asma control test
TRANSCRIPT
8/19/2019 Asma Control Test
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1. In the past 4 weeks, how much of the time did your asthma keep you fromgetting as much done at work, school or at home?
All ofthe time
Most ofthe time
Some of the time
A little
of thetime
None ofthe time
2. uring the past 4 weeks, how often ha!e you had shortness of "reath?
Morethan
once a
day
#nce a
day
$ to %times a
week
#nce ortwice a
week
Not at
all
$. uring the past 4 weeks, how often did your asthma symptoms &whee'ing,
coughing, shortness of "reath, chest tightness or pain( wake you up at night or
earlier than usualin the morning?
) ormore
nights a
week
2 or $nights a
week
#nce a
week
#nce or
twice
Not at
all
). uring the past 4 weeks, how often ha!e you used your rescue inhaler or
ne"uli'er medication &such as al"uterol(?
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$ or
more
times per day
1 or 2
times per day
2 or $
times
perweek
#nce a
week orless
Not at
all
*. +ow would you rate your asthma control during the past 4 weeks?
Not
controlledat all
oorlycontrolled
Somewhatcontrolled
-ellcontrolled
ompletelycontrolled
Step 1: /et your child
respond to the first four
questions (1 to 4). If your child needs help
in reading or understanding
the 0uestion, you mayhelp, "ut let your child
select the response.
omplete the remaining
three questions (5 to 7)
on your own and without
letting your childs
responses influence youranswers. here are no
right or wrong answers.
Step 2: lick an answer
"utton for each 0uestion.
3ou will see a num"er
score populate thecolumn to the right.
Step 3: -hen all se!en0uestions ha!e "een
answered, press the 4S55
3#67 S#754 "utton to
!iew your score.
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Step 4: ake a printout
of the test results to the
doctor to talk a"out yourchilds total score.
Have your hi!" omp!ete these questions.
1. +ow is your asthma today? Score
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8ery 9ad 9ad :ood 8ery :ood
2. +ow much of a pro"lem is your asthma when you run, e;ercise or play sports?
Its a "ig pro"lem,I cant do what I
want to do.
Its a pro"lem and
I dont like it.
Its a
little pro"lem "ut its okay.
Its not a pro"lem.
$. o you cough "ecause of your asthma?
3es, all of
the time.3es, most of
the time.
3es, some of
the time.
No, none of
the time.
). o you wake up during the night "ecause of your asthma?
3es, all of
the time.3es, most of
the time.3es, some of
the time. No, none of
the time.
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#!ease omp!ete these questions on your own.
*. uring the last ) weeks, how many days did your child ha!e any
daytime asthma symptoms?
Not at all 1<$ days )<1= days 11<1> days 1<2) days 5!eryday
%. uring the last ) weeks, how many days did your child whee'e during
the day "ecause of asthma?
Not at all 1<$ days )<1= days 11<1> days 1<2) days 5!eryday
@. uring the last ) weeks, how many days did your child wake up during the night "ecause of asthma?
Not at all 1<$ days )<1= days 11<1> days 1<2) days 5!eryday