Avaliação dos níveis de conhecimento, alfabetismo em saúde e carga da doença em crianças e adolescentes com asma

Abstract

Introduction: Currently, asthma is still a poorly understood disease that causes great impact on the lives of patients and relatives. In asthmatic children, parents and caregivers are responsible for the management of the disease and it is essential that they have adequate levels of health literacy and knowledge in asthma. Our group believes that knowledge of asthma and health literacy of caregivers of children with the diagnosis of the disease is still low in the southern region of Brazil, and this study corroborates a better understanding of this panorama. Objective: To evaluate the level of knowledge in asthma and health literacy of caregivers of children and adolescents diagnosed with the disease, together with asthma control, quality of life and adherence to treatment. Methods: This is a cross-sectional, descriptive and analytical study conducted in two referral centers in pediatric pulmonology in southern Brazil, between November 2015 and April 2018, where parents and caregivers of children and adolescents with medical diagnosis of asthma. We included parents and caregivers with a minimum age of 18 years, who were regularly with the patient, that is, living with the child/adolescent or caring for periods exceeding 3 days (72 hours) per week, as well as those who kept me direct contact between Child, disease and treatment, defined as: Knowing the prescribed medical treatment, applying the medication and having received basic guidance on the disease. Children and adolescents should be between 1 and 17 years old and be in outpatient follow-up. Caregivers who had cognitive problems were excluded, as well as those patients with cognitive, motor or other chronic diseases (except rhinitis and atopic dermatitis). The main questionnaires applied to caregivers were: a) socio-demographic and economic classification (CCEB); b) Short Assessment of Health Literacy for Portuguese-Speaking Adults (SAHLPA-18), to evaluate the health literacy; c) Questionário de Conhecimento em Asma Pediátrica (Q-CAP); d) Pediatric Asthma Parent Quality of Life Questionnaire (PACQLQ); and e) Global Initiative for Asthma (GINA), to assess asthma control. In the patients, the questionnaires were applied Morisky Medication Adherence Scales (MMAS‐8) and the Pediatric Asthma Quality of Life Questionnair (PAQLQ). For statistical purposes, Student t test, Person Chi-square test and Binary Logistic Regression test were used. The significance was 5% (p < 0.05). Results: A total of 125 parents/caregivers were included in the study, with a mean age of 35.7 ± 9.2 years, 65 (52%) With full high school, 100 (80%) belonging to economic class C, and mothers were majority during consultations (n = 101; 80.8%). In relation to the patients, 125 children and adolescents were included, 64 (51.2%) males and mean age of 6,68 ± 3,98, of these, 91 (72.8%) were not with the disease fully controlled. Regarding adherence to treatment, a sub-sample was analyzed with 59 (47.2%) patients who answered the MMAS-8 questionnaire, and none of them (n = 0; 0%) showed high adherence to treatment. Still, almost all (n = 54; 91, 5%) had low adherence. Only 51 (40.8%) of parents and caregivers had adequate levels of health literacy (SAHLPA-18). In addition, 117 (94.4%) parents presented inadequate levels of specific knowledge in asthma (Q-CAP). Quality of life was also affected by low asthma control, especially in the areas of activity limitation and emotional function. Conclusion: However, it can be observed that the population analyzed presented levels of in health literacy and knowledge in unsatisfactory asthma. Also, the levels of disease control and adherence to treatment were low and may be associated with quality of life levels. It is hoped that the health education levels of caregivers of children with asthma are adequate for the management of the disease to be effective.