Cunha A J L A, Santos M A R C, Galvão M G A, Ibiapina A A A P
Primary Health Units. Rio de Janeiro. Brazil.
Allergol Immunopathol (Madr). 2003 Mar-Apr;31(2):87-90.
Despite the numerous guidelines on the diagnosis and treatment of asthma, there are data that indicate that general pediatrician's knowledge of the disease and its preferred treatment is limited, which may influence the quality of care given to asthmatic children. The purpose of this study was to describe pediatrician's knowledge of spacers and of concepts of chilhood asthma, as well as their prescribing habits concerning inhalation therapy, in the public health system of the city of Rio de Janeiro.
A descriptive cross-sectional study was performed in a sample of 72 pediatricians from the public health system of Rio de Janeiro. A questionnaire was used to assess prescriptions for spacers, the reasons whay spacers were not used, the models employed, classification of asthma according to clinical severity and symptom frequency, recommendation for the correct spacer volume according to age group, and the concept of asthma as an inflammatory disease. Seventy percent (51/72) of the physicians did not routinely prescribe the spacer. The reasons given were as follows: a) lack of spacer availability in the public health system in 55 % (28/51); b) high cost in 57 % (29/51); c) the complexity of their use in 35 % (18/51); d) unwillingness to use aerosol type medication in 15 % (8/51), and e)lack of knowledge of their function and utilization in 59 % (30/51). Of the 30 % (21/72) who reported they regularly and routinely prescribed the spacer in daily practice, 48 % (10/21) stated that this routine prescription, even when indicated, was below 25 % of what was expected and makeshift models were preferred by 24 % (5/21) of the pediatricians. Six percent of the pediatricians chose the appropriate spacer volume according to age group, 62.5 % (45/72) reported that they classified asthma according to severity, 16 % (7/45) gave the correct answers when classifying asthma according to national consensus, and 22 % (16/72) considered asthma to be an inflammatory disease.
The results of this study suggest that pediatrician's knowledge of inhalation therapy with dosed aerosol spacers and of asthma-related concepts in the public health system in Rio de Janeiro is limited. This may restrict the quality of care given to the asthmatic children in the city and suggests the need for training programs for the management of asthmatic children.
尽管有众多关于哮喘诊断和治疗的指南，但有数据表明，普通儿科医生对该疾病及其首选治疗方法的了解有限，这可能会影响对哮喘儿童的护理质量。本研究的目的是描述里约热内卢市公共卫生系统中儿科医生对储雾罐以及儿童哮喘概念的了解，以及他们在吸入疗法方面的处方习惯。
对里约热内卢市公共卫生系统的72名儿科医生进行了一项描述性横断面研究。使用一份问卷来评估储雾罐的处方情况、不使用储雾罐的原因、所采用的型号、根据临床严重程度和症状频率对哮喘的分类、根据年龄组推荐正确的储雾罐容量，以及将哮喘视为炎症性疾病的概念。70%（51/72）的医生没有常规开具储雾罐处方。给出的原因如下：a）55%（28/51）的医生表示公共卫生系统中没有储雾罐；b）57%（29/51）的医生认为成本高；c）35%（18/51）的医生认为其使用复杂；d）15%（8/51）的医生不愿意使用气雾剂类药物；e）59%（30/51）的医生对其功能和使用缺乏了解。在报告在日常实践中定期且常规开具储雾罐处方的30%（21/72）的医生中，48%（10/21）表示即使有指征，这种常规处方也低于预期的25%，24%（5/21）的儿科医生更喜欢使用临时制作的型号。6%的儿科医生根据年龄组选择了合适的储雾罐容量，62.5%（45/72）的医生报告他们根据严重程度对哮喘进行分类，16%（7/45）的医生在根据国家共识对哮喘进行分类时给出了正确答案，22%（16/72）的医生认为哮喘是一种炎症性疾病。
本研究结果表明，里约热内卢市公共卫生系统中儿科医生对定量气雾剂储雾罐吸入疗法以及与哮喘相关概念的了解有限。这可能会限制该市对哮喘儿童的护理质量，并表明需要开展哮喘儿童管理培训项目。
