Correia de Sousa Jaime, Pina Alexandra, Cruz Ana Margarida, Quelhas Ana, Almada-Lobo Filipa, Cabrita Joana, Oliveira Pedro, Yaphe John
Life and Health Sciences Research Institute, ICVS, School of Health Sciences, University of Minho, Braga and ICVS-3Bs, PT Government Associate Laboratory, Braga, Guimarães, Portugal.
Prim Care Respir J. 2013 Jun;22(2):181-7. doi: 10.4104/pcrj.2013.00037.
Self-assessment of asthma and a stronger doctor-patient relationship can improve asthma outcomes. Evidence for the influence of patient enablement on quality of life and the control of asthma is lacking.
To assess asthma severity, medication use, asthma control, and patient enablement in patients with asthma treated in primary care and to study the relationship between these variables and quality of life.
A cross-sectional study was conducted in an urban clinic in northern Portugal. Data were collected from both clinical records and questionnaires from a random sample of asthma patients. The modified Patient Enablement Instrument, the Asthma Quality of Life Questionnaire, and the Asthma Control Questionnaire were used. Peak expiratory flow and forced expiratory volume in one second (FEV1) were measured. Receiver operating characteristic curve analysis was performed to establish cut-off values for the quality of life measurements. The associations between enablement, asthma control, and quality of life were tested using logistic regression models.
The study sample included 180 patients. There was a strong correlation between asthma control and quality of life (r=0.81, p<0.001). A weak association between patient enablement and asthma control and quality of life was found in the logistic regression models. Poor control of asthma was associated with female gender, concomitant co-morbidities, reduced FEV1, and increased severity of asthma.
The weak correlation between enablement and asthma control requires further study to determine if improved enablement can improve asthma outcomes independent of gender, severity, and concomitant co-morbidities. This study confirms the strong correlation between asthma control and quality of life.
哮喘的自我评估以及更紧密的医患关系可改善哮喘治疗效果。目前缺乏关于患者赋能对生活质量和哮喘控制影响的证据。
评估在初级保健机构接受治疗的哮喘患者的哮喘严重程度、药物使用情况、哮喘控制情况和患者赋能情况，并研究这些变量与生活质量之间的关系。
在葡萄牙北部的一家城市诊所进行了一项横断面研究。从哮喘患者的随机样本的临床记录和问卷中收集数据。使用了改良的患者赋能工具、哮喘生活质量问卷和哮喘控制问卷。测量了呼气峰值流速和一秒用力呼气量（FEV1）。进行了受试者工作特征曲线分析以确定生活质量测量的临界值。使用逻辑回归模型测试赋能、哮喘控制和生活质量之间的关联。
研究样本包括180名患者。哮喘控制与生活质量之间存在很强的相关性（r = 0.81，p < 0.001）。在逻辑回归模型中发现患者赋能与哮喘控制和生活质量之间存在弱关联。哮喘控制不佳与女性性别、合并症、FEV1降低以及哮喘严重程度增加有关。
赋能与哮喘控制之间的弱相关性需要进一步研究，以确定改善赋能是否能独立于性别、严重程度和合并症改善哮喘治疗效果。本研究证实了哮喘控制与生活质量之间的强相关性。
