ABSTRACT
AIMS: The study aims to determine the reliability of a 24-h history of reported cough presence and quality (wet/dry) compared with objectively recorded cough, and evaluate factors that may influence cough reporting. METHODS: A digital recorder (ICD-PX720, Sony, Tokyo, Japan) was attached to 47 Indigenous children for 24 h during admission at Royal Darwin Hospital. After recording, carers reported their child's cough details. Cough counts were objectively measured and details of cough reports by carer (cough present/absent, quality wet/dry, cough severity determined by visual analogue scale and verbal category descriptive score) were the main outcomes measured. Other factors examined were: carer's sex, age, education, smoking, carer's cough, parent versus non-parent, respiratory illness in child and mean parent-proxy cough-specific quality of life questionnaire. Data were entered into STATA (V.10, STATA Corp., College Station, TX, USA). Cohen's kappa (κ) coefficients and Spearman's rank correlation coefficient (rs ) were used for data analysis. RESULTS: Reporting of cough by Indigenous carers (compared with cough monitoring) was slight when a low cough threshold (0.25 coughs/h) was used (κ = 0.17, 95% CI -0.15, 0.49) and moderate when a higher cough threshold was used (κ = 0.57, 95% CI 0.28, 0.88). Carers' evaluation of wet cough disagreed with clinician's evaluation (κ = -0.24, 95% CI -0.58, 0.09). Subjective reporting of cough severity moderately correlated with objective cough rates (rs = 0.41 to 0.44, 95% CI 0.11, 0.67). None of the factors examined was associated with reliability of cough reporting. CONCLUSIONS: The unreliability of reporting of cough highlights the need for community education on the importance of cough to improve health-seeking behaviour for early detection and treatment of respiratory disease.
