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Managing Asthma for Patients and Families
Use of Asthma Diaries: Figure 3
Figure 3
Asthma Diary for _________________________________
Complete diary by checking the correct box or filling in the
requested value
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Month __________ Day
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Last night
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Good night
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Slept well but a little wheeze or cough
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Woke once or twice
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Bad night, awake a lot
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Morning Peak Flow
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(best of 3 efforts)
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Activity
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No problem
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Can run a little bit
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Can't run at all
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Had to rest all day
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Wheeze
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No
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Yes, 2 times or less
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Yes, more than 2 times
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Yes, all the time
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Cough
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No
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Yes, a little
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Yes, keeps me from doing some things
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Yes, bothers me a lot
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Evening Peak Flow
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(best of 3 efforts)
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Intervention
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Inhaled bronchodilator (no. of treatments)
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Oral Corticosteroid (dose)
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Title Page
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