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“生活与呼吸”研究:一项关于患者对哮喘及其治疗看法的研究。

The Living & Breathing Study: a study of patients' views of asthma and its treatment.

作者信息

Haughney John, Barnes Greta, Partridge Martyn, Cleland Jennifer

机构信息

Department of General Practice and Primary Care, University of Aberdeen, Westburn Road, Aberdeen AB25 2AY, UK.

出版信息

Prim Care Respir J. 2004 Mar;13(1):28-35. doi: 10.1016/j.pcrj.2003.11.007.

Abstract

AIM

To evaluate patient understanding of their asthma and determine patient preferences regarding the delivery of asthma care and treatment.

METHODS

Adults with asthma receiving treatment for mild to moderate asthma were recruited to a two-part study: a qualitative phase using a semi-structured interview schedule followed by a quantitative phase based on a structured interview schedule. All interviews were undertaken face-to-face.

SETTING AND SUBJECTS

A random sample of 40 patients with mild to moderate asthma from seven areas of the UK took part in the qualitative phase of the study. In the quantitative phase, 517 patients on treatment for mild to moderate asthma were interviewed in person by market researchers. This population was achieved using a quota sampling approach that also achieved a representative demographic profile. Initial contact was made in door-to-door calls. Interviews took place in 64 locations across the UK.

RESULTS

Ninety-one percent (n=468) of respondents felt their asthma was under control, yet two-thirds (n=339) experienced symptoms at least 2-3 times a week. Only 24% (n=123) felt their asthma could improve over time, and 71% (n=366) received no advice from healthcare professionals on how their asthma might change in the future. Fourteen percent (n=74) of respondents had no ongoing contact with any healthcare professional regarding their asthma. Fifty-eight percent (n=301) were very satisfied with their asthma care, but this dropped to 33% (n=173) when respondents were shown asthma guidelines regarding what to expect from treatment. Sixty-two percent (n=318) of respondents said their asthma varied at different times of the day, and 86% (n=444) stated that their asthma varied at different times of the year. Eighty percent (n=414) of respondents had never been provided with a written, personal asthma action plan recommending changes patients could make themselves to prescribed treatment according to symptom severity, though 68% (n=353) said they would feel comfortable following such a plan.

CONCLUSIONS

Most patients have low expectations of what can be achieved by asthma management and do not realise their condition can be improved. Many are resigned to the effects of poor asthma control until made aware that guidelines indicate this can be better. Given that many are receptive to the notion of written, personal asthma action plans, the implementation of these, supported by appropriate education, could help patients achieve improved asthma control.

摘要

目的

评估患者对自身哮喘的了解程度,并确定患者在哮喘护理和治疗方式上的偏好。

方法

招募接受轻至中度哮喘治疗的成年患者参与一项分为两部分的研究:第一部分为定性阶段,采用半结构化访谈提纲;第二部分为定量阶段,基于结构化访谈提纲。所有访谈均为面对面进行。

背景与研究对象

从英国七个地区随机抽取40例轻至中度哮喘患者参与研究的定性阶段。在定量阶段,市场研究人员对517例接受轻至中度哮喘治疗的患者进行了面对面访谈。该样本通过配额抽样方法获得,具有代表性的人口统计学特征。最初通过挨家挨户上门拜访进行联系。访谈在英国64个地点进行。

结果

91%(n = 468)的受访者认为其哮喘得到了控制,但三分之二(n = 339)的受访者每周至少出现2 - 3次症状。只有24%(n = 123)的受访者认为其哮喘会随着时间改善,71%(n = 366)的受访者未从医疗保健专业人员处获得关于其哮喘未来可能如何变化的建议。14%(n = 74)的受访者在哮喘方面未与任何医疗保健专业人员保持持续联系。58%(n = 301)的受访者对其哮喘护理非常满意,但当向受访者展示哮喘治疗指南中关于治疗预期的内容后,这一比例降至33%(n = 173)。62%(n = 318)的受访者表示其哮喘在一天中的不同时间有所变化,86%(n = 444)的受访者表示其哮喘在一年中的不同时间有所变化。80%(n = 414)的受访者从未收到过一份书面的个人哮喘行动计划,该计划根据症状严重程度建议患者对规定治疗自行做出调整,不过68%(n = 353)的受访者表示他们会愿意遵循这样的计划。

结论

大多数患者对哮喘管理所能达到的效果期望较低,并未意识到其病情可以改善。许多人在未意识到指南表明病情可以得到更好控制之前,只能忍受哮喘控制不佳的影响。鉴于许多人接受书面个人哮喘行动计划的概念,在适当教育的支持下实施这些计划,可能有助于患者实现更好的哮喘控制。

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