Asthma in the context of global alliance against respiratory diseases (GARD) in Turkey

Asthma self-efficacy scale for teachers: psychometric properties of the Turkish version

OBJECTIVE

Asthma is common among Turkish schoolchildren, and teachers thus have considerable responsibility for asthma management in schools. However, there is no valid and reliable instrument to evaluate teachers' asthma management self-efficacy in schools. The purpose of this study was to investigate the cross-cultural adaptation and psychometric properties of the Turkish version of the Asthma Self-Efficacy Scale (ASE-T) among elementary school teachers.

METHODS

This methodological study included 216 elementary school teachers. The reliability of the ASE-T was expressed using Cronbach's alpha coefficient and item-total score correlations. The validity of the scale was examined via confirmatory factor analysis, item analysis, and the content validity index.

RESULTS

The Cronbach's alpha coefficient of the scale was 0.70, and the item-total score correlations ranged between 0.24 and 0.57. The results of the confirmatory factor analysis determined the model fit indices to be χ2/df = 1.461, RMSEA = 0.046, GFI = 0.94, AGFI = 0.91, NNFI = 0.98, and CFI = 0.92. The item analysis results revealed the differences between teachers with low and high levels of self-efficacy.

CONCLUSION

The results indicated the usefulness of the ASE-T for Turkish teachers. It is essential to determine teachers' competence in asthma management in order to improve their performance in school settings.

Overprescription of short-acting β2-agonists is associated with poor asthma symptom control: results from five Middle Eastern countries included in the SABINA International (III) study

BACKGROUND

Although short-acting β₂-agonist (SABA) overuse is associated with poor treatment outcomes, data on SABA use in the Middle East are lacking.

RESEARCH DESIGN AND METHODS

In this cross-sectional study in patients (aged ≥12 years) with asthma, data on disease characteristics and asthma treatments were collected from the Middle Eastern cohort of the SABA use IN Asthma (SABINA) III study. Patients were classified by investigator-defined asthma severity and practice type. Multivariable regression models analyzed the association between SABA prescriptions and clinical outcomes.

RESULTS

Of 1389 patients (mean age, 46.7 years; female, 69.5%), 85.7% had moderate-to-severe asthma and 88.7% were treated by specialists. Overall, 51.3% of patients experienced ≥1 severe asthma exacerbation in the previous 12 months, with 58.2% having partly controlled or uncontrolled asthma. Notably, 47.1% of patients were prescribed ≥3 SABA canisters (considered overprescription). SABA canisters were purchased over the counter by 15.3% of patients. Higher SABA prescriptions (vs 1-2 canisters), except 3-5 canisters, were associated with increased odds of uncontrolled asthma (p<0.05).

CONCLUSIONS

SABA overprescription occurred in almost half of all patients in the Middle East, underscoring the need for healthcare providers and policymakers to adhere to the latest evidence-based recommendations to address this public health concern.

Short-acting β2-agonist prescription patterns in patients with asthma in Turkey: results from SABINA III

Background

Over-reliance on short-acting β₂-agonists (SABAs) is associated with poor asthma outcomes. However, the extent of SABA use in Turkey is unclear owing to a lack of comprehensive healthcare databases. Here, we describe the demographics, disease characteristics and treatment patterns from the Turkish cohort of the SABA use IN Asthma (SABINA) III study.

Methods

This observational, cross-sectional study included patients aged ≥ 12 years with asthma from 24 centres across Turkey. Data on sociodemographics, disease characteristics and asthma treatments were collected using electronic case report forms. Patients were classified by investigator-defined asthma severity (guided by the 2017 Global Initiative for Asthma [GINA]) and practice type (primary/specialist care). The primary objective was to describe SABA prescription patterns in the 12 months prior to the study visit.

Results

Overall, 579 patients were included (mean age [standard deviation; SD]: 47.4 [16.1] years; 74.3% female), all of whom were treated by specialists. Most patients had moderate-to-severe asthma (82.7%, GINA steps 3–5), were overweight or obese (70.5%), had high school or university/post-graduate education (51.8%) and reported fully reimbursed healthcare (97.1%). The mean (SD) asthma duration was 12.0 (9.9) years. Asthma was partly controlled/uncontrolled in 56.3% of patients, and 46.5% experienced ≥ 1 severe exacerbation in the preceding 12 months. Overall, 23.9% of patients were prescribed ≥ 3 SABA canisters in the previous 12 months (considered over-prescription); 42.9% received no SABA prescriptions. As few patients had mild asthma, only 5.7% were prescribed SABA monotherapy. Therefore, most patients (61.5%) were prescribed SABA in addition to maintenance therapy, with 42.8% receiving ≥ 3 SABA canisters in the previous 12 months. Inhaled corticosteroids (ICS), ICS + a long-acting β-agonist fixed-dose combination and oral corticosteroids were prescribed to 14.5%, 88.3% and 28.5% of all patients, respectively. Additionally, 10.2% of patients purchased SABA over the counter, of whom 27.1% purchased ≥ 3 canisters in the preceding 12 months.

Conclusions

Despite all patients being treated by specialists and most receiving fully reimbursed healthcare, nearly a quarter of patients received prescriptions for ≥ 3 SABA canisters in the previous 12 months. This highlights a public health concern and emphasizes the need to align clinical practices with the latest evidence-based recommendations.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12890-022-02008-9.

Prevalence of upper respiratory tract infections and associated factors among children in Turkey

PURPOSE

Upper respiratory tract infections (URIs) are the most common diseases observed in children aged 0-6 years in Turkey. This study was conducted to investigate URIs in 0-6 year-old children in Turkey.

DESIGN AND METHODS

Data of children aged 0-6 years who were included in the 2014 Turkey Health Survey conducted by the Turkish Statistical Institute were collected from their parents.

RESULTS

In total, 1,293 and 1,732 children with and without URIs, respectively, were identified. The weighted point prevalence of URIs was 42.23%. Compared with the uninsured and female children belonging to high-income families, insured male children belonging to low-income families were more likely to develop URIs (p < .001). Moreover, comorbidities such as communicable diseases, anemia and diarrhea, and factors like health services utilization were associated with URIs. Analysis of health services utilization highlights that URIs were reported more among the children who had not visited a hospital than among those who had visited a hospital, with an odds ratio of 1.23.

CONCLUSIONS

The results of this study provide a deeper understanding of sociodemographic, comorbid, and health services utilization factors associated with URIs. These results provide useful insights for pediatric nursing professionals to improve the quality and efficiency of pediatric respiratory nursing services.

PRACTICE IMPLICATIONS

Collaborative networks with other health professionals, parents, and public health policy-makers are essential to decrease the prevalence of URIs in Turkey. These study results provide several insights for health professionals to improve pediatric action plans for ultimately improving child health status.