Prabhakaran L, Lim G, Abisheganaden J, Chee C B E, Choo Y M
Department of Nursing, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433.
Singapore Med J. 2006 Mar;47(3):225-31.
We conducted a study to assess the impact of an asthma education programme (AEP) on knowledge of asthma and medication, compliance to treatment and inhaler technique, emergency department visits and hospital re-admissions.
Patients hospitalised for asthma exacerbation were administered a questionnaire to test their baseline knowledge and beliefs on asthma, its medications and their compliance to treatment. Their inhaler technique was assessed. They then underwent an AEP consisting of two individualised education sessions. Re-testing was performed after three months. Per protocol approach and McNemar's test was used to analyse the statistical significance of the change in the pre- and post-AEP test scores. Hospital administrative data were used to determine the number of ED visits and hospital admissions pre- and post-AEP.
Among the 67 patients who completed the two-phase AEP, there was significant improvement in some knowledge aspects (ability to identify rescue medication [p-value is 0.031], that different stimuli can trigger asthma symptoms [p-value is 0.016], that a peak flow meter is used for monitoring asthma [p-value is 0.004], that asthma symptoms are caused by airway swelling/narrowing [p-value is less than 0.001], that steroid inhaler are to be used daily as preventive therapy [p-value is less than 0.001], in self-reported inhaler compliance (number of puffs per administration [p-value is less than 0.001] and per day [p-value is less than 0.001]), and in inhaler technique [p-value is 0.001]. There was also significant reduction in emergency department attendances (p-value is less than 0.001) and hospital admissions (p-value is less than 0.001) among all 97 subjects over a one-year period.
This study demonstrated the effectiveness of an AEP in patients hospitalised for asthma exacerbation.
我们开展了一项研究，以评估哮喘教育项目（AEP）对哮喘及药物知识、治疗依从性和吸入器使用技术、急诊科就诊次数及医院再入院情况的影响。
对因哮喘急性加重而住院的患者进行问卷调查，以测试他们对哮喘、其药物治疗以及治疗依从性的基线知识和信念。评估他们的吸入器使用技术。然后，他们接受了由两次个性化教育课程组成的AEP。三个月后进行重新测试。采用按方案分析方法和 McNemar 检验来分析AEP前后测试分数变化的统计学意义。利用医院行政数据确定AEP前后的急诊科就诊次数和住院人数。
在完成两阶段AEP的67名患者中，某些知识方面有显著改善（识别急救药物的能力[p值为0.031]、不同刺激可引发哮喘症状[p值为0.016]、使用峰值流量计监测哮喘[p值为0.004]、哮喘症状由气道肿胀/狭窄引起[p值小于0.001]、每日使用类固醇吸入器作为预防性治疗[p值小于0.001]），自我报告的吸入器依从性（每次给药的喷数[p值小于0.001]和每天的喷数[p值小于0.001]）以及吸入器使用技术[p值为0.001]。在所有97名受试者中，一年期间急诊科就诊次数（p值小于0.001）和住院人数也显著减少（p值小于0.001）。
本研究证明了AEP对因哮喘急性加重而住院的患者有效。
