Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden.
Acta Paediatr. 2009 Dec;98(12):1939-44. doi: 10.1111/j.1651-2227.2009.01477.x. Epub 2009 Aug 18.
In a randomized controlled study involving 60 preschool children with asthma, an intervention with extra information and support to parents in the form of group discussions was performed. An earlier follow-up after 18 months revealed an improved adherence and a reduction of exacerbation days. This is a 6-year follow-up.
Fifty-four children performed clinical examinations, blood tests, measurements of exhaled nitric oxide, spirometry, bronchial provocation with dry air and skin prick tests. Data from the patients' records and questionnaires were obtained.
Twenty-nine per cent had no current signs of asthma, whereas 43% exhibited persistent and 28% intermittent asthma. The burden on the healthcare system was minimal. Intermittent inhaled corticosteroid (ICS) therapy was used by 81%. The intervention group (IG) had fewer contacts with nurses. Their parents had a better quality of life. Interviewing children separately contributed in identification of children needing treatment. More children in the IG had to restart ICS as they had signs of worse asthma control.
Straightforward and timely support to parents of children with asthma can have long-term positive effects by strengthening the ability of parents to treat their children at home, although parents may also develop an underestimation of mild symptoms. It is important to directly ask children about their disease and to maintain regular follow-up visits.
在一项涉及 60 名患有哮喘的学龄前儿童的随机对照研究中，对父母进行了额外信息和支持的干预，形式为小组讨论。18 个月后的早期随访显示，依从性提高，加重天数减少。这是一项 6 年的随访。
54 名儿童进行了临床检查、血液检查、呼气一氧化氮测量、肺活量测定、干空气支气管激发试验和皮肤点刺试验。从患者记录和问卷中获取数据。
29%的儿童目前没有哮喘迹象，43%的儿童持续存在哮喘，28%的儿童间歇性哮喘。对医疗系统的负担最小。81%的儿童间歇性吸入皮质类固醇（ICS）治疗。干预组（IG）与护士的接触较少。他们的父母生活质量更好。对儿童进行单独访谈有助于发现需要治疗的儿童。IG 中有更多的儿童需要重新开始 ICS 治疗，因为他们的哮喘控制情况恶化。
通过加强父母在家中治疗孩子的能力，为哮喘儿童的父母提供简单及时的支持，可以产生长期的积极影响，尽管父母可能也会对轻微症状产生低估。直接询问儿童有关他们疾病的情况并保持定期随访非常重要。
