Translation and Validation of the AIRS-S :Asthma Illness Representation Scale – Spanish©

Objective: Research shows parents and healthcare providers (HCPs) think about asthma differently. The professional model of asthma management views asthma as a chronic illness; present when symptoms are controlled and not apparent. Parents describe asthma as episodic, acute, not readily controllable, and view daily controller medications negatively, commonly known as “lay models” of illness management. Illness representations (IRs) congruent with the professional model lead to greater use of controller medications while lay model beliefs lead to increased use of complementary and alternative medicine and a sub-optimal regimen. IRs are rarely discussed, yet are critical in determining healthcare seeking behaviors and adherence to medication regimens. No validated Spanish, asthma-specific illness representation instruments exist. This study describes the translation/validation of the Asthma Illness Representation Scale-Spanish© (AIRS-S).

Methods: The 56-item AIRS-S yields 5 subscales and a total score: nature of asthma, cause, ideas about medications, treatment expectations, and HCP interaction. Certified, bi-lingual translators translated the validated English AIRS to Spanish and back to English. The original AIRS was compared to this version for content integrity. The bi-lingual clinic staff reviewed the AIRS-S for readability/interpretability prior to the validation study. 150 Spanish-speaking parents of children with asthma (Mexican and Puerto Rican) are currently being enrolled. Psychometric analyses are planned comparing results to the original AIRS.

Results: The AIRS-S will discriminate between Mexican and Puerto Rican parents and good symptom control versus poor control. A positive relationship with the HCP will predict higher AIRS-S scores, congruent with the professional model of asthma management.

Conclusions: These findings will yield a reliable, valid Spanish instrument for assessing asthma illness beliefs for use by researchers and HCPs. If parents' beliefs are discordant with the HCP's beliefs and not addressed when devising the management plan, risk for non-adherence increases.