Rathkopf Melinda M, Quinn James M, Proffer David L, Napoli Diane C
Department of Allergy/Immunology, Wilford Hall Medical Center, Lackland AFB, Texas 78236, USA.
Ann Allergy Asthma Immunol. 2004 Aug;93(2):147-53. doi: 10.1016/S1081-1206(10)61467-6.
Immunotherapy is an invaluable therapy for allergic asthma, allergic rhinitis, and hymenoptera hypersensitivity. It is, however, not without risks.
To examine patient knowledge regarding immunotherapy and to determine the most effective educational method to improve their knowledge by answering the following questions: Before educational intervention, what is the current knowledge level regarding allergy vaccinations of patients receiving immunotherapy? What effect does an educational encounter have on that level of knowledge? Which educational intervention--a one-on-one session vs a handout--if either, increases patient knowledge more?
An original, self-administered patient questionnaire was distributed to all patients receiving immunotherapy. Patients were randomly assigned to a control group, an intervention group that received an educational handout monthly for 2 months, or an intervention group that had a one-on-one educational session with a physician or nurse practitioner. After 3 months, all patients completed an identical follow-up questionnaire. Pretest and posttest scores were compared for each group and among the different groups to determine which method was more effective. Repeated-measures analysis of variance was used to determine the effect of instruction type on differences in pretest and posttest scores.
All 3 groups significantly improved their mean overall questionnaire scores (P < .001). The amount of change was greater in the intervention groups than in the control group, but it did not reach statistical significance (P = .59).
Baseline immunotherapy knowledge of allergy vaccination patients was better than expected, and further educational interventions did not significantly improve this knowledge.
免疫疗法是治疗过敏性哮喘、过敏性鼻炎和膜翅目昆虫过敏的一种重要疗法。然而,它并非毫无风险。
通过回答以下问题来检查患者对免疫疗法的了解情况,并确定提高其知识水平的最有效教育方法:在进行教育干预之前,接受免疫疗法的患者对过敏疫苗接种的当前知识水平如何?一次教育接触对该知识水平有何影响?哪种教育干预方式(一对一辅导与发放资料)(如果有的话)能使患者知识增加更多?
向所有接受免疫疗法的患者发放一份原创的自填式患者问卷。患者被随机分配到对照组、连续2个月每月接受一份教育资料的干预组,或与医生或执业护士进行一对一教育辅导的干预组。3个月后,所有患者完成一份相同的随访问卷。比较每组以及不同组之间的预测试和后测试分数,以确定哪种方法更有效。采用重复测量方差分析来确定指导类型对预测试和后测试分数差异的影响。
所有3组的平均问卷总分均有显著提高(P < .001)。干预组的分数变化量大于对照组,但未达到统计学显著性(P = .59)。
过敏疫苗接种患者的免疫疗法基线知识比预期更好,进一步的教育干预并未显著提高这一知识水平。