Huang Tzu-Ting, Li Yu-Tsui, Wang Chun-Hua
School of Nursing, Chang-Gung University, Taoyuan, Taiwan.
J Adv Nurs. 2009 Feb;65(2):348-58. doi: 10.1111/j.1365-2648.2008.04874.x. Epub 2008 Nov 27.
This paper is a report of a trial to examine the effectiveness of individualized self-care education programmes in older adults with moderate-to-severe asthma.
Asthma is a common chronic disease in adults and a major cause of frequent work absences, emergency room visits, and hospitalization. The results of studies of self-care education programmes have been largely supportive and suggest that they have positive outcomes for people with asthma. However, for older people with asthma, the effectiveness of computer-aided, self-learning video programmes has been controversial.
Older adult patients with asthma (N = 148) were randomly assigned to one of three groups: usual care, individualized education, or individualized education with peak flow monitoring, and followed for 6 months. Data were collected from January to December 2006. The variables studied included demographic data, asthma self-care competence, asthma self-efficacy, and asthma self-care behaviour. FINDINGS. Patients in both individualized education groups reported higher asthma self-care competence scores (F = 334.06 and 481.37, P < 0.001) and asthma self-care and self-efficacy scores (F = 104.08 and 68.42, P < 0.001) than patients in the usual care group. In addition, patients who received individualized education with peak flow monitoring had statistically significantly higher asthma self-care behaviour and self-efficacy scores (P < 0.001) and asthma control indicators (P = 0.025) than the education alone group. No differences were found among the three groups in unscheduled health service usage.
Our results suggest that individualized education helps older people with asthma to enhance their self-care behaviours, manage their disease, and increase their quality of life.
本文是一项关于个体化自我护理教育计划对中重度哮喘老年患者有效性的试验报告。
哮喘是成人常见的慢性疾病，也是导致频繁旷工、急诊就诊和住院的主要原因。自我护理教育计划的研究结果大多具有支持性，表明其对哮喘患者有积极效果。然而，对于老年哮喘患者，计算机辅助的自学视频计划的有效性一直存在争议。
将148例老年哮喘患者随机分为三组：常规护理组、个体化教育组或个体化教育加峰流速监测组，并随访6个月。数据收集时间为2006年1月至12月。研究变量包括人口统计学数据、哮喘自我护理能力、哮喘自我效能感和哮喘自我护理行为。结果：两个个体化教育组的患者报告的哮喘自我护理能力得分（F = 334.06和481.37，P < 0.001）、哮喘自我护理和自我效能感得分（F = 104.08和68.42，P < 0.001）均高于常规护理组患者。此外，接受个体化教育加峰流速监测的患者在哮喘自我护理行为和自我效能感得分（P < 0.001）以及哮喘控制指标（P = 0.025）方面显著高于单纯教育组。三组在非计划卫生服务使用方面未发现差异。
我们的结果表明，个体化教育有助于老年哮喘患者增强自我护理行为、管理疾病并提高生活质量。
