Symptom perception and evaluation in childhood asthma

Background: Inaccuracies in symptom perception may contribute to morbidity and mortality in childhood asthma. Objective: To systematically examine the accuracy of symptom perception on the part of children with asthma and their parents, as well as their interp retation and evaluation of the symptoms. Method: Twenty-eight patient/parent pairs from suburban and underserved urb an pediatric populations participated in a 5-week protocol tracking subject ive assessments of asthma severity (visual analog scales) and peak expirato ry flow rates. Relationships between perceptual accuracy and demographic an d disease factors were investigated. Results: Adolescents were more accurate than school-aged children, more acc urate children had better morbidity outcomes, and African American parents were more accurate than Caucasian parents. Socioeconomic status did not aff ect accuracy. Both children and parents missed early symptoms and waited to o long prior to intervening in an exacerbation. Conclusions: There are multiple opportunities for error in symptom percepti on and evaluation. Identification of the source of error is critical to the effective utilization of education on self-management.