Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Department of Education Leadership, School of Education, University of Cincinnati, Cincinnati, OH, USA.
Rhinology. 2022 Aug 1;60(4):282-292. doi: 10.4193/Rhin21.448.
The definition of disease control in chronic rhinosinusitis (CRS) is an active area of study. However, investigations have not engaged CRS patients in how they think about disease control. This study seeks to understand the patient perspective on CRS disease control.
Qualitative phenomenological study using constant comparative methodology was applied. The research team conducted 10, one-on-one interviews with CRS patients ranging from 22 to 55 minutes in length. The content of the interview protocol was determined through iterative discussion amongst all authors. Two authors served as coders to identify recurrent themes. Themes were analyzed for meaning and conclusions were summarized.
Three recurring themes determined from patients were that (1) use of the terminology control adequately represents this phenomenon, (2) components of control could be classified into four main themes relating to CRS symptomatology, exacerbation of comorbid disease, quality of life and acute exacerbations of CRS, and (3) when patients deem their CRS is uncontrolled they are more willing to escalate their treatment to include escalating their daily maintenance regimen, seeking otolaryngology referral, taking rescue medication or undergoing endoscopic sinus surgery.
CRS patients consider their daily symptoms, the severity and frequency of CRS exacerbations, impact on quality of life as well as exacerbation of comorbid disease when thinking about their disease control. Disease control is a goal of treatment for patients and uncontrolled disease motivates patients to seek further treatment. Physicians should explore all components of CRS control when considering disease status and need for further treatment.
慢性鼻-鼻窦炎（CRS）的疾病控制定义是一个活跃的研究领域。然而，研究并未让 CRS 患者参与到他们对疾病控制的看法中来。本研究旨在了解患者对 CRS 疾病控制的看法。
采用恒定性比较方法进行定性现象学研究。研究小组对 10 名 CRS 患者进行了一对一访谈，访谈时间从 22 分钟到 55 分钟不等。访谈协议的内容是通过所有作者之间的反复讨论确定的。两名作者担任编码员，以确定反复出现的主题。对主题进行了分析，以总结其意义和结论。
从患者中确定了三个反复出现的主题，即：（1）使用术语“控制”可以充分代表这一现象；（2）控制的组成部分可以分为四个主要主题，与 CRS 症状、合并症恶化、生活质量和 CRS 急性加重有关；（3）当患者认为他们的 CRS 不受控制时，他们更愿意加强治疗，包括加强日常维持治疗、寻求耳鼻喉科转介、使用急救药物或接受内镜鼻窦手术。
CRS 患者在考虑疾病控制时，会考虑他们的日常症状、CRS 加重的严重程度和频率、对生活质量的影响以及合并症的恶化。疾病控制是患者治疗的目标，不受控制的疾病会促使患者寻求进一步的治疗。医生在考虑疾病状况和进一步治疗的需求时，应探讨 CRS 控制的所有组成部分。
