School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Clinical Epidemiology and Biostatistics, Örebro University, Örebro, Sweden.
J Asthma. 2021 Aug;58(8):1087-1093. doi: 10.1080/02770903.2020.1753209. Epub 2020 May 5.
Self-management is important for asthma control. We examined associations of patient- and healthcare-related factors with self-reported knowledge of self-management of worsening asthma.
Two asthma patient cohorts from 2012 ( = 527) and 2015 ( = 915) were randomly selected from 54 primary health care centers (PHCC) in central Sweden. Data were collected using patient questionnaires and questionnaires to the PHCCs. Logistic regression analyzed associations of relevant variables with knowledge of self-management of worsening asthma.
In total, 63% of patients reported moderate to complete knowledge of self-management procedures. The adjusted OR for moderate to complete knowledge relative to high education level was 1.38 [95% CI 1.03-1.85)]; for physician continuity 2.19 (95% CI 1.62-2.96); for a written action plan 11.9 (95% CI 6.16-22.9); for Step 2 maintenance treatment 1.53 (95% CI 0.04-2.24); and 2.07 (95% CI 1.44-2.99) for Step 3. An asthma/COPD nurse visit within the previous 12 months was associated with greater knowledge in women but not in men (p for interaction = 0.042). Smoking [OR 0.56 (95% CI 0.34-0.95)], co-morbidities ≥1 [OR 0.68 (95% CI 0.49-0.93)], and self-rated moderate/severe disease [OR 0.68 (95% CI 0.51-0.90)] were associated with low self-management knowledge.
Self-reported knowledge of self-management procedures was associated with a higher educational level, physician continuity, a written action plan, advanced treatment and, in women, visiting an asthma/COPD nurse. The results reinforce the importance of implementing guidelines of patient access to a specific physician, a written action plan, and structured education by an asthma/COPD nurse.
自我管理对哮喘控制很重要。我们研究了患者和医疗相关因素与自我报告的恶化哮喘自我管理知识之间的关联。
2012 年（ = 527）和 2015 年（ = 915）从瑞典中部 54 个基层医疗保健中心（PHCC）中随机选择了两个哮喘患者队列。使用患者问卷和 PHCC 问卷收集数据。使用逻辑回归分析了相关变量与恶化哮喘自我管理知识的关联。
共有 63%的患者报告了对自我管理程序有中等至完全的了解。与高教育水平相比，中等至完全了解的调整后 OR 为 1.38 [95%CI 1.03-1.85)]；与医生连续性相关的 OR 为 2.19 [95%CI 1.62-2.96)]；与书面行动计划相关的 OR 为 11.9 [95%CI 6.16-22.9)]；与维持治疗的第 2 步相关的 OR 为 1.53 [95%CI 0.04-2.24)]；与第 3 步相关的 OR 为 2.07 [95%CI 1.44-2.99)。在过去 12 个月内，哮喘/COPD 护士就诊与女性的知识水平较高相关，但与男性无关（p 交互 = 0.042）。吸烟[OR 0.56 (95%CI 0.34-0.95)]、合并症≥1 [OR 0.68 (95%CI 0.49-0.93)]和自我评估的中度/重度疾病[OR 0.68 (95%CI 0.51-0.90)]与自我管理知识水平较低相关。
自我报告的自我管理程序知识与较高的教育水平、医生连续性、书面行动计划、高级治疗以及女性就诊哮喘/COPD 护士有关。结果强调了实施患者获得特定医生、书面行动计划以及哮喘/COPD 护士结构化教育的指南的重要性。
