Repercusiones del deseo y la búsqueda activa de información sobre la toma de decisiones en pacientes asmáticos.

Abstract

Asthma management guidelines emphasive increased autonomy for asthmatics throught patient education and patient-iniated action plans. OBJECTIVE: The main aim of this study was to design a new instrument for determing the asthamtics desires for information (DI) as well as his or her active search for it (SI) and ability to make decisions (DM) about his or her disease. METHODOLOGY: A questionnaire titled Information and Decisions in Asthma (IDEA) that containing 31 items in three subscales: DI, SI and DM was answered by 80 asthmatics adults of both sexes in stable condition and with varying levels of severity of disease. After interviews to take down medical histories (age of onset, years of evolution, visits to the emergency room within the past year), educational level and economic status, all patients completed a battery of test assessing the following: quality of life (QL), alexithymia (TAS-20), health opinions (HOS), state-trait anxiety (STAI-E/R), asthma symptoms control (ASC), health locus control (HLC), somatosensory amplification (SAS) and personality (BFQ). RESULTS: Cronbach a coefficients were satisfactory for DI and SI (0.86 and 0.77, respectively) and did not improve with the elimination of any items. Factorial analysis overall for DI and AS detected two correlated factors (r=0.34, p<0,01). The DM subscale contained problems of internal consistency which were solved by removing five items. Factorial analysis for DM then revealed a tri-factorial structure in which each factor adjusted well to each of the scenarios. Although most patients expressed interest in obtaining information, their level of active seeking and decision making were much lower. DI and SI were associated with higher educational levels and economic status, whereas DM correlated with the presence of atopy, age (young patients), sex (women) and few visits to the emergency room. CONCLUSIONS: The global analysis of the results indicate that the IDEA shows very acceptable internal consistency and validity, suggesting that it could be used to assess the aspects it is intented to meassure.