Tehran University Medical Journal
مجله دانشکده پزشکی، دانشگاه علوم پزشکی تهران
Tehran Univ Med J
Medical Sciences
http://tumj.tums.ac.ir
1
admin
1683-1764
1735-7322
10.18869/acadpub.tumj
000
000
000
fa
jalali
1402
7
1
gregorian
2023
10
1
81
7
online
1
fulltext
other
دو روش آزمون کنترل آسم برای کودکان (ACT-CHILD) و پرسشنامه کنترل آسم (ACQ) در کودکان مبتلا به بیماری آسم مراجعهکننده به درمانگاه بیمارستان طالقانی گرگان
Two asthma control test for children and asthma control questionnaire in pediatric asthma patients referred to taleghani hospial clinics, Gorgan
مقاله اصیل
Original Article
<span style="font-family:yekanYW;"><span style="font-size:12pt"><span style="line-height:102%"><span style="direction:rtl"><span style="unicode-bidi:embed"><b><i><span lang="FA" style="font-size:10.0pt"><span style="line-height:102%">زمینه و هدف: </span></span></i></b><span lang="FA" style="font-size:10.0pt"><span style="line-height:102%">آسم یک بیماری التهابی مزمن مجاری هوایی است. تستهای گوناگون و پرسشنامههای مختلفی برای پایش شدت بیماری آسم طراحی شده است. این مطالعه با هدف مقایسه بین دو پرسشنامه کنترل آسم به نامهای </span></span><span dir="LTR" style="font-size:8.0pt"><span style="line-height:102%">ACQ</span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:102%"> و </span></span><span dir="LTR" style="font-size:8.0pt"><span style="line-height:102%">ACT-CHILD</span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:102%"> در کودکان مبتلا به آسم انجام شد.</span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:102%"><span style="direction:rtl"><span style="unicode-bidi:embed"><b><i><span lang="FA" style="font-size:10.0pt"><span style="line-height:102%">روش بررسی:</span></span></i></b> <span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:102%">این مطالعه مقطعی-توصیفی روی 92 کودک مبتلا به آسم مراجعهکننده به مرکز آموزشیدرمانی طالقانی گرگان در سال 1402-1401 انجام شد. میزان کنترل آسم بیماران به دو روش آزمون </span></span><span dir="LTR" style="font-size:8.0pt"><span style="line-height:102%">ACT-CHILD</span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:102%"> و پرسشنامه </span></span><span dir="LTR" style="font-size:8.0pt"><span style="line-height:102%">ACQ</span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:102%"> سنجیده و مقایسه شد.</span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:102%"><span style="direction:rtl"><span style="unicode-bidi:embed"><b><i><span lang="FA" style="font-size:10.0pt"><span style="line-height:102%">یافتهها:</span></span></i></b><span lang="FA" style="font-size:10.0pt"><span style="line-height:102%"> 84 کودک 11-4 سال و هشت کودک 16-12 سال به مطالعه وارد شدند. براساس پرسشنامه </span></span><span dir="LTR" style="font-size:8.0pt"><span style="line-height:102%">ACT-CHILD</span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:102%"> در (2/40%)37 نفر کودکان آسم کنترلشده، (46/44%)44 نفر آسم نسبتا کنترلشده و (20/15%)14 نفر آسم کنترلنشده بود. براساس پرسشنامه </span></span><span dir="LTR" style="font-size:8.0pt"><span style="line-height:102%">ACQ</span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:102%"> آسم کنترلشده در (5/18%)17 نفر، آسم نسبتا کنترلشده در (8/35%)33 نفر و آسم کنترلنشده در (7/45%)42 نفر از کودکان مشاهده شد. نتایج کنترل آسم براساس دو پرسشنامه اختلاف معناداری با یکدیگر داشتند (001/0</span></span><span dir="LTR" style="font-size:8.0pt"><span style="line-height:102%">P<</span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:102%">). توافق میان دو روش </span></span><span dir="LTR" style="font-size:8.0pt"><span style="line-height:102%">ACT-CHILD</span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:102%"> و </span></span><span dir="LTR" style="font-size:8.0pt"><span style="line-height:102%">ACQ</span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:102%"> در ارزیابی آسم کودکان در سطح ضعیفی بود (014/0</span></span><span dir="LTR" style="font-size:8.0pt"><span style="line-height:102%">P=</span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:102%">، 157/0</span></span><span dir="LTR" style="font-size:6.0pt"><span style="line-height:102%">=</span></span><span lang="FA" style="font-size:8.0pt"><span style="line-height:102%">κ</span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:102%">).</span></span> <span lang="FA" style="font-size:10.0pt"><span style="line-height:102%">با اینحال بین امتیازات دو پرسشنامه </span></span><span dir="LTR" style="font-size:8.0pt"><span style="line-height:102%">ACT-CHILD</span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:102%"> و </span></span><span dir="LTR" style="font-size:8.0pt"><span style="line-height:102%">ACQ</span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:102%"> همبستگی منفی و معناداری مشاهده شد (001/0</span></span><span dir="LTR" style="font-size:8.0pt"><span style="line-height:102%">P<</span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:102%">، 588/0</span></span><span dir="LTR" style="font-size:8.0pt"><span style="line-height:102%">r=</span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:102%">) که پس از تفکیک برمبنای رده سنی این همبستگی تنها در کودکان 11-4 سال تایید شد (001/0</span></span><span lang="FA" style="font-size:8.0pt"><span style="line-height:102%">></span></span><span dir="LTR" style="font-size:8.0pt"><span style="line-height:102%">P</span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:102%">، 627/0</span></span><span dir="LTR" style="font-size:8.0pt"><span style="line-height:102%">r=</span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:102%">).</span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:102%"><span style="font-family:"B Lotus""></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:102%"><span style="direction:rtl"><span style="unicode-bidi:embed"><b><i><span lang="FA" style="font-size:10.0pt"><span style="line-height:102%">نتیجهگیری:</span></span></i></b><span lang="FA" style="font-size:10.0pt"><span style="line-height:102%"> یافتههای ما نشان دادند که توافق ضعیفی میان یافتههای دو ابزار </span></span><span dir="LTR" style="font-size:8.0pt"><span style="line-height:102%">ACT-CHILD</span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:102%"> و </span></span><span dir="LTR" style="font-size:8.0pt"><span style="line-height:102%">ACQ</span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:102%"> در ارزیابی کنترل آسم وجود دارد. مطالعات بیشتر توصیه میشود.</span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:102%"><span style="font-family:"B Lotus""></span></span></span></span></span></span></span></span><br>
<div><span style="font-size:12pt"><span style="line-height:130%"><span new="" roman="" style="font-family:" times=""><b><i><span style="font-size:10.0pt"><span style="line-height:130%">Background:</span></span></i></b><span style="font-size:10.0pt"><span style="line-height:130%"> Asthma is a chronic inflammatory disease of the airways. Various tests and questionnaires are designed to monitor the severity of asthma and help the therapist and the health system prescribe the best treatment to control it. This study was designed to compare two methods Asthma Control Questionnaires (ACQ) and Asthma Control test-child (ACT-CHILD) in children with asthma.</span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:130%"><span new="" roman="" style="font-family:" times=""><b><i><span style="font-size:10.0pt"><span style="line-height:130%">Methods:</span></span></i></b><span style="font-size:10.0pt"><span style="line-height:130%"> This descriptive cross-sectional study was conducted on 92 children with asthma referred to the Taleghani hospital, Gorgan, in 2022-2023. Patients were in a range of age 4-16 years. Asthma control was evaluated and compared by two methods ACT-CHILD and ACQ. ACT-CHILD included one version for 4-11-year patients completed by their parents and another one for 12-16 –year patients completed by the patients. The clinical symptoms, age, gender and the parents' records related to asthma were completed during the clinical interview. Data was analyzed using Chi-square and Spearman correlation tests. The degree of agreement between two questionnaires was determined using the Kappa coefficient.</span></span></span></span></span></div>
<div>
<table align="center" hspace="0" vspace="0">
<tbody>
<tr>
<td align="left" style="padding-top:0in; padding-right:12px; padding-bottom:0in; padding-left:12px" valign="top">
<div><span style="font-size:12pt"><span style="line-height:130%"><span new="" roman="" style="font-family:" times=""><b><i><span style="font-size:10.0pt"><span style="line-height:130%">Results:</span></span></i></b><span style="font-size:10.0pt"><span style="line-height:130%"> 84 children aged 4-11 years (91.3%) and 8 children aged 12-16 years (8.7%) were included in the study. According to the ACT-CHILD, 40.2% of children (n=37) had controlled asthma, 44.6% (n=41) had partially controlled asthma, and 15.2% (n=14) had uncontrolled asthma. Based on the ACQ, controlled asthma was observed in 18.5% (n=17), partially controlled asthma in 35.8% (n=33), and uncontrolled asthma in 45.7% (n=42) of children. Asthma control results based on two questionnaires were significantly different from each other (P<0.001). The agreement between the ACT-CHILD and ACQ methods in evaluating children's asthma was at a weak level (P=0.014, κ=0.157), however, a significant negative correlation was observed between the scores of the ACT-CHILD and ACQ questionnaires (r=-0.588, P>0.001) which after categorizing based on age group, this correlation was confirmed only in children aged 4-11 years (r=-0.627, P>0.001).</span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:130%"><span new="" roman="" style="font-family:" times=""><b><i><span style="font-size:10.0pt"><span style="line-height:130%">Conclusion:</span></span></i></b><span style="font-size:10.0pt"><span style="line-height:130%"> Our findings showed that there is a poor agreement between ACT-CHILD and ACQ results in the assessment of asthma control. Further studies are recommended.</span></span><span dir="RTL" lang="AR-SA" style="line-height:130%"><span style="font-family:"B Lotus""></span></span></span></span></span></div>
</td>
</tr>
</tbody>
</table>
</div>
<div></div>
آسم, پرسشنامه ACT-CHILD, کودکان, بیماری ریوی.
asthma, act child questionnaire, children, pulmonary disease.
529
537
http://tumj.tums.ac.ir/browse.php?a_code=A-10-3666-702&slc_lang=other&sid=1
Mohsen
Ebrahimi
محسن
ابراهیمی