Departamento de Psicología Clínica y Psicobiología, Facultad de Psicología, Universidad de Santiago de Compostela, Santiago de Compostela, Spain.
J Psychosom Res. 2010 Feb;68(2):175-81. doi: 10.1016/j.jpsychores.2009.04.012. Epub 2009 Jun 27.
Several studies that have analyzed differences in psychological and self-management variables between patients with a near-fatal asthma (NFA) attack and asthmatics without a NFA attack (non-NFA) have shown conflicting results, probably due to the heterogeneity of the events studied and the selection of comparison groups.
To determine whether NFA patients, in stable situation, have greater psychological morbidity and worse self-management behavior than non-NFA patients with similar sociodemographic and clinical characteristics.
A sample of 44 NFA patients (mean=5.65 years after the NFA episode) and 44 non-NFA patients matched for age, sex, and asthma severity was assessed. All patients were in clinical stable situation. Information about sociodemographic, clinical, functional, and morbidity variables was collected for each patient, and the Cognitive Depression Inventory, the Trait-Anxiety Scale, the Toronto Alexithymia Scale, the Practical Knowledge of Self-management questionnaire, and the Medication Adherence scale were administered.
In comparison with non-NFA patients, NFA patients showed higher levels of trait-anxiety (23.84 vs. 16.86; P=.001) and more difficulties describing and communicating feelings (11.36 vs. 8.90; P=.002). NFA and non-NFA patients did not differ in self-management variables. After adjustment in multivariate logistic regression analysis for age, sex, and asthma severity, significant differences were observed between NFA and control group patients in marital status [odds ratio (OR)=0.26; P=.017; 95% confidence interval (CI)=0.09-0.78], prescribed dose of inhaled corticoids (OR=4.48; P=.006;95% CI=1.53-13.09), and trait-anxiety (OR=1.071;P=.025;95%CI=1.01-1.14).
NFA patients show higher psychological morbidity than non-NFA, even years after the NFA episode.
多项分析有濒死性哮喘（near-fatal asthma，NFA）发作和无 NFA 发作哮喘患者心理和自我管理变量差异的研究结果存在矛盾，这可能是由于所研究事件的异质性和对照组的选择不同所致。
确定在稳定状态下，NFA 患者是否比具有相似社会人口统计学和临床特征的非 NFA 患者有更大的心理病态和更差的自我管理行为。
对 44 名 NFA 患者（NFA 发作后平均 5.65 年）和 44 名非 NFA 患者进行了样本匹配，比较了年龄、性别和哮喘严重程度。所有患者均处于临床稳定状态。收集每位患者的社会人口学、临床、功能和发病变量信息，并进行认知抑郁量表、特质焦虑量表、多伦多述情障碍量表、自我管理实用知识问卷和药物依从性量表评估。
与非 NFA 患者相比，NFA 患者表现出更高的特质焦虑（23.84 比 16.86；P=.001）和更难以描述和表达情感（11.36 比 8.90；P=.002）。NFA 和非 NFA 患者在自我管理变量方面没有差异。在多元逻辑回归分析中，调整年龄、性别和哮喘严重程度后，NFA 组和对照组患者在婚姻状况[比值比（odds ratio，OR）=0.26；P=.017；95%置信区间（confidence interval，CI）=0.09-0.78]、吸入皮质激素的处方剂量（OR=4.48；P=.006；95%CI=1.53-13.09）和特质焦虑（OR=1.071；P=.025；95%CI=1.01-1.14）方面存在显著差异。
即使在 NFA 发作多年后，NFA 患者的心理病态也高于非 NFA 患者。
