Cotton Sian, Luberto Christina M, Yi Michael S, Tsevat Joel
Department of Family and Community Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0840, USA.
J Asthma. 2011 Jun;48(5):531-8. doi: 10.3109/02770903.2011.570406. Epub 2011 Apr 19.
BACKGROUND/PURPOSE: Up to 80% of adolescents with asthma have used complementary and alternative medicine (CAM) for symptom management. However, little is known about patient characteristics associated with CAM factors other than use. Previous studies recommend provider-patient discussion of CAM use, although few adolescents with asthma disclose their CAM use to their providers. To inform clinical interactions, this study examined prevalence and predictors of CAM use, consideration of use, disclosure of use, and perceived efficacy of use, in urban adolescents with asthma.
Adolescents with asthma (N = 151) recruited from a children's hospital completed questionnaires addressing demographic and clinical variables and 10 CAM modalities. Response frequencies to four questions assessing CAM use, consideration of use, disclosure, and perceived efficacy were calculated for each modality. Multivariable logistic regression analyses examined characteristics associated with responses to each question for the two most commonly used CAM modalities.
Participants' mean age was 15.8 (SD = 1.8), 60% were female and 85% were African-American. Seventy-one percent reported using CAM for symptom management in the past month. Relaxation (64%) and prayer (61%) were the most frequently reported modalities and were perceived to be the most efficacious. Adolescents most commonly reported considering using relaxation (85%) and prayer (80%) for future symptom management. Participants were most likely to disclose their use of yoga (59%) and diet (57%), and least likely to disclose prayer (33%) and guided imagery (36%) to providers. In multivariable analyses, older adolescents (OR = 1.27, p < .05) and African-Americans (OR = 2.76, p < .05) were more likely to use relaxation. Adolescents with more frequent asthma symptoms (OR = 0.98, p < .05) were more likely to use prayer. African-Americans were more likely to report using prayer (OR = 3.47, p < .05) and consider using prayer (OR = 7.98, p < .01) in the future for symptom management.
Many urban adolescents used and would consider using CAM, specifically relaxation and prayer, for asthma symptom management. African-Americans, older adolescents, and those with more frequent symptoms were more likely to use and/or consider using CAM. Providers caring for urban adolescents with asthma should discuss CAM with patients, particularly those identified as likely to use CAM. Future studies should examine relationships between CAM use and health outcomes.
背景/目的:高达80%的哮喘青少年使用过补充和替代医学(CAM)来管理症状。然而,除了使用情况外,对于与CAM因素相关的患者特征知之甚少。先前的研究建议医生与患者讨论CAM的使用情况,尽管很少有哮喘青少年会向医生透露他们使用CAM的情况。为了指导临床互动,本研究调查了城市哮喘青少年中CAM的使用情况、使用考虑因素、使用披露情况以及使用的感知疗效的患病率和预测因素。
从一家儿童医院招募的151名哮喘青少年完成了关于人口统计学和临床变量以及10种CAM方式的问卷。计算了每种方式对评估CAM使用、使用考虑因素、披露情况和感知疗效的四个问题的回答频率。多变量逻辑回归分析研究了与两种最常用CAM方式的每个问题回答相关的特征。
参与者的平均年龄为15.8岁(标准差=1.8),60%为女性,85%为非裔美国人。71%的人报告在过去一个月使用CAM来管理症状。放松(64%)和祈祷(61%)是报告频率最高的方式,并且被认为是最有效的。青少年最常报告考虑在未来症状管理中使用放松(85%)和祈祷(80%)。参与者最有可能向医生披露他们使用瑜伽(59%)和饮食(57%)的情况,而最不可能披露祈祷(33%)和引导意象(36%)的情况。在多变量分析中,年龄较大的青少年(比值比=1.27,p<.05)和非裔美国人(比值比=2.76,p<.05)更有可能使用放松。哮喘症状更频繁的青少年(比值比=0.98,p<.05)更有可能使用祈祷。非裔美国人更有可能报告使用祈祷(比值比=3.47,p<.05)并考虑在未来症状管理中使用祈祷(比值比=7.98,p<.01)。
许多城市哮喘青少年使用并会考虑使用CAM,特别是放松和祈祷,来管理哮喘症状。非裔美国人、年龄较大的青少年以及症状更频繁的青少年更有可能使用和/或考虑使用CAM。照顾城市哮喘青少年的医生应该与患者讨论CAM,特别是那些被确定可能使用CAM的患者。未来的研究应该检查CAM使用与健康结果之间的关系。