MEASUREMENT OF PSYCHOLOGICAL DISTRESS IN ASTHMA AND ASTHMA MANAGEMENTPROGRAMS

The Asthma Bother Profile assesses one of the components of asthma exp erience: asthma distress. An initial questionnaire was constructed fro m the content of earlier asthma quality of life research and modified by comments of 32 asthmatics in focus groups. Psychometric analysis of responses of 131 asthmatics to the final questionnaire showed that th e 15 'bother items' constitute a unidimensional measure of asthma dist ress with high internal consistency, and the seven 'management items' assess the patient's confidence of asthma knowledge, perception of the quality of care and confidence in managing asthma attacks. Patients w ho had attended a self-management clinic reported more knowledge of as thma, more bother from treatment but not significantly less bother in other contexts. Knowledge about when to call the doctor but not knowle dge about medicine or asthma was correlated with total bother. Self-ma nagement programmes that encourage problem-focused coping strategies m ay not reduce asthma distress unless distress reduction counselling is included within the education programme.