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[评估教育/信息干预对特应性皮炎患者(CUIDA-DEL)情绪状态(焦虑)影响的观察性研究]

[Observational study to evaluate the impact of an educational/informative intervention in the emotional status (anxiety) of patients with atopic dermatitis (CUIDA-DEL)].

作者信息

Guerra-Tapia A, Lleonart M, Balañá M

机构信息

Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España.

出版信息

Actas Dermosifiliogr. 2007 May;98(4):250-8.

Abstract

INTRODUCTION

One of the first therapeutic measures in atopic dermatitis should be the educational and informative approach about prophylactic aspects and evolution of the disease. This type of proceedings has been shown to be beneficial for the anxious type of emotional status in patients with atopic dermatitis. We evaluated the impact of an educational/informative intervention in the emotional status (anxiety) of patients with atopic dermatitis in Spain.

MATERIAL AND METHODS

Investigators were randomized into two study groups: the control group (CG) that followed current clinical practice and the intervention group (IG) that handed patients, in each visit, a booklet of information about different prophylactic aspects and care of atopic dermatitis. The duration of the study was 6 months with quarterly visits. All included patients had a diagnosis of atopic dermatitis. Anxiety was evaluated with the STAI anxiety questionnaire and clinical data regarding dermatological aspects (IGA, pruritus scale, location of the lesions) were also recorded.

RESULTS

A total of 1,247 patients were recruited thanks to the collaboration of 158 investigators. Patients were distributed as follows: 683 (54.7 %) in the CG and 564 (45.2 %) in the IG. Both group were homogeneous with respect to basal characteristics, and were constituted by 54 % of women with a mean age of 19 years. Eighty-six percent of atopic dermatitis lesions were preferentially located in extremities. Patients of both study groups showed improvement in their emotional status (trait and state anxiety) throughout the study with significant decreases in the STAI scores compared to basal ones. Regarding improvement in the questionnaire scores, no significant differences were observed between groups except in children aged 9 to 15 years, in the pediatric version of the STAI trait where the percentage of score decrease at 6 months adjusted to the basal score was 5.5 (19.0) for the CG and 10.6 (18.9) for the IG, (p < 0.05). A higher percentage of patients finished the study in the IG compared to the CG (83.1 % vs. 76.1 % p < 0.005).

DISCUSSION AND CONCLUSIONS

Although patients in the IG showed greater compliance with the follow-up of the study, the informative intervention about prophylactic aspects of atopic dermatitis designed in this study does not appear to have had an impact in improving the emotional status of adult patients.

摘要

引言

特应性皮炎的首要治疗措施之一应是就该疾病的预防方面和病情发展进行教育和提供信息。已证明这种做法对特应性皮炎患者焦虑型情绪状态有益。我们评估了一项教育/信息干预对西班牙特应性皮炎患者情绪状态(焦虑)的影响。

材料与方法

研究人员被随机分为两个研究组:遵循当前临床实践的对照组(CG)和每次就诊时向患者发放一本关于特应性皮炎不同预防方面和护理信息手册的干预组(IG)。研究持续时间为6个月,每季度就诊一次。所有纳入患者均诊断为特应性皮炎。使用状态-特质焦虑问卷评估焦虑情况,并记录有关皮肤病学方面的临床数据(特应性皮炎严重程度指数、瘙痒量表、皮损部位)。

结果

得益于158名研究人员的合作,共招募了1247名患者。患者分布如下:CG组683例(54.7%),IG组564例(45.2%)。两组在基础特征方面具有同质性,均由54%的女性组成,平均年龄为19岁。86%的特应性皮炎皮损优先位于四肢。两个研究组的患者在整个研究过程中情绪状态(特质和状态焦虑)均有改善,与基础状态相比,状态-特质焦虑问卷得分显著降低。关于问卷得分的改善情况,除了9至15岁儿童在特质焦虑问卷儿童版中,CG组6个月时相对于基础得分的得分降低百分比为5.5(19.0),IG组为10.6(18.9)(p<0.05)外,两组之间未观察到显著差异。与CG组相比,IG组完成研究的患者百分比更高(83.1%对76.1%,p<0.005)。

讨论与结论

尽管IG组患者对研究随访的依从性更高,但本研究中设计的关于特应性皮炎预防方面的信息干预似乎并未对改善成年患者的情绪状态产生影响。

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