Holt Shaun, Masoli Matthew, Beasley Richard
P3Research, Wellington, New Zealand.
Prim Care Respir J. 2004 Mar;13(1):19-27. doi: 10.1016/j.pcrj.2003.11.001.
The development of self-management plans arose as clinicians tried to design better methods by which they could deliver asthma care and reduce the significant mortality and morbidity associated with this disease. The basic principles that resulted have been widely endorsed, and self-management plans are now recommended in the long-term management of adult asthma. Self-management plans essentially focus on the early recognition of unstable or deteriorating asthma, by monitoring peak flow or symptoms. Through the use of written guidelines, patients are then able to determine when it is necessary to adjust therapy or obtain medical assistance. There is now convincing evidence that the use of self-management plans by patients with asthma leads to a marked reduction in morbidity and a reduced requirement for acute medical treatment including hospital admissions. Recent research has also clarified many of the different issues concerning their structure and implementation. In some respects the skill in the use of the asthma self-management plan system of care is the ability to modify the standard plans to meet the particular needs of the individual asthmatic patient, including their preferences.
自我管理计划的发展源于临床医生试图设计出更好的方法，以便他们能够提供哮喘护理，并降低与该疾病相关的显著死亡率和发病率。由此产生的基本原则已得到广泛认可，自我管理计划现在被推荐用于成人哮喘的长期管理。自我管理计划主要通过监测呼气峰流速或症状来关注哮喘不稳定或恶化的早期识别。通过使用书面指南，患者能够确定何时需要调整治疗或寻求医疗帮助。现在有令人信服的证据表明，哮喘患者使用自我管理计划可显著降低发病率，并减少包括住院在内的急性医疗需求。最近的研究也阐明了许多关于其结构和实施的不同问题。在某些方面，使用哮喘自我管理计划护理系统的技巧在于能够修改标准计划，以满足个体哮喘患者的特殊需求，包括他们的偏好。
