Ducharme Francine M, Noya Francisco, McGillivray David, Resendes Sandy, Ducharme-Bénard Stéphanie, Zemek Roger, Bhogal Sanjit Kaur, Rouleau Rachel
Clinical Research on Chilhood Asthma,University of Montreal, Canada.
Can Respir J. 2008 Oct;15(7):347-54. doi: 10.1155/2008/353402.
Despite strong recommendations in the asthma guidelines, the use of written self-management plans remains low among asthmatic patients.
To develop a written self-management plan, based on scientific evidence and expert opinions, in a format intended to facilitate its dispensing by health care professionals, and to test the perception of its relevance and clarity by asthmatic children, adolescents and adults.
Inspired by previously tested self-management plans, surveys of asthma educators, expert opinions and the 2004 Canadian Asthma Guidelines, the authors simultaneously developed French and English versions of a written self-management plan that coupled with a prescription. The self-management plan was tested in parents and their asthmatic children (aged one to 17 years), and it was revised until 85% clarity and perceived relevance was achieved.
Ninety-seven children and their parents were interviewed. Twenty per cent had a self-management plan. On the final revision, nearly all items were clear and perceived relevant by 85% or more of the interviewees. Two self-management plans were designed for clinics and acute care settings, respectively. The plans are divided into three control zones identified by symptoms with optional peak flow values and symbolized by traffic light colours. They are designed in triplicate format with a prescription slip, a medical chart copy and a patient copy.
The written self-management plans, based on available scientific evidence and expert opinions, are clear and perceived to be relevant by children, adolescents and their parents. By incorporating the prescription and chart copies, they were designed to facilitate dispensing by physicians in both clinics and acute care settings.
尽管哮喘指南中有强烈建议,但哮喘患者中书面自我管理计划的使用仍然很少。
基于科学证据和专家意见制定一份书面自我管理计划,其格式旨在便于医护人员发放,并测试哮喘儿童、青少年和成人对其相关性和清晰度的认知。
受先前测试过的自我管理计划、对哮喘教育者的调查、专家意见以及《2004年加拿大哮喘指南》的启发,作者同时制定了一份与处方相结合的书面自我管理计划的法语和英语版本。该自我管理计划在父母及其哮喘儿童(1至17岁)中进行了测试,并不断修订,直到达到85%的清晰度和相关性认知。
对97名儿童及其父母进行了访谈。20%的人有自我管理计划。在最终修订版中,几乎所有项目对85%或更多的受访者来说都是清晰且被认为相关的。分别为诊所和急症护理环境设计了两种自我管理计划。这些计划分为三个由症状确定的控制区,有可选的峰值流量值,并以交通信号灯颜色表示。它们设计为一式三份,包括一张处方单、一份病历副本和一份患者副本。
基于现有科学证据和专家意见的书面自我管理计划清晰明了,儿童、青少年及其父母认为其具有相关性。通过纳入处方和病历副本,其设计便于医生在诊所和急症护理环境中发放。