Meurer J R, Helstad C P, Wiegmann S M, Kelly K J, Fisher R, Bukstein D, Wegehaupt P
Community Pediatrics Center, Advancement of Urban Children, Medical College of Wisconsin and Children's Health System, USA.
WMJ. 2001;100(8):26-34.
Asthma management should follow evidence-based national guidelines. We compared patient self-reports of usual care to clinical practice guidelines.
Cross-sectional survey of parents of 245 children age 2-14 years with asthma seen by physicians at 13 practices in Wisconsin.
Most children with asthma were atopic and a substantial number experienced psychosocial problems. Families infrequently used written care plans. Knowledge about asthma triggers, especially tobacco smoke, was deficient. Increasing asthma severity was associated with poorer health. Although most parents rated their physician's expertise as excellent or very good, one-third of children with persistent symptoms used no daily control medication. Significant differences were observed between primary care and specialty care with the best asthma self-management done by patients of specialists.
Care of Wisconsin children with asthma inconsistently follows national guidelines. They and their families require improved education, written care plans, appropriate medications, and psychosocial support.
哮喘管理应遵循循证国家指南。我们将患者对常规护理的自我报告与临床实践指南进行了比较。
对威斯康星州13家医疗机构中245名2至14岁哮喘儿童的家长进行横断面调查。
大多数哮喘儿童属于特应性体质，相当一部分儿童存在心理社会问题。家庭很少使用书面护理计划。对哮喘诱因，尤其是烟草烟雾的认知不足。哮喘严重程度增加与健康状况较差相关。尽管大多数家长对其医生的专业水平评价为优秀或非常好，但三分之一有持续症状的儿童未使用任何日常控制药物。初级保健和专科护理之间存在显著差异，专科患者的哮喘自我管理最佳。
威斯康星州哮喘儿童的护理未始终遵循国家指南。他们及其家庭需要改善教育、书面护理计划、适当的药物治疗以及心理社会支持。
