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从父母/照顾者角度看支气管扩张症患儿的护理负担

Burden of Care for Children with Bronchiectasis from Parents/Carers Perspective.

作者信息

Marchant Julie M, Cook Anne L, Roberts Jack, Yerkovich Stephanie T, Goyal Vikas, Arnold Daniel, O'Farrell Hannah E, Chang Anne B

机构信息

Australian Centre for Health Services Innovation @ Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD 4059, Australia.

NHMRC Centre for Research Excellence in Paediatric Bronchiectasis (AusBREATHE), Queensland Children's Hospital, Brisbane, QLD 4101, Australia.

出版信息

J Clin Med. 2021 Dec 14;10(24):5856. doi: 10.3390/jcm10245856.

Abstract

Bronchiectasis is a neglected chronic respiratory condition. In children optimal appropriate management can halt the disease process, and in some cases reverse the radiological abnormality. This requires many facets, including parental/carer bronchiectasis-specific knowledge, for which there is currently no such published data. Further, the importance of patient voices in guiding clinical research is becoming increasingly appreciated. To address these issues, we aimed to describe the voices of parents of children with bronchiectasis relating to (a) burden of illness and quality of life (QoL), (b) their major worries/concerns and (c) understanding/management of exacerbations. The parents of 152 children with bronchiectasis (median age = 5.8 years, range 3.5-8.4) recruited from the Queensland Children's Hospital (Australia) completed questionnaires, including a parent-proxy cough-specific QoL. We found that parents of children with bronchiectasis had impaired QoL (median 4.38, range 3.13-5.63) and a high disease burden with median 7.0 (range 4.0-10.0) doctor visits in 12-months. Parental knowledge varied with only 41% understanding appropriate management of an exacerbation. The highest worry/concern expressed were long-term effects ( = 42, 29.8%) and perceived declining health ( = 36, 25.5%). Our study has highlighted the need for improved education, high parental burden and areas of concern/worry which may inform development of a bronchiectasis-specific paediatric QoL tool.

摘要

支气管扩张症是一种被忽视的慢性呼吸道疾病。在儿童中,恰当的最佳管理可以阻止疾病进程,在某些情况下还能逆转放射学异常。这需要多方面的努力,包括父母/照料者具备支气管扩张症的专业知识,但目前尚无此类公开数据。此外,患者意见在指导临床研究中的重要性日益受到重视。为解决这些问题,我们旨在描述支气管扩张症患儿父母在以下方面的意见:(a) 疾病负担和生活质量 (QoL),(b) 他们的主要担忧,以及 (c) 对病情加重的理解/管理。从澳大利亚昆士兰儿童医院招募的152名支气管扩张症患儿的父母(中位年龄 = 5.8岁,范围3.5 - 8.4岁)完成了问卷调查,包括一份家长代理的咳嗽特异性生活质量问卷。我们发现,支气管扩张症患儿的父母生活质量受损(中位值4.38,范围3.13 - 5.63),疾病负担较重,12个月内看医生的中位次数为7.0次(范围4.0 - 10.0次)。父母的知识水平参差不齐,只有41%的人了解病情加重时的恰当管理方法。最常表达的担忧是长期影响(n = 42,29.8%)和健康状况下降(n = 36,25.5%)。我们的研究强调了改善教育的必要性、高父母负担以及可能为开发支气管扩张症特异性儿科生活质量工具提供依据的担忧领域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a915/8707334/1c72478ecdcf/jcm-10-05856-g001.jpg

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