Braganza Sandra, Ozuah Philip O, Sharif Iman
Department of Pediatrics, Albert Einstein College of Medicine/Children's Hospital at Montefiore, Bronx, New York 10467, USA.
J Asthma. 2003;40(7):823-7. doi: 10.1081/jas-120023574.
Use of complementary/alternative medicine (CAM) has been increasing, especially among patients with a chronic illness. Although asthma is the most common chronic illness affecting children in the United States, very little is known about the use of CAM in children with asthma. Our objective was to determine the prevalence and correlates of CAM use among inner-city children with asthma. A cross-sectional survey of parents of children with asthma attending an urban health center was performed. Parents were surveyed regarding CAM use over the past year, perceived efficacy of CAM, severity of child's asthma symptoms and demographic information. Differences in proportions were tested by chi-square or Fisher's exact test as appropriate. Three hundred ten parents participated, of whom 61% were Hispanic and 37% were African American. Parental mean age was 33 years and the mean age of the child was 7.2 years; 89% of parents had treated their child in the past year with some form of CAM. However, only 18% had informed a physician of doing so. The most common forms of CAM used were as follows: prayers (53%), rubs (53%), and massage (45%). Of those who used CAM, 59% perceived it to be at least as effective as pharmacotherapy, and 44% used CAM as first treatment of an asthma attack. Mild and moderate persistent asthmatics had significantly higher rates of CAM use than did mild intermittent and severe persistent asthmatics. We found a very high rate of CAM use among children with asthma in this inner-city population. Most importantly, a very high proportion of parents perceived the therapies to be effective, used them as first treatment of an acute exacerbation, and did not inform a physician of doing so. These findings have implications for the care of asthmatic children by pediatricians practicing in urban settings.
补充和替代医学(CAM)的使用一直在增加,尤其是在慢性病患者中。虽然哮喘是美国影响儿童的最常见慢性病,但对于哮喘儿童使用补充和替代医学的情况却知之甚少。我们的目标是确定市中心哮喘儿童中补充和替代医学的使用情况及其相关因素。对在城市健康中心就诊的哮喘儿童的家长进行了一项横断面调查。就家长在过去一年中使用补充和替代医学的情况、对补充和替代医学疗效的认知、孩子哮喘症状的严重程度以及人口统计学信息进行了调查。根据情况,采用卡方检验或费舍尔精确检验来检验比例差异。310名家长参与了调查,其中61%为西班牙裔,37%为非裔美国人。家长的平均年龄为33岁,孩子的平均年龄为7.2岁;89%的家长在过去一年中曾用某种形式的补充和替代医学为孩子治疗。然而,只有18%的家长告知了医生他们这样做。最常用的补充和替代医学形式如下:祈祷(53%)、涂抹剂(53%)和按摩(45%)。在使用补充和替代医学的家长中,59%认为其至少与药物治疗一样有效,44%将补充和替代医学作为哮喘发作的首选治疗方法。轻度和中度持续性哮喘患儿的补充和替代医学使用率明显高于轻度间歇性和重度持续性哮喘患儿。我们发现,在这个市中心人群中,哮喘儿童的补充和替代医学使用率非常高。最重要的是,很大一部分家长认为这些疗法有效,将其作为急性加重期的首选治疗方法,并且没有告知医生他们这样做。这些发现对在城市环境中执业的儿科医生照顾哮喘儿童具有启示意义。