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Research ArticleOriginal Article
Open Access

Psychological stress and its association with bronchial asthma in Saudi Arabia

A cross-sectional study

Alaa A. Bugis, Faisal A. Turkestani, Mohammed E. Ahmed, Mohammed M. Alqahtani, Abdullah K. Alnafisi, Bassam O. Alamri and Alhasan M. Algobayshi
Saudi Medical Journal May 2025, 46 (5) 560-566; DOI: https://doi.org/10.15537/smj.2025.46.5.20250028
Alaa A. Bugis
From the Department of Respiratory Therapy (Bugis, Turkestani, Alqahtani, Alnafisi, Alamri, Algobayshi); from the Department of Echo-cardiovascular Technology (Turkestani), College of Applied Medical Sciences; from the College of Science and Health Professions (Eldigir), King Saud bin Abdulaziz University for Health Sciences, and from King Abdullah International Medical Research Center (Bugis, Turkestani, Eldigir, Alqahtani, Alnafisi, Alamri, Algobayshi), National Guard Health Affairs, Jeddah, Kingdom of Saudi Arabia.
MSc, MSRCL
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Faisal A. Turkestani
From the Department of Respiratory Therapy (Bugis, Turkestani, Alqahtani, Alnafisi, Alamri, Algobayshi); from the Department of Echo-cardiovascular Technology (Turkestani), College of Applied Medical Sciences; from the College of Science and Health Professions (Eldigir), King Saud bin Abdulaziz University for Health Sciences, and from King Abdullah International Medical Research Center (Bugis, Turkestani, Eldigir, Alqahtani, Alnafisi, Alamri, Algobayshi), National Guard Health Affairs, Jeddah, Kingdom of Saudi Arabia.
MsRC, PhD
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  • ORCID record for Faisal A. Turkestani
  • For correspondence: [email protected]
Mohammed E. Ahmed
From the Department of Respiratory Therapy (Bugis, Turkestani, Alqahtani, Alnafisi, Alamri, Algobayshi); from the Department of Echo-cardiovascular Technology (Turkestani), College of Applied Medical Sciences; from the College of Science and Health Professions (Eldigir), King Saud bin Abdulaziz University for Health Sciences, and from King Abdullah International Medical Research Center (Bugis, Turkestani, Eldigir, Alqahtani, Alnafisi, Alamri, Algobayshi), National Guard Health Affairs, Jeddah, Kingdom of Saudi Arabia.
PhD
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Mohammed M. Alqahtani
From the Department of Respiratory Therapy (Bugis, Turkestani, Alqahtani, Alnafisi, Alamri, Algobayshi); from the Department of Echo-cardiovascular Technology (Turkestani), College of Applied Medical Sciences; from the College of Science and Health Professions (Eldigir), King Saud bin Abdulaziz University for Health Sciences, and from King Abdullah International Medical Research Center (Bugis, Turkestani, Eldigir, Alqahtani, Alnafisi, Alamri, Algobayshi), National Guard Health Affairs, Jeddah, Kingdom of Saudi Arabia.
BSc
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Abdullah K. Alnafisi
From the Department of Respiratory Therapy (Bugis, Turkestani, Alqahtani, Alnafisi, Alamri, Algobayshi); from the Department of Echo-cardiovascular Technology (Turkestani), College of Applied Medical Sciences; from the College of Science and Health Professions (Eldigir), King Saud bin Abdulaziz University for Health Sciences, and from King Abdullah International Medical Research Center (Bugis, Turkestani, Eldigir, Alqahtani, Alnafisi, Alamri, Algobayshi), National Guard Health Affairs, Jeddah, Kingdom of Saudi Arabia.
BSc
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Bassam O. Alamri
From the Department of Respiratory Therapy (Bugis, Turkestani, Alqahtani, Alnafisi, Alamri, Algobayshi); from the Department of Echo-cardiovascular Technology (Turkestani), College of Applied Medical Sciences; from the College of Science and Health Professions (Eldigir), King Saud bin Abdulaziz University for Health Sciences, and from King Abdullah International Medical Research Center (Bugis, Turkestani, Eldigir, Alqahtani, Alnafisi, Alamri, Algobayshi), National Guard Health Affairs, Jeddah, Kingdom of Saudi Arabia.
BSc
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Alhasan M. Algobayshi
From the Department of Respiratory Therapy (Bugis, Turkestani, Alqahtani, Alnafisi, Alamri, Algobayshi); from the Department of Echo-cardiovascular Technology (Turkestani), College of Applied Medical Sciences; from the College of Science and Health Professions (Eldigir), King Saud bin Abdulaziz University for Health Sciences, and from King Abdullah International Medical Research Center (Bugis, Turkestani, Eldigir, Alqahtani, Alnafisi, Alamri, Algobayshi), National Guard Health Affairs, Jeddah, Kingdom of Saudi Arabia.
BSc
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Article Figures & Data

Figures

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  • Figure 1
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    Figure 1

    - Plot box illustrates the difference between males and females in responding to stress using the perceived stress scale.

  • Figure 2
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    Figure 2

    - The plot box illustrates the variation in asthma control levels between males and females, as measured by the asthma control scale.

Tables

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    Table 1

    - Reliability, frequency, and demographic characteristics.

    Variablesn (%)Cronbach’s alpha
    Reliability  
    Stress scale (n=10)733 (100)0.728
    Asthma scale (n=5)733 (100)0.819
    Frequency  
    Age733 (100) 
    Gender733 (100)
    Region733 (100)
    Valid missing0 (0.0)
    Age (years)  
    18-25357 (48.7) 
    26-39198 (27.0)
    40 and older178 (24.3)
    Gender  
    Male352 (48) 
    Female381 (52)
    Regions  
    Northern11 (1.5) 
    Western340 (46.4)
    Southern181 (24.7)
    Central75 (10.2)
    Eastern126 (17.2)

    Values are presented as numbers and percentages (%). Cronbach’s alpha test shows high internal consistency in stress and asthma scales.

      • View popup
      Table 2

      - Frequency of stress and asthma categories and correlations.

      Variablesn (%)
      Stress category 
      Low14 (1.9)
      Moderate93 (12.7)
      High626 (85.4)
      Total733 (100)
      Asthma category 
      Uncontrolled149 (20.3)
      Partial controlled184 (25.1)
      Complete control400 (54.6)
      Total733 (100)
      Correlations 
      Stress level (n=733) 
      Pearson correlation-0.22 stress, 1.0 asthma
      Sig. (2-tailed)0.000
      Asthma scale (n=733) 
      Pearson correlation1.0 stress, -0.22 asthma
      Sig. (2-tailed)0.000

      Values are presented as numbers and percentages (%).

        • View popup
        Table 3

        - Mean score, standard deviation, frequency, and p-value of stress and asthma association regarding age and gender.

        VariablesMean±SDFP-values
        Stress level   
        Age group (years)   
        18-2531.2464±6.459100.1100.896
        26-3931.2778±4.94319
        40+31.0281±4.95223
        Total31.2019±5.72767
        Asthma   
        Age group (years)   
        18-2519.4454±4.785920.6980.498
        26-3919.1818±4.33698
        40+19.7416±4.44051
        Total19.4461±4.58364
        Stress category   
        Gender   
        Male30.1250±5.83791.291<0.001
        Female32.1969±5.4449
        Asthma category   
        Gender   
        Male20.0881±4.424831.165<0.001
        Female18.853±4.65317

        Values are presented as mean ± standard deviation (SD). P-values regarding gender is <0.05 consider significant.

          • View popup
          Table 4

          - The frequency and percentages for the asthma scale categories.

          Asthma categoryStress categoryP-values
          LowModerateHigh
          A1    
          A1-12 (11.0)3 (16.0)14 (74.0)0.002
          A1-20 (0.0)8 (9.4)77 (91.0)
          A1-30 (0.0)15 (10.0)140 (90.3)
          A1-41 (0.6)29 (18.0)131 (81.4)
          A1-511 (3.5)38 (12.1)264 (84.3)
          A2    
          A2-10 (0.0)4 (18.2)18 (82.0)0.001
          A2-20 (0.0)5 (6.0)79 (94.0)
          A2-30 (0.0)20 (11.4)155 (89.0)
          A2-42 (0.9)26 (12.3)183 (87.0)
          A2-512 (5.0)38 (16.0)191 (79.3)
          A3    
          A3-10 (0.0)3 (8.1)34 (92.0)0.015
          A3-20 (0.0)9 (10.1)80 (90.0)
          A3-30 (0.0)11 (18.0)51 (82.3)
          A3-40 (0.0)27 (13.4)174 (87.0)
          A3-514 (4.1)43 (13.0)287 (83.4)
          A4    
          A4-10 (0.0)3 (9.0)31 (91.2)0.097
          A4-20 (0.0)7 (12.3)50 (88.0)
          A4-30 (0.0)17 (21.0)64 (79.0)
          A4-41 (0.7)18 (12.4)126 (90.0)
          A4-513 (3.1)48 (12.0)355 (85.3)
          A5    
          A5-16 (7.1)14 (17.0)64 (76.2)0.001
          A5-21 (1.5)1 (1.5)63 (97.0)
          A5-30 (0.0)19 (13.0)131 (87.3)
          A5-41 (0.5)24 (13.1)158 (86.3)
          A5-56 (2.4)35 (14.0)210 (84.0)

          Values are presented as numbers and percentages (%). The frequency and percentages for the asthma scale categories are presented as following: A1 corresponds to the first question which estimates activities of daily living; A2 pertains to the second question which assesses dyspnea; A3 corresponds to the third question which evaluates the frequency of nighttime awakenings; A4 pertains to the fourth question which focuses on asthma medication usage; and A5 corresponds to the fifth question which shows patients’ self-assessment of their asthma control level.

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          1 May 2025
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          Psychological stress and its association with bronchial asthma in Saudi Arabia
          Alaa A. Bugis, Faisal A. Turkestani, Mohammed E. Ahmed, Mohammed M. Alqahtani, Abdullah K. Alnafisi, Bassam O. Alamri, Alhasan M. Algobayshi
          Saudi Medical Journal May 2025, 46 (5) 560-566; DOI: 10.15537/smj.2025.46.5.20250028

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          Psychological stress and its association with bronchial asthma in Saudi Arabia
          Alaa A. Bugis, Faisal A. Turkestani, Mohammed E. Ahmed, Mohammed M. Alqahtani, Abdullah K. Alnafisi, Bassam O. Alamri, Alhasan M. Algobayshi
          Saudi Medical Journal May 2025, 46 (5) 560-566; DOI: 10.15537/smj.2025.46.5.20250028
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          Keywords

          • asthma
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          • insomnia
          • activities of daily living

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