Qualidade de vida em adolescentes asmáticos e seus determinantes clínicos e sociais

Abstract

Asthma is a public health problem that affects people in all parts of the world. With variable prevalence, in Brazil the disease has one of its highest rates. It affects children and adolescents, constituting one of the major chronic diseases in this period of life. The limitations imposed by the symptoms of the disease on physical activities affect the quality of life of its sufferers. The aim of this study was to evaluate the quality of life for adolescents with asthma, and to describe the health and treatment conditions of these patients, identifying those that would be its clinical and social determinants. For this we conducted a cross-sectional, observational and epidemiological study on an outpatient basis of patients between 12 and 18 years old. The sample was composed of 114 adolescents with doctor-diagnosed asthma treated between August 2011 and August 2012 at the Pulmonology outpatient clinic of the Department for Child and Adolescent Health of the Health Department of the City of Juiz de Fora. The instrument selected for assessing the quality of life was the Paediatric Asthma Quality of Life Questionnaire (PAQLQ), while we also assessed clinical variables, such as the severity and level of control of asthma, employing criteria of the Global Initiative for Asthma (GINA) and the National Asthma Education and Prevention Program (NAEPP), and socio-demographic variables. The data were processed in a database created using the Statistical Package for Social Sciences (SPSS) version 15.0. After the Kolmogorov-Smirnov normality test, the average values for quality of life were compared through the ANOVA test with a level of significance of 5%. When comparing the averages for PAQLQ, both overall and per domain, according to potentially explanatory variables, significantly lower averages in each of the PAQLQ domains, and in the overall score, were identified in individuals with inadequate level of asthma control. The same occurred in those patients classified as having more severe forms of the disease and obese. We also observed higher averages in the PAQLQ’s emotional domain for adolescents whose caregiver had more education and higher averages for all quality of life domains for adolescents with pets. The negative impact on quality of life is directly related to the inadequate control of asthma, which is indicated by the subjective components that compose the classification of disease control. These data reveal the need for assessing the quality of life and level of disease control in the monitoring of asthmatic adolescents, as well as the need for improvement and creation of public policies and actions targeting the education, treatment adherence and appropriate monitoring of this population, enabling these adolescents to acquire the necessary skills for self-care and safe management of asthma in their transition to adult life.