Allergy & Respiratory Research Group, Centre for Population Health Sciences, The University of Edinburgh, Medical School, Edinburgh, UK.
Clin Exp Allergy. 2011 Jun;41(6):869-77. doi: 10.1111/j.1365-2222.2011.03743.x. Epub 2011 Apr 11.
Adolescents with severe allergies are at particular risk of severe and fatal anaphylactic reactions. Epinephrine (adrenaline) is known to be under-utilized by teenagers.
We sought to gain knowledge of adolescents' attitudes towards and experience of epinephrine auto-injectors in order to inform improvements in patient education.
A qualitative study of adolescents in Scotland, UK with a history of anaphylaxis and their parents. In-depth interviews explored adolescents' accounts of anaphylactic reactions, including issues related to using epinephrine auto-injectors. Focus groups with adolescents and parents were used to discuss interventions to improve adolescent self-management of anaphylaxis.
Twenty-six adolescents and 28 parents were interviewed. Eight adolescents and 10 parents participated in separate focus groups. Most adolescents had not used the auto-injector in an anaphylactic emergency. We identified multi-faceted barriers to use, including: failure to recognize anaphylaxis; uncertainty about auto-injector technique and when to administer it; fear of using the auto-injector. Most adolescents reported carrying auto-injectors some of the time, though several found this inconvenient due to the size; only one reported non-use of an auto-injector because it had not been carried.
Adolescents and parents reported under-use of epinephrine auto-injectors. Carriage is insufficient to ensure that auto-injectors are used. Barriers to use are multiple and complex, and unlikely to be overcome using simple educational interventions. Auto-injector training currently offered is often inadequate preparation for an emergency. A more comprehensive approach is needed, addressing the psychosocial dimensions of anaphylactic emergencies as well as treatment. Training should ideally be provided by specialist allergists or nurses, but can also be provided and reinforced in primary care.
患有严重过敏症的青少年有发生严重和致命过敏反应的特殊风险。已知肾上腺素（肾上腺素）在青少年中未得到充分利用。
我们旨在了解青少年对肾上腺素自动注射器的态度和使用经验，以便为改善患者教育提供信息。
对英国苏格兰有过敏反应史的青少年及其父母进行了一项定性研究。深入访谈探讨了青少年过敏反应的经历，包括与使用肾上腺素自动注射器相关的问题。使用青少年和父母的焦点小组讨论了改善青少年过敏自我管理的干预措施。
对 26 名青少年和 28 名父母进行了访谈。有 8 名青少年和 10 名父母参加了单独的焦点小组。大多数青少年在过敏紧急情况下没有使用自动注射器。我们发现使用存在多方面的障碍，包括：未能识别过敏反应；对自动注射器技术和何时使用存在不确定性；害怕使用自动注射器。大多数青少年报告有时携带自动注射器，但由于尺寸问题，有几个人觉得携带不方便；只有一名青少年报告未使用自动注射器，因为未携带。
青少年和家长报告说肾上腺素自动注射器使用不足。携带不足以确保自动注射器的使用。使用障碍是多方面且复杂的，并且不太可能通过简单的教育干预来克服。目前提供的自动注射器培训通常不能为紧急情况做好充分准备。需要采取更全面的方法，解决过敏反应紧急情况的心理社会方面以及治疗问题。培训最好由专科过敏症专家或护士提供，但也可以在初级保健中提供和加强培训。
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