The constructs of asthma quality of life: Psychometric, experimental and correlational evidence

Author(s): Bellesis, M., Thompson, P. J., Kenyon, C. A. P.

Journal/Book: Psychol Health. 1996; 12: C/O Stbs Ltd, PO Box 90, Reading, Berks, England RG1 8JL. Harwood Acad Publ GmbH. 101-121.

Abstract: Health-related quality of life (QOL) questionnaires are designed to be content valid and cover several domains of life experience. We examined the QOL constructs of asthma by factor analysing responses of 810 asthmatics to the Living with Asthma Questionnaire. Oblique rotation showed two cognitive factors (activities and avoidance) and two emotional factors (distress and preoccupation), and these factors were highly correlated due to a general factor of disease severity. The factors, i.e., the asthma constructs, did not coincide with the content valid domains of the questionnaire. In a second study on a further 118 mild to moderate asthmatics whose asthma was poorly controlled, the physiology of asthma was manipulated experimentally with the new asthma medicine, salmeterol, and quality of life and lung function measured. Lung function and change in lung function correlated more highly with cognitive than emotional constructs. Under double blind conditions salmeterol compared with salbutamol improved quality of life significantly on the constructs of activities, avoidance and preoccupation but not distress; there were improvements on all constructs after a period of open label treatment. The differential responsiveness to change of the QOL constructs may be due to their different relationships with lung function, and these data provide evidence for a multi-construct approach to QOL change.

Note: Article Hyland ME, Univ Plymouth, Dept Psychol, Plymouth PL4 8AA, Devon, ENGLAND

Keyword(s): asthma; constructs; quality of life; change; SICKNESS IMPACT PROFILE; AIR-FLOW LIMITATION; HEALTH SURVEY SF-36; OF-LIFE; QUESTIONNAIRE; SALMETEROL; SCALE; MEDICATION; VALIDITY; DOMAINS

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