques est due en partie à l'augmentation de l'espérance de vie et à un meilleur dispositif de diagnostic, l'exposition aux facteurs de risque pendant la période sensible de l'enfance est une hypothèse explicative de plus en plus étudiée. L'insuffisance d'activité physique et les comportements sédentaires sont des facteurs de risques sanitaires avec leurs effets propres, dont le cumul accentue le développement des maladies chroniques. Pendant longtemps, l'activité physique et sportive était proscrite pour les jeunes patients atteints de maladies chroniques. Aujourd'hui, il est clairement établi que l'activité physique a des effets positifs tant au niveau de la motricité, de la santé physique et métabolique qu'au niveau de la santé mentale, chez les jeunes comme chez les adultes. L'activité physique améliore la qualité de vie et le bien-être des jeunes patients, mais aussi la tolérance aux traitements. Les enfants et les adolescents atteints de maladies chroniques sont généralement moins actifs et plus sédentaires que leurs pairs ne présentant pas de pathologie. Bien que l'intolérance à l'exercice soit prévalente dans les maladies chroniques pédiatriques, l'activité physique est importante et sans danger pour la plupart de ces jeunes patients. Cependant, la prescription d'activité physique doit impliquer l'ensemble des accompagnants (famille, professionnels de santé, de l'éducation, de l'activité physique...) pour créer un programme personnalisé afin de considérer chaque enfant individuellement et les effets secondaires des traitements. L'intégration de l'activité physique adaptée à l'enfant et à sa pathologie vise à augmenter son niveau d'activité physique quotidien et à réduire ses comportements sédentaires. L'objectif de cette synthèse est de questionner les modalités de l'activité physique (la fréquence, le type, l'intensité, la durée et la nature) à recommander pour les enfants et les adolescents atteints des principales maladies chroniques pédiatriques. © 2024 Elsevier Masson SAS. Tous les droits sont réservés, y compris ceux relatifs à l'exploration de textes et de données, à la formation en intelligence artificielle et aux technologies similaires.
View
... But there was no statistically significant difference in mean PAQLQ score according to residence of subjects. These findings suggest that mean PAQLQ score in urban area subjects was less in asthmatic patients in rural inhabitants because of the difficulties to reach medical health care services, while urban children can probably attend medical facilities more easily and thus receive better care of their asthma.In study done by Al-Gewely MS et al., (2013) 20 the residence of the patients did not significantly affect QoL scores (p>0.05).But according to Trzcieniecka-Green A et al., (2009) 12 there was a significant relation between the place of living and quality of life of asthmatic children. It was found that children living in the country assessed their quality of life better than those from the city. ...
Quality Of life In Children with Bronchial Asthma
Article
Full-text available
  • Nov 2023
Aim: To evaluate the quality of life in children with bronchial asthma.Material & Methods: This was a cross sectional hospital based study conducted in the Department of Paediatrics, Mahatma Gandhi Medical College and Hospital, Jaipur among 100 patients of Bronchial asthma with age group of Children in the age group of 2-18 years between March 2021 to July 2022. Grades of severity of asthma at initial diagnosis were categorized into intermittent, mild persistent, moderate persistent and severe persistent on the basis of day time and night time symptoms. The PAQLQ (S) has been developed to measure the functional (physical, emotional, occupational and social) problems that are most troublesome to children of 2-18 years with asthma. Data was collected and subjected to statistical analysis. Results: Maximum subjects were having moderate asthma (57%). The mean PAQLQ score was least in normal BMI subjects i.e., 3.87±0.70, followed by underweight subjects (4.03±0.71) and maximum was in 4.23±0.79. The mean PAQLQ score in subjects with mild asthma was 3.86±0.73, in moderate asthma subjects it was 4.12±0.65 and in patients with severe asthma it was 4.43±0.74. According to Pearson correlation analysis, there was a statistically significant positive correlation between duration of asthma and PAQLQ score (r= 0.42, p<0.01).Conclusion: The severity of the individuals' asthma and their BMI have an impact on their quality of life, thus appropriate steps should be done to reduce their BMI and to treat their asthma. The PAQLQ score and the duration of asthma have a positive statistically significant correlation, which leads to the conclusion that the quality of life of subjects is negatively impacted as the duration of asthma increases. As a result, steps should be taken to treat the disease effectively and promptly.
View
... 1,5 In addition to the extensive benefits of leading an active lifestyle without sustained periods of sedentary behaviors in healthy populations, 6,7 being active elicits further health benefits for those with asthma. Specifically, those with higher levels of physical activity and lower sedentary time, in comparison to their peers, may lead to reduced, and improved management of, symptoms, [8][9][10] as well as improved quality of life 11,12 and lung function. 13 However, paradoxically, symptoms may be triggered by physical exertion, particularly vigorous intensity, 14 which, coupled with the fear of exercise-induced bronchoconstriction (EIB), may impact on the physical activity levels in those with asthma. ...
Physical Activity and Sedentary Time in Children and Adolescents with Asthma: A Systematic Review and Meta‐analysis
Article
Full-text available
  • Feb 2021
  • SCAND J MED SCI SPOR
The influence of asthma on physical activity (PA) in youth remains equivocal. This review synthesises the evidence regarding the influence of asthma on PA and sedentary time and evaluates the role of key moderators for this relationship. In accordance with PRISMA guidelines, six electronic databases and grey literature were searched. Primary studies in English were included if they reported device‐assessed PA in youth with and without asthma. Random effects meta‐analyses examined the effect of asthma on PA and, separately, sedentary time. Mixed‐effect meta‐regression analyses were conducted using age and sex as moderators, with sub‐group comparisons for study quality and asthma diagnosis criteria. Overall, of 3,944 citations retrieved, 2,850 were screened after the removal of supplication and 2,743 citations excluded. Of the 107 full‐text publications reviewed, 16 were included in data extraction and analysis, with 15 and five studies included in the PA and sedentary time meta‐analyses, respectively. The robust effect size estimate for the influence of asthma on PA and sedentary time was ‐0.04 [95%CI=‐0.11,0.03] and ‐0.09 [95%CI=‐0.12,‐0.06], indicating a non‐significant and significant trivial effect, respectively. The effect of asthma on PA levels or sedentary time was not associated with age or sex. Youth with controlled asthma are equally physically (in)active as their healthy peers, with asthma associated with less sedentary time. However, methodological limitations and a paucity of clear methodological reporting temper these conclusions. More rigorous device‐based assessments, with a particular focus on sedentary time, and more robust diagnoses of asthma, especially with regard to severity, are needed.
View
... Typically, treatment success of surgical diaphragmatic duplication is evaluated by objective assessments, such as lung function, chest X-ray or testing of exercise capacity, while the subjective assessment is restricted to pure anamnestic information, which is difficult to include in clinical trials. There are, however, numerous examples in respiratory medicine, where objective changes in diagnostic testing are not well correlated to subjective changes in HRQL, such asthma [21,22], chronic obstructive pulmonary disease [23,24] or home mechanical ventilation as used to treat chronic hypercapnic respiratory failure [25,26]. Based on the necessity of establishing patient-centred outcome parameters, the DPQ is designed as a measuring instrument for conservative therapies as well as to assess different therapeutic successes of surgical interventions. ...
Development of the Diaphragmatic Paralysis Questionnaire: a simple tool for patient relevant outcome
Article
  • Nov 2020
OBJECTIVES Measurement tools of health-related quality of life (HRQL) that are specific for the underlying disorder are inevitably needed to assess HRQL changes following specific treatment strategies. The aim of the current study was to develop a questionnaire assessing HRQL in patients with unilateral diaphragmatic paresis. METHODS Firstly, topics of health impairments covering physical, psychological, social and functional aspects were predefined by a physician expert panel to ensure face validity. Secondly, all predefined topics were rated by a patient group with unilateral diaphragmatic paresis (untreated: n = 11; postoperative: n = 9) using a 5-point Likert scale ranging from ‘not relevant at all’ (−2) to ‘absolutely relevant’ (+2) to guarantee content validity. Thirdly, only relevant topics (0 to +2) were used for item development, while non-relevant items (<0) were not subject for item development. RESULTS In total, 20 patients rated a total of 43 topics covering a broad spectrum of health impairment. 21 were considered as relevant for item development. Items are answered on a 5-point Likert scale ranging from ‘completely untrue’ (−2) to ‘always true’ (+2). The Diaphragmatic Paralysis Questionnaire (DPQ) Summary Score ranges from 0 (worst HRQL) to 100 (best HRQL). Finally, the German DPQ was professionally translated and transculturally adapted into English, Italian, Dutch, French, Greek and Spanish, using translation/back-translation procedures. CONCLUSIONS The DPQ is the first diseases-specific HRQL measure developed for patients with diaphragmatic paresis. In addition, the DPQ is available in 7 languages free of charge for non-profit purposes. Clinical trial registration German clinical trials register: DRKS00017056
View
... Along with the development of civilization and increased environmental pollution, the incidence of allergic diseases, including bronchial asthma has increased. According to WHO, 300 million people suffer from asthma around the world (1). The prevalence of this disease is 10-12% in adults and 15% in children. ...
Evaluation of the Relationship Between Childhood Asthma and Helicobacter pylori Sero-Prevalence
Article
Full-text available
  • Nov 2019
In recent years, the prevalence of asthma and allergic rhinitis has increased in developed countries. Helicobacter pylori (H. pylori) infection can exacerbate asthma. The purpose of this study was to investigate the relationship between asthma and H. pylori seroprevalence in children. In this cross-sectional study, 100 children aged 5-15 years hospitalized in Besat hospital in Sanandaj were investigated from 2015 to 2016. Fifty children with asthma were considered as the case group and 50 non-asthmatic children as the control group. The questionnaires were completed, including demographic information, history of asthma, exposure to cigarette smoke, and family history of gastric and duodenal ulcers. Blood samples were collected from the children, and the serum level of specific antibodies (IgG) of H. pylori was measured. There were 42 and 31 boys in the case and control group, respectively. The mean age in the case group was 8.12±2.29 and in the control group was 8.9±2.52 years. In the case group, 48% were exposed to cigarette smoke and in the control group, 18%. There was a statistically significant difference between the groups in terms of gender and exposure to cigarette smoke (P=0.001 and P=0.013, respectively). There was no significant difference between the case and control groups in terms of H. pylori seroprevalence. (P=0.211). There was no significant association between asthma and H. pylori seroprevalence. (P=0.22). According to our study, there no correlation between childhood asthma and H. pylori seroprevalence. © 2019 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2019;57(5):299-302.
View
... Este deterioro puede deberse a una falta de control del asma, ya que la presencia de síntomas y exacerbaciones frecuentes perjudica que los niñosni˜niños puedan realizar con normalidad actividades como asistir a la escuela, practicar deporte o dormir 4,31 . Además, las creencias erróneas sobre el ejercicio físico en niñosni˜niños con asma pueden hacer que muchos cuidadores sean sobreprotectores y opten por restringir la práctica de una actividad e incluso que los propios menores se abstengan de realizarla 32 . Aunque aquellos niñosni˜niños con un alto nivel de autoeficacia para el tratamiento tienen menos limitaciones, no se han encontrado diferencias significativas con los otros grupos. ...
Impact of Self-Efficacy on the Quality of Life of Children With Asthma and Their Caregivers
Article
  • Mar 2019
Introduction: Health-related quality of life is an important outcome measurement in the monitoring of asthma control. Self-efficacy is a determinant of self-management behaviors that can contribute to the improvement of asthma control and quality of life. Our objective was to analyze the relationship between self-efficacy and quality of life in children with asthma and their caregivers. Methods: We included 176 patients aged 6–14 years with asthma, and determined their level of self-efficacy according to three groups (low, medium and high levels). Each child and their main caregiver completed the PAQLQ and PACQLQ questionnaires, respectively. Results: PAQLQ range=1–7: 5.61±1.11; PACQLQ range=1–7: 5.42±1.35; self-efficacy range=0–60: low level 28.44±4.58; average level 37.41±1.7, and high level 47.50±5.5. Significant differences were observed in quality of life according to low-medium vs high levels of self-efficacy. Specific related domains: PAQLQ emotions and PAQLQ symptoms with self-efficacy in problem-solving skills related to asthma and treatment self-efficacy; PACQLQ emotions with self-efficacy in problem-solving skills related to asthma. Conclusions: A high level of self-efficacy is associated with a better quality of life for children and their caregivers. Based on these results, the measurement of self-efficacy could be incorporated in the assessment of educational interventions in self-management targeted at the quality of life of the patient and his or her family.
View
Quality of Life in Asthmatic Children in Asia
Article
Full-text available
  • Jun 2022
Objectives: To assess the quality of life (QoL) among Asian children with asthma. Methodology: This was a systematic review based on PRISMA guidelines, searching four engines; PubMed, Embase, Scopus, and Medline. Those studies were selected that evaluated the QoL using the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) using both the overall score and scores on the individual physical, emotional, and symptoms domains. Results: We screened 80 articles and out of those only 3 were selected for the systematic review, collectively including 282 participants. A review was carried out and showed that the overall QoL score was 5.43 with a standard deviation of 1.2. Conclusion: The total QoL score proved that asthmatic children in Asia have a low quality of life.
View
The social and economic consequences of childhood asthma across the lifecourse: A systematic review
Article
Full-text available
  • Dec 2004
Asthma prevalence rates are high, and may be increasing in the Western world, particularly among children. The aim of this study was to evaluate the longer-term social and economic consequences of having asthma as a child and to determine whether adverse consequences are more severe for poorer children. Results from published and unpublished, quantitative and qualitative studies were synthesized narratively to examine the impact of childhood-onset asthma on school attendance, academic achievement and employment in adulthood. The question of whether the impact differed for different social groups was also examined. Twenty-nine good quality studies were identified, including in total 12 183 children with asthma or wheeze. Compared with asymptomatic children, those with asthma missed more days of school (additional absence as a result of asthma ranged from 2.1 to 14.8 days). Studies of academic achievement found that children with asthma performed as well as their healthy peers. The existing evidence on labour market performance is sparse, but there is an indication that people with asthma during childhood experience disadvantage in later employment. In an examination of consequences by social position, children with asthma from deprived areas were more likely to miss school than their more affluent peers, and minority ethnic children were also more likely to have poor school attendance. The only qualitative study suggested that children with asthma strove to participate fully in every aspect of their daily lives. Although asthma limits children's daily activities and affects their social activities, this research synthesis found little evidence of major, adverse long-term social and economic consequences in studies reviewed. Further longitudinal research using comparison groups is needed to fill key gaps in the existing evidence base.
View
Enhancing subjective well‐being in individuals with asthma
Article
  • Jan 2004
  • PSYCHOL SCHOOLS
Asthma, a chronic respiratory disease, is caused by a complex interaction between genetic and environmental variables. The intent of this article is to propose a theory that provides an explanation for the reduction of emotionally triggered asthma through treatments derived from positive psychology. The basic tenet of the theory is that physical health issues, such as asthma, can be promoted through systematic interventions that are designed to enhance the individual's sense of independence, intimacies or friendships, and/or feelings of competence. This theoretical approach is based largely on Bertrand Russell's definition of happiness and is consistent with positive psychology in that it focuses on variables that promote subjective well-being, or a satisfying daily life. © 2004 Wiley Periodicals, Inc. Psychol Schs 41: 95–100, 2004.
View
Written Emotional Expression as an Intervention for Asthma
Article
  • Mar 2003
  • PSYCHOL SCHOOLS
This investigation employed a multiple baseline design across five participants to examine written emotional expression as an intervention to improve lung function in high school-aged students, college students, and adults with asthma. The predicted forced expiratory volume in 1 second (FEV1 measure of large airway functioning) and forced expiratory flow (FEF25–75 measure of small airway functioning) were evaluated using spirometry. In addition, anxiety was measured using state and trait anxiety self-report scales. Generally, results were effective. Individuals with asthma are at higher risk for increased hospitalization and death. For the school-aged population, asthma is associated with increased absenteeism, restriction of various class activities such as physical education, and poor relationships with peers. Therefore, adults and children with asthma are in need of services and school psychologists appear uniquely qualified to intervene. More recently, the role of the school psychologist is diversifying with corresponding training (e.g., wellness, consultation, prevention, assessment and treatment of health issues) in the areas of health-related disorders that involve a psychological component. © 2003 Wiley Periodicals, Inc. Psychol Schs 40: 193–207, 2003.
View
View
The International Study of Asthma and Allergies in Childhood (ISAAC)
Article
  • Dec 1998
Despite considerable research, the aetiology of asthma and allergic disease remains poorly understood. The International Study of Asthma and Allergies In Childhood (ISAAC), was founded to maximize the value of epidemiological research into asthma and allergic disease by establishing a standardized methodology and facilitating international collaboration. It has achieved its specific aims which are to describe the prevalence and severity of asthma, rhinitis and eczema in children living in different centres and to make comparisons within and between countries; to obtain baseline measures for assessment of future trends in the prevalence and severity of these diseases; and to provide a framework for further aetiological research into genetic, lifestyle, environmental and medical care factors affecting these diseases. The ISAAC design comprises three phases. Phase One used simple core written questionnaires for two age groups, and was completed in 156 collaborating centres in 56 countries and a total of 721 601 children participated. In the 13–14 years age group 155 centres from 56 countries participated, of which 99 centres completed a video questionnaire. For the 6–7 years age group there were 91 collaborating centres in 38 countries. ISAAC Phase One has demonstrated a large variation in the prevalence of asthma symptoms in children throughout the world including hitherto unstudied populations. It is likely that environmental factors were responsible for major differences between countries. The results provide a framework for studies between populations in contrasting environ‐ments which are likely to yield new clues about the aetiology of asthma. ISAAC Phase Two will investigate possible aetiological factors, particularly those suggested by the findings of Phase One. ISAAC Phase Three will be a repetition of Phase One in the year 2000 to assess trends in prevalence.
View
Pediatric Asthma Quality of Life Questionnaire: Validation in children from Singapore
Article
  • Sep 1999
"Quality of Life" is a multidimensional measure encompassing the physical, emotional and social functioning of the child. The asthma specific questionnaire contains 23 questions (items) in three areas (domains) of activity, symptoms and emotions. The objective of the present study was to validate the Paediatric Asthma Quality of Life Questionnaire "PAQLQ"(copyright 1991 McMaster University). If the questionnaire is valid, a change in the child's asthma will be accompanied by a change in the "Quality of Life" questionnaire score. The questionnaire was administered twice over four weeks and the child's asthma status was assessed concurrently. Two groups were thus identified; Group A = unchanged asthma, Group B = changed asthma. Forty-seven children, aged 7 to 14 years, completed the study. Reliability of the questionnaire shows an intraclass-correlation coefficient of only 0.71. Cross-sectional construct validity was demonstrated by a significant correlation between the whole questionnaire and the clinical asthma score (p<0.001) but not in the separate domains. Longitudinal construct validity was also demonstrated by the significant correlation between change in the total questionnaire score, but not separate domains, with change in the child's asthma score (p<0.05). Responsiveness was shown by a significant difference in the magnitude of the change in the questionnaire score between the two groups (p<0.001), but again not in the separate domains. It was concluded that the questionnaire was validated as a whole but not in as convincing a manner, as has been done by others, and we are therefore in a position to advise caution in its application in our population.
View
Emotions and Stress Increase Respiratory Resistance in Asthma
Article
  • May 2000
Clinical reports suggest that various emotions and types of stress can precipitate asthmatic symptoms, but there is little experimental evidence to substantiate this claim. We studied the impact of different emotional states and stress on respiratory resistance in asthmatic and nonasthmatic individuals. Participants (24 asthmatic and 24 nonasthmatic patients) viewed short film sequences selected to induce anxiety, anger, depression, elation, happiness, contentment, or a neutral affective state and completed two stressful tasks, mental arithmetic to induce active coping efforts and viewing of medical slides to induce passive coping efforts. Oscillatory resistance, heart rate, blood pressure, baroreflex sensitivity, skin conductance level, respiration rate and volume, and self-reported affective state were measured throughout the session. Uniform increases in oscillatory resistance were found in all emotional states compared with the neutral state and during mental arithmetic in both groups. Asthmatic patients showed stronger reactions to the medical slides than healthy control subjects, with significant increases in oscillatory resistance, blood pressure, skin conductance level, and minute volume, as well as higher levels of self-reported depression, arousal, and shortness of breath. Changes in oscillatory resistance were inconsistently correlated with other physiological indices. Various emotional states and stress increase oscillatory resistance largely independently of concurrent increases in autonomic or ventilatory activity. The particular sensitivity of asthmatics to passive coping demand requires additional research.
View
Genomic Characterization of LIGHT Reveals Linkage to an Immune Response Locus on Chromosome 19p13.3 and Distinct Isoforms Generated by Alternate Splicing or Proteolysis
Article
  • Dec 2001
LIGHT is a member of the TNF cytokine superfamily that signals through the lymphotoxin (LT)beta receptor and the herpesvirus entry mediator. LIGHT may function as a costimulatory factor for the activation of lymphoid cells and as a deterrent to infection by herpesvirus, which may provide significant selective pressure shaping the evolution of LIGHT. Here, we define the molecular genetics of the human LIGHT locus, revealing its close linkage to the TNF superfamily members CD27 ligand and 4-1BB ligand, and the third complement protein (C3), which positions LIGHT within the MHC paralog on chromosome 19p13.3. An alternately spliced isoform of LIGHT mRNA that encodes a transmembrane-deleted form is detected in activated T cells and gives rise to a nonglycosylated protein that resides in the cytosol. Furthermore, membrane LIGHT is shed from the cell surface of human 293 T cells. These studies reveal new mechanisms involved in regulating the physical forms and cellular compartmentalization of LIGHT that may contribute to the regulation and biological function of this cytokine.
View
Psychological aspects of asthma
Article
  • Jul 2002
Asthma can be affected by stress, anxiety, sadness, and suggestion, as well as by environmental irritants or allergens, exercise, and infection. It also is associated with an elevated prevalence of anxiety and depressive disorders. Asthma and these psychological states and traits may mutually potentiate each other through direct psychophysiological mediation, nonadherence to medical regimen, exposure to asthma triggers, and inaccuracy of asthma symptom perception. Defensiveness is associated with inaccurate perception of airway resistance and stress-related bronchoconstriction. Asthma education programs that teach about the nature of the disease, medications, and trigger avoidance tend to reduce asthma morbidity. Other promising psychological interventions as adjuncts to medical treatment include training in symptom perception, stress management, hypnosis, yoga, and several biofeedback procedures.
View
Aggarwal, B.B. Signalling pathways of the TNF superfamily: a double-edged sword. Nat. Rev. Immunol. 3, 745-756
Article
  • Oct 2003
  • NAT REV IMMUNOL
Two different tumour-necrosis factors (TNFs), first isolated in 1984, were found to be cytotoxic to tumour cells and to induce tumour regression in mice. Research during the past two decades has shown the existence of a superfamily of TNF proteins consisting of 19 members that signal through 29 receptors. These ligands, while regulating normal functions such as immune responses, haematopoiesis and morphogenesis, have also been implicated in tumorigenesis, transplant rejection, septic shock, viral replication, bone resorption, rheumatoid arthritis and diabetes; so indicating their role as 'double-edged swords'. These cytokines either induce cellular proliferation, survival, differentiation or apoptosis. Blockers of TNF have been approved for human use in treating TNF-linked autoimmune diseases in the United States and other countries.
View