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慢性阻塞性肺疾病诊断与治疗的知识、态度及实践方面的性别差异:一项中国全国性、多中心横断面调查

Gender difference on the knowledge, attitude, and practice of COPD diagnosis and treatment: a national, multicenter, cross-sectional survey in China.

作者信息

Jia Guohua, Lu Ming, Wu Rui, Chen Yahong, Yao Wanzhen

机构信息

Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China,

出版信息

Int J Chron Obstruct Pulmon Dis. 2018 Oct 10;13:3269-3280. doi: 10.2147/COPD.S176173. eCollection 2018.

Abstract

PURPOSE

To investigate the gender difference in knowledge, attitude, and practice of COPD diagnosis and treatment in China.

PATIENTS AND METHODS

A nationwide, multicenter, cross-sectional questionnaire study was carried out to investigate patients' understanding and experience of COPD between September 2007 and December 2008.

RESULTS

Two thousand and seventy-two patients were recruited from eleven centers. The final effective questionnaires were those of 1,698 cases, of which 32% were female. Women were younger, had higher body mass index, were more never smokers, and had lesser pack-years (all <0.01). More women had under elementary education level and monthly income <1,000 RMB (about 160 USD) (all <0.01). Women had higher ratio of FEV/FVC (54.1±10.9 vs 50.2±11.5), FEV% (50.0±19.1 vs 45.4±29.0), and lower short form-36 mental component summary (57.5±26.8 vs 61.3±25.0) (all <0.01). Fewer women reported severe exacerbation (defined as an acute worsening of respiratory symptoms that results in patient's hospitalization) in the previous year (44.5% vs 51.6%, <0.05). More women reported that they never heard of COPD before (67.0% vs 59.0%, <0.01). Less women reported that physician had to tell them they had emphysema (50.5% vs 60.4%) or COPD (31.9% vs 37.9%). Less women had pulmonary function test (PFT) done before (65.2% vs 70.4%, <0.05). More women reported that they would not repeat PFT annually (91.7% vs 87.6%, <0.05) and did not know the PFT results (78.6% vs 73.1%, <0.05). More women reported not having had pulmonary rehabilitation before (87.8% vs 83.6%, <0.05). Fewer women reported knowing that COPD should be given combined therapy (38.3% vs 44.5%) and long-term treatment (46.1% vs 51.9%) (all <0.05).

CONCLUSION

Male and female patients had different experiences on COPD diagnosis and treatment. Physicians should pay more attention to patients' education on COPD, especially of women.

摘要

目的

调查中国慢性阻塞性肺疾病(COPD)诊断与治疗的知识、态度及实践方面的性别差异。

患者与方法

于2007年9月至2008年12月开展了一项全国性、多中心横断面问卷调查研究,以调查患者对COPD的了解及经历。

结果

从11个中心招募了2072例患者。最终有效问卷为1698例,其中女性占32%。女性年龄更小,体重指数更高,从不吸烟者更多,吸烟包年数更少(均P<0.01)。更多女性受教育程度为小学及以下且月收入<1000元人民币(约160美元)(均P<0.01)。女性的第1秒用力呼气容积/用力肺活量(FEV/FVC)(54.1±10.9对50.2±11.5)、第1秒用力呼气容积占预计值百分比(FEV%)(50.0±19.1对45.4±29.0)更高,而36条目简明健康状况调查问卷精神健康分量表得分更低(57.5±26.8对61.3±25.0)(均P<0.01)。更少女性报告上一年有严重加重(定义为导致患者住院的呼吸道症状急性恶化)(44.5%对51.6%,P<0.05)。更多女性报告她们之前从未听说过COPD(67.0%对59.0%,P<0.01)。更少女性报告医生曾告知她们患有肺气肿(50.5%对60.4%)或COPD(31.9%对37.9%)。更少女性之前进行过肺功能检查(PFT)(65.2%对70.4%,P<0.05)。更多女性报告她们不会每年重复进行PFT(91.7%对87.6%,P<0.05)且不知道PFT结果(78.6%对73.1%,P<0.05)。更多女性报告之前未接受过肺康复治疗(87.8%对83.6%,P<0.05)。更少女性报告知道COPD应接受联合治疗(38.3%对44.5%)和长期治疗(46.1%对51.9%)(均P<0.05)。

结论

男性和女性患者在COPD诊断与治疗方面有不同经历。医生应更加关注对患者,尤其是女性患者的COPD教育。

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