Thema : Therapie(on)trouw in de kinderartsenpraktijk

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Accuracy of symptom perception in asthma and illness severity

he inaccurate perception of airway obstruction is a risk factor in fatal asthma and a common problem in asthma management. Perceptual inaccuracy often has been attributed to airway pathophysiology. Accuracy is defined in terms of airway obstruction, reflected in lung function. The accuracy of symptom perception was investigated in this study during induced airway obstruction. In Exp 1, 30 children and adolescents with asthma underwent a histamine provocation test. In Exp 2, 64 children and adolescents with asthma and 30 without asthma performed a physical exercise task. Ages ranged from 7-18 yrs. Lung function and self-reported dyspnea were measured in parallel. The results showed that dyspnea reporting was independent of lung function, asthma severity, and airway hyperresponsiveness. Ss with asthma but without airway obstruction reported significantly more dyspnea than controls. It was suggested that dyspnea is a highly subjective experience with its magnitude determine!d by psychological and situational factors rather than airway pathophysiology

The influence of respiratory sounds on breathlessness in children with asthma: A symptom-perception approach

The discordance between the objective and subjective symptoms of asthma has major effects on proper medication and management. In 2 studies the influence of respiratory sounds in the process of symptom perception underlying breathlessness was investigated in children aged 7-17 years. In Experiment 1, asthmatic wheezing sounds were recorded in 16 children during histamine-induced airway obstruction. Breathlessness correlated significantly with rank order of amount of wheezing, but not with lung function. In Experiment 2, after standardized physical exercise, 45 asthmatic and 45 nonasthmatic children were randomly assigned to (a) false feedback of wheezing, (b) quiet respiratory sounds, or (c) no sound. Asthmatic children reported significantly more breathlessness in the 1st versus the 3rd condition. In conclusion, many asthmatic children were easily influenced by wheezing in their estimation of asthma severity, reflected in breathlessness

The influence of respiratory sounds on breath- lesness in children with asthma: a symptom perception approach

The discordance between the objective and subjective symptoms of asthma has major effects on proper medication and management. In 2 studies the influence of respiratory sounds in the process of symptom perception underlying breathlessness was investigated in children aged 7-17 years. In Experiment 1, asthmatic wheezing sounds were recorded in 16 children during histamine-induced airway obstruction. Breathlessness correlated significantly with rank order of amount of wheezing, but not with lung function. In Experiment 2, after standardized physical exercise, 45 asthmatic and 45 nonasthmatic children were randomly assigned to (a) false feedback of wheezing, (b) quiet respiratory sounds, or (c) no sound. Asthmatic children reported significantly more breathlessness in the 1st versus the 3rd condition. In conclusion, many asthmatic children were easily influenced by wheezing in their estimation of asthma severity, reflected in breathlessness