Nursing Service, Tan Tock Seng Hospital, Jalan Tan Tock Seng, Singapore.
Ann Acad Med Singap. 2009 Dec;38(12):1064-9.
The Asthma Control Test (ACT) is a 5-item self-administered tool designed to assess asthma control. It is said to be simple, easy and can be administered quickly by patients in the clinical practice setting. This stated benefit has yet to be demonstrated in our local clinical practice setting. The aim was to identify factors associated with difficulty in the administration of the ACT in different clinical practice settings in a tertiary hospital in Singapore.
This is a prospective study performed from April to June 2008. All patients diagnosed with asthma and referred to an asthma nurse from the in-patient and out-patient clinical practice setting in Tan Tock Seng Hospital were enrolled.
Four hundred and thirty-four patients were asked to complete the ACT tool. In the univariate model, we found that age, clinical setting and medical history to be significantly associated with the completion of the ACT. The odds of completion decreased by a factor of 0.92 (95% CI, 0.89 to 0.94) for every year's increase in age, and this was statistically significant (P <0.001). Similarly, the odds ratio of completion for those with more than 3 medical conditions by history were 0.59 (95% CI, 0.48 to 0.71) as compared to those with less than 3 medical conditions by history, and this was also significant (P <0.001). In the multivariate model, we only found age to be an independent and significant factor. After adjusting for age, none of the other variables initially significant in the univariate model remained significant.
The results show that the ACT was simple and easy to be administered in younger-aged patients.
哮喘控制测试(ACT)是一种 5 项自评工具,旨在评估哮喘控制情况。据称,该测试简单易用,患者在临床实践环境中可自行快速完成。然而,这一优势尚未在我们当地的临床实践环境中得到证实。本研究旨在确定在新加坡一家三级医院的不同临床实践环境中,影响 ACT 实施难度的相关因素。
这是一项 2008 年 4 月至 6 月期间进行的前瞻性研究。所有被诊断为哮喘并从住院和门诊临床实践环境转介至哮喘护士的患者均被纳入研究。
共有 434 名患者被要求完成 ACT 工具。在单变量模型中,我们发现年龄、临床环境和病史与完成 ACT 显著相关。年龄每增加 1 岁,完成 ACT 的几率就会降低 0.92 倍(95%置信区间,0.89 至 0.94),这具有统计学意义(P<0.001)。同样,与病史记录少于 3 种疾病的患者相比,病史记录超过 3 种疾病的患者完成 ACT 的几率为 0.59(95%置信区间,0.48 至 0.71),这也具有统计学意义(P<0.001)。在多变量模型中,我们仅发现年龄是一个独立且显著的因素。在调整年龄后,原本在单变量模型中具有显著意义的其他变量均不再具有显著意义。
研究结果表明,ACT 对于年轻患者来说简单易用。