Department of Otorhinolaryngology, Freeman Hospital, Newcastle upon Tyne, UK.
Rhinology. 2011 Oct;49(4):387-91. doi: 10.4193/Rhino11.055.
No study to date has looked at the symptoms of chronic catarrh as defined by the patients themselves. We looked to explore the catarrh experience through the eyes of patients using a qualitative approach.
METHODOLOGY/PRINCIPAL: Forty-eight patients referred to Secondary Care with chronic catarrh, postnasal drip or persistent throat clearing completed an open-ended questionnaire from which a comprehensive symptom list was generated. Nineteen of these patients undertook semi-structured interviews to explore symptomatic themes relating to their catarrh using grounded theory analysis.
A standardised list of 38 catarrh-related symptoms was generated covering a wide topography. A common theme amongst interviewees was the frustration of being unable to expectorate mucus rather than expelling too much.
Difficulties exist in establishing whether the extensive list of symptoms associated with catarrh is a result of differing experiences for patients or simply differing lexicon describing the same experience. Many of these symptoms are not included in the most commonly used nose/throat symptom instruments. Furthermore a distinction should be made between patients with true rhinitis who expel mucus and those who present with apparent postnasal drip or throat clearing but who cannot expectorate, whose management ought be focused more on symptom-coping strategies rather than medication or investigation.
目前尚无研究着眼于患者自身定义的慢性卡他症状。我们试图通过定性方法从患者的角度探索卡他体验。
方法/原理:48 名因慢性卡他、鼻后滴注或持续清喉而被转介至二级护理的患者填写了一份开放式问卷,从中生成了一份全面的症状清单。其中 19 名患者接受了半结构化访谈,使用扎根理论分析来探讨与他们的卡他有关的症状主题。
生成了一份标准化的 38 项与卡他相关的症状清单,涵盖了广泛的解剖部位。受访者的一个共同主题是无法咳出黏液而感到沮丧,而不是咳出过多的黏液。
目前尚不清楚与卡他相关的广泛症状列表是由于患者的不同体验还是仅仅是描述相同体验的不同词汇造成的。这些症状中有许多并不包括在最常用的鼻部/喉部症状量表中。此外,应该在真正有黏液排出的鼻炎患者和表现为明显鼻后滴注或清喉但无法咳出黏液的患者之间做出区分,后者的治疗重点应该更多地放在症状应对策略上,而不是药物治疗或检查上。