Measurement and Operationalization

Measurement and Operationalization

            The prevalence of asthma has been on the increase in recent decades among the adolescents. Measurement and Asthma-related variables require accuracy since the condition is contagious and should be contained effectively. One of the variables of interest in the treatment of asthma is adherence to medication and the adolescents are prone to poor adherence to medication. Non-adherence to medication leads to poor health care outcomes and increased health care costs. The prevalence of non-adherence to medication leads to a world-wide disaster associated with chronic diseases.   The measurement of a variable involves several levels, which begin at the nominal level where the variable is named and labeled without any form of ranking. The first level of variable measured involves all variable. The variables that can be measured are addressed in the next level that is referred to as interval and ratio measurements. The quality of measurement is rated using reliability, validity, and the ability to put the variable into operation.

An asthma adherence measurement tool is efficient for assessing adherence among asthma patients (Juniper et al. 1993). The management of the asthma issue depends on how effectively patients adhere to medication. Therefore, the measurement of medication adherence is crucial in the study of asthma control measures (Arnet et al. 2016). Without knowledge on the adherence patterns of asthma patients, bodies tasked with managing the condition will not be able to draw reliable conclusions. Medication adherence can be defined as the extent to which an individual behaves in correspondence with the medical recommendations given by a medical practitioner. The significance of adherence to medication is based on the fact that chronic infections are at risk of causing a burden on the control of infections. Interventions on the adherence of medications always have a significant impact on the improvement of adherence among asthma patients. When adherence is improved among patients, the spread of asthma is managed. The need to measure adherence is because the parameters measuring adherence vary between individual patients. The effect of different parameters changes among the different individuals.

The consistency evident in using Asthma Adherence to Medication Questionnaire has proved the tool to be efficient in assessing adherence. The measurements of adherence have been categorized into two by the World Health Organization; subjective and objective (Dima et al. 2015). The subjective measures involve the evaluation of the patient’s medication adherence behavior. The tools used in subjective measurements are healthcare professional assessments and self-reports. However, the subjective methods of measuring adherence have the drawback in that patients will always not report non-adherence since healthcare providers could withdraw their support. On the other side, objective measures comprise of pill counts, electronic behavior monitoring, analyzing secondary database and the use of biochemical measures (Rhee et al. 2018). The use of objective measures should be in a position to assess the validity and correlation in subjective measurement methods. Although subjective measures have more valid application than the objective measures, the objective measures are more accurate.

To operationalize a variable, a definition has to be made for a measurable and observable concept. The process of operationalizing a variable will involve developing research procedures that can give empirical results. The concepts chosen should be exhaustive in the presentation of the different variations that can occur from a variable. The measure of adherence involves the use of different concepts which are finally analyzed to give conclusions concerning the overall performance of the individual. Among the concepts used in asthma, medication adherence measurement is the medication possession ratio. The medication possession ration measures the proportion by which an individual is supplied with medication (Treffers-Daller & Silva-Corvalán, 2016). The rate of supply is measured using the prescription duration where an individual is expected to pick additional medication at specified intervals. The strict adherence to the set interval could mean that the individual is adhering well to medication. However, lateness in the picking of additional medication or no appearance after the first dosage could mean that the individual is facing challenges adhering to the medication process. A dichotomous variable value is set to identify the cut-off point for distinguishing adherence and non-adherence to medication. However, the dichotomous variable value is much sensitive to patient behaviors and necessitates the use of continuous variable measures.

Questionnaires and scales are used to give mathematical statistics so as to make the measurement of adherence, or non-adherence effective. The advantage of using questionnaires and scales is that the information obtained is raw from the patients and the conclusions made reflect the opinions of the patients. The validity of questionnaires and scales is based on flexibility during application. Questionnaires and scales leave room for customization to fit the population under study and thus highly valid. Since questionnaires could have a setback in that patients with low literacy abilities are unable to give information, data collectors are required to allow caretakers and guardians to assist the patients in filling the questionnaires.  The validity of questionnaires is only limited to the extent to which a patient is willing to give honest responses. However, with the requirement that privacy and confidentiality are maintained in the use of questionnaire and scale measures, patients could feel free to give honest responses since the patient’s identities are kept secret. The use of questionnaires and scales ensures anonymity and patients are not required to reveal their identities. The use of questionnaires is reliable in that information is obtained either freely or at minimal costs. The provision of information depends on the willingness of the patients to volunteer in giving information freely. The results obtained from questionnaires are free from manipulation from secondary parties. The researchers who use data from questionnaires are guaranteed to obtain results based on first-hand information.

Self-report adherence scales have been used in the past to assess the adherence patterns of asthma patients. The different scales have been grouped into five categories according to the information recorded (Peters et al. 2016). The five classifications are medication-taking behaviors alone, medication-taking behavior and barriers to adherence, barriers to adherence only, only beliefs associated with medication adherence, and both barriers to and beliefs associated with adherence. The factors affecting the adherence patterns have been identified as forgetfulness, disease-related reasons, complexity in a given regime, or even side-effects of taking specific medications.

The use of questionnaires and scales are relevant in giving the measurements required to model the adherence patterns of asthma patients to medication. The use of Asthma routine questionnaire gives a reliable method for assessing the adherence patterns of asthma patients to medication. The method gives a way to differentiate the psychological burden of the family organization from medical intake. The fact that the questionnaire targets the primary population makes it a reliable tool of measurement. The consistence in using the tool is proved by evidence from previous applications. The method is economical since costs are only involved in preparing the questionnaires and analyzing information from the questionnaires.