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使用肾上腺素自动注射器获得技能的真实研究。

A real-life study on acquired skills from using an adrenaline autoinjector.

机构信息

Department of Pediatric Allergy and Asthma, Gazi University Faculty of Medicine, Ankara, Turkey. erdemtopal44 @ gmail.com

出版信息

Int Arch Allergy Immunol. 2013;160(3):301-6. doi: 10.1159/000341367. Epub 2012 Oct 18.

Abstract

BACKGROUND

Training programs performed by allergists have increased the ability of patients' recognition and management of anaphylaxis. We aim to investigate the permanence of effect of an anaphylaxis training program and to determine the factors affecting it beyond training given by allergists.

METHODS

Children and/or their caregivers who had been prescribed an adrenaline autoinjector at least 1 year before were invited to take part in the study. The knowledge about anaphylaxis was assessed using a questionnaire and the skills were practically tested.

RESULTS

Sixty-four (50 caregivers/14 children >12 years of age) of 80 patients who accepted the invitation were included in the study. Fifty-nine patients obtained the autoinjector after initial prescription. Among them, 42 (71%) still had the device at the time of the study. The most common reason for not having the autoinjector was no longer feeling it was necessary (54.6%). Of the cases, 39.4% were competent in autoinjector use. There was a significant relation between adrenaline autoinjector competency and regular allergy visits (p = 0.010), believing that it is necessary (p = 0.04), having an adrenaline autoinjector (p = 0.003), and previous history of severe anaphylaxis (p = 0.010). Autoinjector competency score decreased as time elapsed from the last visit (rho = -0.382; p = 0.002) and the first instruction (rho = -0.317; p = 0.01). Regular visits (p = 0.009) and history of severe anaphylaxis (p = 0.007) were found as independent factors having an effect on adrenaline autoinjector competency.

CONCLUSIONS

Training of patients/caregivers by allergists does not guarantee the permanence of acquired skills on anaphylaxis in the long run. Regular follow-up visits should be fostered.

摘要

背景

过敏专科医生开展的培训项目提高了患者对过敏反应的识别和管理能力。我们旨在研究过敏反应培训项目的效果持久性,并确定除过敏专科医生提供的培训外,还有哪些因素会影响培训效果。

方法

我们邀请了至少在 1 年前被处方肾上腺素自动注射器的儿童及其照护者参加研究。通过问卷调查评估过敏反应知识,并用实际操作测试技能。

结果

在 80 名接受邀请的患者中,有 64 名(50 名照护者/14 名年龄>12 岁的儿童)参加了研究。59 名患者在最初处方后获得了自动注射器。其中,42 名(71%)在研究时仍有该设备。不再觉得需要(54.6%)是不再拥有自动注射器的最常见原因。在这些病例中,39.4%的患者能够正确使用自动注射器。肾上腺素自动注射器使用能力与定期过敏就诊(p = 0.010)、认为有必要(p = 0.04)、拥有肾上腺素自动注射器(p = 0.003)和有严重过敏反应史(p = 0.010)之间存在显著关系。自上次就诊(rho = -0.382;p = 0.002)和第一次指导(rho = -0.317;p = 0.01)以来,自动注射器使用能力评分随时间的推移而下降。定期就诊(p = 0.009)和严重过敏反应史(p = 0.007)被认为是影响肾上腺素自动注射器使用能力的独立因素。

结论

过敏专科医生对患者/照护者的培训并不能保证长期内获得的过敏反应技能的持久性。应鼓励定期随访。

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