Poureslami Iraj, Shum Jessica, Nimmon Laura, FitzGerald J Mark
Faculty of Medicine, Respiratory Medicine Division, Centre for Clinical Epidemiology and Evaluation (C2E2), University of British Columbia, Vancouver, Canada.
Faculty of Population and Public Health, University of British Columbia, Vancouver, Canada.
Respir Care. 2016 Dec;61(12):1588-1596. doi: 10.4187/respcare.04853. Epub 2016 Nov 8.
Little work has been done on identifying the impact of educational materials developed by immigrant patients themselves, along with their caregivers and health professionals in terms of inhaler use technique. The purpose of this study was to evaluate understanding of physicians' instructions on asthma management and inhaler techniques in Punjabi and Chinese subjects using educational interventions in their native languages.
Eighty-seven subjects with asthma were randomly assigned to either one of 3 experimental groups (physician-led video, subject-generated community video, or both) or a control group (educational pamphlet). Medication knowledge and inhaler skills were measured during 3 in-person interviews.
Subjects in all 3 experimental groups, when compared with control subjects, demonstrated improvements in the follow-up test in terms of ability to use inhalers correctly (P < .001) and understanding of physicians' instructions (P = .008). Chinese participants showed significantly greater improvements compared with Punjabi participants for the correct use of inhalers (P < .047), and females showed greater improvements compared with male subjects (P = .04).
The educational interventions developed were successful in behavioral modification and beneficial beyond usual care in terms of improving proper use of inhalers and understanding of physicians' instructions. The findings can be translated to health education practice, promoting the development of short, simple, and culturally linguistically appropriate learning materials for patients. Such interventions that draw on patients' life experiences and socio-cultural context can overcome certain limitations of conventional patient education approaches. (ClinicalTrials.gov registration NCT01474928.).
关于确定移民患者及其护理人员和卫生专业人员自行编写的教育材料对吸入器使用技术的影响，目前开展的工作较少。本研究的目的是使用母语教育干预措施，评估旁遮普语和中文受试者对医生关于哮喘管理和吸入器技术的指导的理解情况。
87名哮喘患者被随机分配到3个实验组（医生主导的视频组、受试者制作的社区视频组或两者结合组）或一个对照组（教育手册组）中的一组。在3次面对面访谈期间测量用药知识和吸入器技能。
与对照组相比，所有3个实验组的受试者在随访测试中，正确使用吸入器的能力（P <.001）和对医生指导的理解（P =.008）均有所改善。与旁遮普语受试者相比，中文受试者在正确使用吸入器方面的改善更为显著（P <.047），女性受试者比男性受试者的改善更大（P =.04）。
所开展的教育干预措施在行为改变方面取得了成功，并且在改善吸入器的正确使用和对医生指导的理解方面，比常规护理更有益。这些研究结果可转化为健康教育实践，促进为患者开发简短、简单且符合文化语言习惯的学习材料。这种借鉴患者生活经历和社会文化背景的干预措施可以克服传统患者教育方法的某些局限性。（ClinicalTrials.gov注册号NCT01474928。）
