Bonner Sebastian, Zimmerman Barry J, Evans David, Irigoyen Matilde, Resnick David, Mellins Robert B
Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York 10029, USA.
J Asthma. 2002 Apr;39(2):167-79. doi: 10.1081/jas-120002198.
We hypothesized that an educational intervention based on a readiness model would lead to improved health outcomes among patients with asthma. Within a randomized control design in an urban Latino and African-American community we conducted an intensive three-month pediatric intervention. A Family Coordinator provided patient education based on a readiness-to-learn model, and facilitated improved interactions between the patient and the doctor. Family education addressed the most basic learning needs of patients with asthma by improving their perception of asthma symptom persistence using asthma diaries and peak flown measures. The physician intervention focused cliniciancs' attention on patients' diary records and peak flow measures, and encouraged physicians to use stepped action plans. Patients were also tested for allergic sensitization and provided strategies to reduce contact with allergens and other asthma triggers. The results showed significant improvements by intervention group families on measures of knowledge, health belief, self-efficacy, self-regulatory skill, and adherence; decreases in symptom persistence and activity restriction; and increased prescription of anti-inflammatory medication by the physicians of the intervention group families.
我们假设基于准备度模型的教育干预将改善哮喘患者的健康状况。在一个城市拉丁裔和非裔美国人社区的随机对照设计中，我们开展了一项为期三个月的强化儿科干预。一名家庭协调员基于学习准备度模型提供患者教育，并促进患者与医生之间更好的互动。家庭教育通过使用哮喘日记和呼气峰流速测量来改善患者对哮喘症状持续时间的认知，从而满足哮喘患者最基本的学习需求。医生干预使临床医生将注意力集中在患者的日记记录和呼气峰流速测量上，并鼓励医生使用逐步行动计划。患者还接受了过敏致敏检测，并获得了减少接触过敏原和其他哮喘触发因素的策略。结果显示，干预组家庭在知识、健康信念、自我效能、自我调节技能和依从性方面有显著改善；症状持续时间和活动受限减少；干预组家庭的医生开具的抗炎药物处方增加。
