Moseley Kathryn L, Hudson Ericka J
Child Health Evaluation and Research Unit, Division of General Pediatrics, University of Michigan Medical School, Ann Arbor 48109, USA.
J Natl Med Assoc. 2009 May;101(5):407-13. doi: 10.1016/s0027-9684(15)30914-7.
Steroid inhaler adherence and influenza immunization rates are low for asthmatic minority children.
To examine associations between parents' adherence to administering their child's steroid inhaler, influenza vaccine receipt, and parental perceptions of the primary care experience.
In 2006 we interviewed parents of children aged 2-12 who had an asthma-related physician visit in 2004 and 2005 about steroid inhaler use and influenza vaccine receipt. Parents rated their child's doctor using the Primary Care Assessment Survey (PCAS).
Outcome variables were inhaler adherence and influenza vaccine receipt. Independent variables included PCAS scores, child health measures, parental personal and financial stress, and demographic variables.
Children of inhaler-adherent parents were more likely to be immunized (OR, 2.94; p = .03). Black parents were less adherent to steroid use (OR, 0.37, p = .01) while nonblack/nonwhite children had lower vaccination rates (OR, 0.29, p = .02). Continuity of care was associated with better inhaler adherence (OR, 1.02, p = .01). Influenza immunization was associated with physician's knowledge of the child's medical history (OR, 1.02, p = .05), interpersonal skills (OR, 1.02, p = .03), and parental trust in the physician (OR, 1.03, p = .02). Minority parents gave lower ratings than white parents to their child's physician and office on characteristics associated with inhaler adherence and immunization.
Minority parents of asthmatic children are less adherent to recommended asthma treatments and rate physicians lower on characteristics associated with adherence. Improving those characteristics may improve asthma outcomes for minority children.
哮喘病少数族裔儿童使用类固醇吸入器的依从性和流感疫苗接种率较低。
研究父母对孩子使用类固醇吸入器的依从性、流感疫苗接种情况以及父母对初级保健体验的看法之间的关联。
2006年，我们采访了2004年和2005年因哮喘相关问题就诊的2至12岁儿童的父母，了解他们孩子使用类固醇吸入器和接种流感疫苗的情况。父母使用初级保健评估调查（PCAS）对孩子的医生进行评分。
结果变量为吸入器依从性和流感疫苗接种情况。自变量包括PCAS评分、儿童健康指标、父母个人和经济压力以及人口统计学变量。
使用吸入器依从性好的父母的孩子更有可能接种疫苗（比值比，2.94；p = 0.03）。黑人父母使用类固醇的依从性较低（比值比，0.37，p = 0.01），而非黑人/非白人儿童的疫苗接种率较低（比值比，0.29，p = 0.02）。连续护理与更好的吸入器依从性相关（比值比，1.02，p = 0.01）。流感疫苗接种与医生对孩子病史的了解（比值比，1.02，p = 0.05）、人际交往能力（比值比，1.02，p = 0.03）以及父母对医生的信任（比值比, 1.03, p = 0.02）有关。少数族裔父母对孩子医生和诊所与吸入器依从性和疫苗接种相关特征的评分低于白人父母。
哮喘病少数族裔儿童的父母对推荐的哮喘治疗方法依从性较低，并且在与依从性相关的特征方面对医生的评分较低。改善这些特征可能会改善少数族裔儿童的哮喘治疗效果。
