Ueshima Y, Kikuchi T, Kaneko N, Kaneshige H, Suzuki H
Department of Respiratory Medicine Fujigaoka Hospital of Showa University.
Arerugi. 2000 May;49(5):420-7.
Since 1993, our hospital has actively pursuing introduction of peak flow monitoring for patients with bronchial asthma. However, a number of patients are found to discontinue PEF monitoring. In order to determine the causes, a comparative analysis of recognition between patients who continued PEF monitoring (continuation group, hereafter) and those who discontinued PEF monitoring (interruption group, hereafter) was conducted through a questionnaire survey. The number of patients with bronchial asthma who responded to the questionnaire was 120; among them, the number of cases who continued and interrupted PEF monitoring were 68 and 52, respectively. The percentage of patients whose symptoms improved after the introduction of PEF monitoring was higher in the continuation group than in the interruption group. Approximately half of the patients in the interruption group commented that PEF monitoring was valid. The percentage of patients who believed that PEF monitoring is valid was higher in the group of patients who experienced reduction in the severity of symptom after introduction of PEF monitoring compared with those who did not. From these results, to keep high compliance of PEF monitoring, we propose that introduction of PEF monitoring and education of self-management should be positively stated for patients in unstable state. Furthermore, we found that some of the patients in the interruption group expressed interest in restarting PEF monitoring, indicating that each patient should be dealt with on a case by case basis. Appeals from doctors, patients education and advice of relatively few measurements, were found to be especially important in motivating patients to use PEF monitoring.
自1993年以来，我院一直积极推行对支气管哮喘患者进行峰流速监测。然而，发现许多患者停止了峰流速监测。为了确定原因，通过问卷调查对继续进行峰流速监测的患者（以下简称继续组）和停止峰流速监测的患者（以下简称中断组）之间的认知情况进行了比较分析。回复问卷的支气管哮喘患者有120名；其中，继续和中断峰流速监测的病例数分别为68例和52例。继续组中引入峰流速监测后症状改善的患者百分比高于中断组。中断组中约一半的患者表示峰流速监测是有效的。与未经历症状严重程度减轻的患者相比，引入峰流速监测后经历症状严重程度减轻的患者组中认为峰流速监测有效的患者百分比更高。从这些结果来看，为保持峰流速监测的高依从性，我们建议对于病情不稳定的患者应积极开展峰流速监测及自我管理教育。此外，我们发现中断组中的一些患者表示有兴趣重新开始峰流速监测，这表明应针对每个患者进行个案处理。发现医生的呼吁、患者教育以及建议较少的测量次数，对于促使患者使用峰流速监测尤为重要。
