An English and Spanish pediatric asthma symptom scale

BACKGROUND. Pediatric asthma survey measures have not been adequately teste d in non-English-speaking populations. OBJECTIVES. To test the reliability and validity of an English and Spanish symptom scale to measure asthma control in children. SUBJECTS. Parents (54% Spanish-speaking; 61% not high school graduates) of 234 children seen in the emergency department for an asthma exacerbation. MEASURES. Parent report of frequency and perceived severity of child asthma symptoms during the beginning and after resolution of the exacerbation. RESULTS. An 8-item scale composed of reports of cough, wheezing, shortness of breath, asthma attacks, chest pain, night symptoms, and overall perceive d severity had very good psychometric properties in both English and Spanis h. The reliability (Cronbach's alpha) of the scale ranged from 0.81 to 0.87 for both languages and time frames. In both languages, the validity of the scale was supported by responsiveness to changes in clinical status (lower symptom score after resolution of the exacerbation, P < 0.001) and by mode rate to strong correlations (P < 0.001) with other asthma morbidity measure s (parent report of child bother: r = 0.59-0.65; school days lost: r = 0.38 -0.67; and activity days lost: p = 0.41-0.59). There were no statistically significant differences in the reliability or construct validity of the sum mary symptom scale by language, although Spanish speakers reported a lower frequency of some symptoms than did English speakers. CONCLUSIONS. A reliable and valid 8-item scale can be used to measure contr ol of asthma symptoms in Spanish-speaking populations of low literacy. Addi tional research to evaluate language equivalency of asthma measures is nece ssary.