BARRIERS TO ANTI-INFLAMMATORY USE IN CHILDHOOD ASTHMA

儿童哮喘的住院率、发病率和死亡率继续上升，尽管科学进步提高了我们对哮喘的病理生理学的了解，并获得了更有效的治疗方法。吸入糖皮质激素被认为是持续性哮喘的主要药物治疗方法。然而，越来越多的文献记录了患者使用抗炎药的情况。造成这种情况的原因尚不清楚。在设计和测试加强适当抗炎使用的干预措施之前，我们需要更多地了解使用这些干预措施的障碍，并有一个心理测量学工具来衡量这些障碍。这项研究的总体目标是确定在儿童哮喘中适当使用抗炎药物的障碍，并开发一种在研究和卫生保健环境中可能有用的工具，以确定高危人群和情况。具体目标是：1)确定与哮喘儿童使用抗炎药物有关的父母信念和态度的领域；2)开发和测试一份反映影响抗炎药物使用的可靠和有效的信念和态度的问卷。样本将包括109名患有中到重度哮喘儿童的父母，他们目前正在参加两项临床试验，评估症状感知的准确性和症状监测策略。有大量的人口和疾病相关数据可供这类儿童使用。我们将在4个阶段为仪器开发收集数据：1)识别消炎使用障碍的潜在领域：专业角度，2)内容验证：获得父母的观点，3)仪器的预测试和改进，4)试点测试。我们将使用经典的心理测量学技术进行工具开发和测试。

Hospitalization rates, morbidity, and mortality from childhood asthma continue to increase despite scientific advances that have improved our understanding of the pathophysiology of asthma and the availability of more effective therapy for its management. Inhaled corticosteroids are considered to be the mainstay of pharmacological treatment for persistent asthma. However, there is a growing body of literature documenting under utilization of anti-inflammatories by patients. The reasons for this are unclear. Before interventions to enhance appropriate anti-inflammatory use can be designed and tested, we need to know more about the barriers to their use and have a psychometrically sound instrument to measure them. The overall aim of this study is to identify barriers to appropriate anti-inflammatory use in childhood asthma and to develop an instrument that may be useful in both research and health care settings to identify at risk populations and circumstances. The specific aims are: are: 1) to identify the domains of parental beliefs and attitudes related to anti-inflammatory use in their children with asthma; 2) to develop and test a questionnaire that reflects the beliefs and attitudes affecting anti-inflammatory use that is reliable and valid. The sample will consist of 109 parents of children with moderate to severe asthma who are currently enrolled in two clinical trials evaluating symptom perceptual accuracy and symptom monitoring strategies. Extensive demographic and disease related data is available for this population of children. We will collect data for instrument development in 4 phases: 1) Identification of potential domains of barriers to anti-inflammatory use: The professional perspective, 2) Content validation: Gaining the parent perspective, 3) Pre-testing and refinement of the Instrument, 4) Pilot testing. We will use classic psychometric techniques for tool development and testing.