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P0659 RELIABILITY AND VALIDITY OF THE “ASTHMA SYMPTOM UTILITY INDEX” IN TURKISH ASTHMA PATIENTS
S216
Abstracts from 8th Congress of the European Federation of Internal Medicine / European Journal of Internal Medicine 20S (2009), S1–S283
failure, pulmonary embolism and cirrhosis of the liver. In exudative effusions, we must consider, amog othe processes, infection, malignancy, immunologic responses, lymphatic abnormalities and onoinfectious inflammation. Pleural involvement is infrecuent in Waldeström’s macroglobulinemia (WM). We present the case of a patient with WM and pleural involvement. Case report: A 68-year-old woman came to hospital in December, 2008, because of a massive pleural effusion on the left-side chest. Her past medical history revealed hypertension, severe aortic stenosis, and WM, which had been diagnosed 13 years earlier. Five months ago she had been evaluated for pleural effusion, which showed findings that were consistent with an exudative process, and was erroneously put in relation with heart failure and treated with diuretics. At the moment that she was admitted, the woman noticed fever, cough and shortness of breath. On physical examination, the patient was comfortable at rest. The temperature was 38°C. The lungs were cleared except for evidence of the left-sided pleural effusion. There were bilateral axillary lymphadenopathy. The hematocrit was 28%; the white-cells count was 5600 per cubic millimetre (66% neutrophils) and 234,000 platelets and an erythrocyte sedimentation rate of 121. The diagnostic thoracocentesis showed a pH of 7.34, a lactate dehydrogenase level of 272 U per liter, a protein level of 5, and a glucose level of 112 mg per decilitre. Cytological examinations of pleural effusion revealed no malignant cells and cultures were negative. Pleural biopsy was negative for malignancy and it showed lynfocityc infiltration. A CT scan of the thorax confirmed a massive left pleural effusion and large axilar adenopathies, without lung involvement. The total serum protein was 7.5 grams per deciliter, and an homogeneous spike in the gamma range was seen on electrophoresis. a quantitative immunoglobulin assay revealed 3.060 grams per deciliter of IgM. This spike was also seen in pleural effusion sample. The findings were consistent with the presence of pleural involvement of WM, in this moment was initiated treatment with Leukeran. Discussion: WM is a rare lymphoproliferative disorder of insidious onset wich predominantly affects the elderly, specially males. WM is characterized by anemia, elevated erythrocyte sedimentation rate, lymphocytic tumor infiltration of the bone marrow, and a monoclonal IgM gammopathy. Pleuropulmonary affectation is exceptional, between 0 and 3 per cent, although it can constitute the predominant manifestation.
P0659 RELIABILITY AND VALIDITY OF THE “ASTHMA SYMPTOM UTILITY INDEX” IN TURKISH ASTHMA PATIENTS
Hicran Aydın Bekta¸s, Ilkay Kayacan Keser, Arzu Özdemir Akcan. Akdeniz University Antalya School of Health Introduction: Chronic diseases like asthma have a great impact on the everyday life of patients. It is estimated that there are approximately 4 million asthmatic patients in Turkey. Asthma is known to limit individual’s physical, emotional and social functions. Also, if the asthma symptoms are not regularly controlled, the emotional factors increase in patients with asthma. Anxiety is a common psychiatric problem in the chronic inflammatory disorder of the airways. The Asthma Symptom Utility Index (ASUI) is a preference-weighted measure of common asthma-related symptoms. Objectives: The aim of the present study was to test the reliability and validity of the Turkish translation of the Asthma Symptom Utility Index (ASUI) in a sample of 105 Turkish patients with asthma. Materials & methods: The English language version of the ASUI was translated into Turkish following the standard translation methodology. The study was initiated after the researchers first obtained written permission from Revicki Dennis to adapt the ASUI. Permission to conduct this study was received from the authors’ institutional ethical committe, the Director of the Hospital, and from all study participants. The questionnaire was administered to 105 asthma patients who had been receiving medical therapy in Akdeniz University Hospital between September 2007 and December 2008. A personal data form and the ASUI were completed by each participant during faceto-face interviews. The statistical analysis was carried out using Cronbach’s alpha to test the internal consistency of the ASUI scale. Results: The patients averaged 55.68 years of age (SD = 12.29 years, range 18-85), included most patients were female (61.9%), married (77.1%), housewife (47.6%), and had completed primary education (40.0%). Mean duration of the illness for the sample was 9.31 years (SD = 9.38 years). The mean ASUI score for our sample was 0.61±0.25, with a range from 0.04 to 1.0. The mean original ASUI score was 0.71±0.23. The Cronbach’s alpha coefficient of the ASUI has been found to be 0.84 for the asthma patients indicating a satisfactory reliability. Pearson’s product-moment correlation of items ranged from 0.333 to 0.645 for 0.01). The Pearson
Variable Age (years)
Gender Marital status Occupational status
Education
Duration of the illness
Scale Cough Wheeze Shortness of breath Awakening at night Side effects of asthma Total CQOLC
Category
N (%)
<36 36-45 46-55 ≥56 Mean ± SD Range Female Male Married Single, divorced or widowed Housewife Retired Public servant Student Self-employed Farmer Worker Illiterate Primary Secondary High University <12 month 1-3 year 4-6 year 7-9 year 10-12 year ≥13 year Mean ± SD Minimum-Maximum
14 (13.3%) 13 (12.4%) 21 (20.0%) 57 (54.3%) 55.68±12.29 18-85 65 (61.9%) 40 (38.1%) 81 (77.1%) 24 (22.9%) 50 (47.6%) 32 (30.5%) 6 (5.7%) 6 (5.7%) 5 (4.8%) 4 (3.8%) 2 (1.9%) 18 (17.1%) 42 (40.0%) 11 (10.5%) 18 (17.1%) 16 (15.3%) 12 (11.4%) 25 (23.8%) 21 (20.0 %) 7 ( 6.7%) 9 (8.6%) 31 (29.5) 9.31±9.38 1 month - 45 years
Range of scores
Total items
0.75-1.00 0.73-1.00 0.68-1.00 0.73-1.00 0.73-1.00 0.04 - 1.00
2 2 2 2 2 10
Asthma Patients (Turkish ASUI) Mean
SD
α
0.94 0.91 0.87 0.89 0.97 0.61
0.71 0.79 0.10 0.09 0.06 0.25
0.84
Pearson Correlation
Cough
Wheeze
Shortness of breath
Awakening at night
Side effects of asthma
Cough Wheeze Shortness of breath Awakening at night Side effects of asthma
1 0.645** 0.562** 0.496** 0.333**
0.645** 1 0.557** 0.621** 0.382**
0.562** 0.557** 1 0.607** 0.485**
0.496** 0.621** 0.607** 1 0.388**
0.333** 0.382** 0.485** 0.388** 1
Discussion & Conclusion: The Turkish version of the ASUI was firstly translated by us, and tested on a sample of Turkish asthma patients. The Turkish version of the ASUI has shown statistically acceptable levels of reliability and validity. The ASUI scale is simple to administer and nurses by using this equipment in routine appointments will be able to better identify asthma patients at risk for developing asthma related symptoms and worse quality of life. This scale should be further evaluated with a larger sample size, and in different regions in Turkey. Keywords: Asthma, Asthma-Related Symptoms, Asthma Symptom Utility Index, Reliability, Validity.
P0660 DETERMINING THE NEEDS, CAREGIVING BURDEN AND ASSOCIATED FACTORS IN PRIMARY CAREGIVERS OF PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASES (COPD)
Fılız Selen. Ba¸skent University Introduction & objectives: This study was carried out for the purpose of determining the needs, caregiving burden and associated factors in primary caregivers of patients diagnosed with chronic obstructive pulmonary diseases (COPD). Materials & methods: Descriptive and cross-sectional type of this research was conducted at inpatient clinics of Baskent University Ankara Hospital, Ankara University Department of Chest Diseases and Ankara Chest Diseases Ataturk Senatoryum Hospital. The sample consisted of 245 caregivers who are older than 18 years age, not having mental diseases or any problems that may affect their communication, volunteer to participate to the study and can be reached between January 1st and May 31st 2008.
Abstracts from 8th Congress of the European Federation of Internal Medicine / European Journal of Internal Medicine 20S (2009), S1–S283
failure, pulmonary embolism and cirrhosis of the liver. In exudative effusions, we must consider, amog othe processes, infection, malignancy, immunologic responses, lymphatic abnormalities and onoinfectious inflammation. Pleural involvement is infrecuent in Waldeström’s macroglobulinemia (WM). We present the case of a patient with WM and pleural involvement. Case report: A 68-year-old woman came to hospital in December, 2008, because of a massive pleural effusion on the left-side chest. Her past medical history revealed hypertension, severe aortic stenosis, and WM, which had been diagnosed 13 years earlier. Five months ago she had been evaluated for pleural effusion, which showed findings that were consistent with an exudative process, and was erroneously put in relation with heart failure and treated with diuretics. At the moment that she was admitted, the woman noticed fever, cough and shortness of breath. On physical examination, the patient was comfortable at rest. The temperature was 38°C. The lungs were cleared except for evidence of the left-sided pleural effusion. There were bilateral axillary lymphadenopathy. The hematocrit was 28%; the white-cells count was 5600 per cubic millimetre (66% neutrophils) and 234,000 platelets and an erythrocyte sedimentation rate of 121. The diagnostic thoracocentesis showed a pH of 7.34, a lactate dehydrogenase level of 272 U per liter, a protein level of 5, and a glucose level of 112 mg per decilitre. Cytological examinations of pleural effusion revealed no malignant cells and cultures were negative. Pleural biopsy was negative for malignancy and it showed lynfocityc infiltration. A CT scan of the thorax confirmed a massive left pleural effusion and large axilar adenopathies, without lung involvement. The total serum protein was 7.5 grams per deciliter, and an homogeneous spike in the gamma range was seen on electrophoresis. a quantitative immunoglobulin assay revealed 3.060 grams per deciliter of IgM. This spike was also seen in pleural effusion sample. The findings were consistent with the presence of pleural involvement of WM, in this moment was initiated treatment with Leukeran. Discussion: WM is a rare lymphoproliferative disorder of insidious onset wich predominantly affects the elderly, specially males. WM is characterized by anemia, elevated erythrocyte sedimentation rate, lymphocytic tumor infiltration of the bone marrow, and a monoclonal IgM gammopathy. Pleuropulmonary affectation is exceptional, between 0 and 3 per cent, although it can constitute the predominant manifestation.
P0659 RELIABILITY AND VALIDITY OF THE “ASTHMA SYMPTOM UTILITY INDEX” IN TURKISH ASTHMA PATIENTS
Hicran Aydın Bekta¸s, Ilkay Kayacan Keser, Arzu Özdemir Akcan. Akdeniz University Antalya School of Health Introduction: Chronic diseases like asthma have a great impact on the everyday life of patients. It is estimated that there are approximately 4 million asthmatic patients in Turkey. Asthma is known to limit individual’s physical, emotional and social functions. Also, if the asthma symptoms are not regularly controlled, the emotional factors increase in patients with asthma. Anxiety is a common psychiatric problem in the chronic inflammatory disorder of the airways. The Asthma Symptom Utility Index (ASUI) is a preference-weighted measure of common asthma-related symptoms. Objectives: The aim of the present study was to test the reliability and validity of the Turkish translation of the Asthma Symptom Utility Index (ASUI) in a sample of 105 Turkish patients with asthma. Materials & methods: The English language version of the ASUI was translated into Turkish following the standard translation methodology. The study was initiated after the researchers first obtained written permission from Revicki Dennis to adapt the ASUI. Permission to conduct this study was received from the authors’ institutional ethical committe, the Director of the Hospital, and from all study participants. The questionnaire was administered to 105 asthma patients who had been receiving medical therapy in Akdeniz University Hospital between September 2007 and December 2008. A personal data form and the ASUI were completed by each participant during faceto-face interviews. The statistical analysis was carried out using Cronbach’s alpha to test the internal consistency of the ASUI scale. Results: The patients averaged 55.68 years of age (SD = 12.29 years, range 18-85), included most patients were female (61.9%), married (77.1%), housewife (47.6%), and had completed primary education (40.0%). Mean duration of the illness for the sample was 9.31 years (SD = 9.38 years). The mean ASUI score for our sample was 0.61±0.25, with a range from 0.04 to 1.0. The mean original ASUI score was 0.71±0.23. The Cronbach’s alpha coefficient of the ASUI has been found to be 0.84 for the asthma patients indicating a satisfactory reliability. Pearson’s product-moment correlation of items ranged from 0.333 to 0.645 for 0.01). The Pearson
Variable Age (years)
Gender Marital status Occupational status
Education
Duration of the illness
Scale Cough Wheeze Shortness of breath Awakening at night Side effects of asthma Total CQOLC
Category
N (%)
<36 36-45 46-55 ≥56 Mean ± SD Range Female Male Married Single, divorced or widowed Housewife Retired Public servant Student Self-employed Farmer Worker Illiterate Primary Secondary High University <12 month 1-3 year 4-6 year 7-9 year 10-12 year ≥13 year Mean ± SD Minimum-Maximum
14 (13.3%) 13 (12.4%) 21 (20.0%) 57 (54.3%) 55.68±12.29 18-85 65 (61.9%) 40 (38.1%) 81 (77.1%) 24 (22.9%) 50 (47.6%) 32 (30.5%) 6 (5.7%) 6 (5.7%) 5 (4.8%) 4 (3.8%) 2 (1.9%) 18 (17.1%) 42 (40.0%) 11 (10.5%) 18 (17.1%) 16 (15.3%) 12 (11.4%) 25 (23.8%) 21 (20.0 %) 7 ( 6.7%) 9 (8.6%) 31 (29.5) 9.31±9.38 1 month - 45 years
Range of scores
Total items
0.75-1.00 0.73-1.00 0.68-1.00 0.73-1.00 0.73-1.00 0.04 - 1.00
2 2 2 2 2 10
Asthma Patients (Turkish ASUI) Mean
SD
α
0.94 0.91 0.87 0.89 0.97 0.61
0.71 0.79 0.10 0.09 0.06 0.25
0.84
Pearson Correlation
Cough
Wheeze
Shortness of breath
Awakening at night
Side effects of asthma
Cough Wheeze Shortness of breath Awakening at night Side effects of asthma
1 0.645** 0.562** 0.496** 0.333**
0.645** 1 0.557** 0.621** 0.382**
0.562** 0.557** 1 0.607** 0.485**
0.496** 0.621** 0.607** 1 0.388**
0.333** 0.382** 0.485** 0.388** 1
Discussion & Conclusion: The Turkish version of the ASUI was firstly translated by us, and tested on a sample of Turkish asthma patients. The Turkish version of the ASUI has shown statistically acceptable levels of reliability and validity. The ASUI scale is simple to administer and nurses by using this equipment in routine appointments will be able to better identify asthma patients at risk for developing asthma related symptoms and worse quality of life. This scale should be further evaluated with a larger sample size, and in different regions in Turkey. Keywords: Asthma, Asthma-Related Symptoms, Asthma Symptom Utility Index, Reliability, Validity.
P0660 DETERMINING THE NEEDS, CAREGIVING BURDEN AND ASSOCIATED FACTORS IN PRIMARY CAREGIVERS OF PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASES (COPD)
Fılız Selen. Ba¸skent University Introduction & objectives: This study was carried out for the purpose of determining the needs, caregiving burden and associated factors in primary caregivers of patients diagnosed with chronic obstructive pulmonary diseases (COPD). Materials & methods: Descriptive and cross-sectional type of this research was conducted at inpatient clinics of Baskent University Ankara Hospital, Ankara University Department of Chest Diseases and Ankara Chest Diseases Ataturk Senatoryum Hospital. The sample consisted of 245 caregivers who are older than 18 years age, not having mental diseases or any problems that may affect their communication, volunteer to participate to the study and can be reached between January 1st and May 31st 2008.