Medical Psychology, Leiden University Medical Center (LUMC), Leiden, The Netherlands. a.a.kaptein@ lumc.nl
Curr Opin Allergy Clin Immunol. 2010 Jun;10(3):194-9. doi: 10.1097/ACI.0b013e32833950c1.
Outcome in asthma is determined not only by pulmonary function or other biomedical characteristics. An important determinant of asthma outcome is illness perceptions: patients' subjective beliefs and emotional responses to their illness. Illness perceptions influence patients' coping and self-management behavior, and thereby outcome.
We review recent studies on associations between illness perceptions and outcome in patients with asthma, with a range of respondents and caregivers, with varying degree of asthma severity, and in different settings of medical care. Most studies pertain to substantial numbers of patients, and have been performed in different countries, adding to the external validity of the findings. All studies report substantial effects of illness perceptions on various categories of outcome: illness perceptions reflecting personal control over the illness are associated with a positive outcome, that is, asthma control. Findings point at the importance and clinical relevance of addressing patients' illness perceptions, and suggest that this may improve outcome in asthma care. Well conducted intervention studies on this topic are called for in order to improve outcomes and quality of life in asthma patients.
Illness perceptions influence the way in which patients with asthma cope and their self-management of the illness. Illness perceptions can be assessed quite easily and directly, they inform healthcare providers about the psychosocial responses of patients towards their asthma, they are responsive to change in the clinical encounter or via self-management intervention training. Exploring patient's illness perceptions, therefore, is a crucial component of good clinical care.
哮喘的预后不仅取决于肺功能或其他生物医学特征。哮喘预后的一个重要决定因素是疾病认知：患者对自身疾病的主观信念和情绪反应。疾病认知影响患者的应对和自我管理行为，从而影响预后。
我们回顾了最近关于哮喘患者疾病认知与预后之间关系的研究，研究对象包括不同程度哮喘严重程度的患者和照顾者，以及不同医疗环境下的患者。大多数研究涉及大量患者，且在不同国家进行，增加了研究结果的外部有效性。所有研究都报告了疾病认知对各种预后类别的显著影响：反映患者对疾病的个人控制感的疾病认知与积极的预后（即哮喘控制）相关。这些发现表明关注患者的疾病认知的重要性和临床相关性，并提示这可能改善哮喘护理的预后。因此，需要开展关于该主题的精心设计的干预研究，以改善哮喘患者的预后和生活质量。
哮喘患者的疾病认知影响其应对方式和疾病自我管理。疾病认知可以相当容易和直接地进行评估，它使医疗保健提供者了解患者对哮喘的心理社会反应，并且对临床接触或通过自我管理干预培训中的变化有反应。因此，探讨患者的疾病认知是良好临床护理的关键组成部分。
