Walker Victoria, Trope Michal, Tichavakunda Antar A, Speth Marlene M, Sedaghat Ahmad R, Phillips Katie M
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, Ohio, USA.
Otolaryngol Head Neck Surg. 2023 Apr;168(4):862-867. doi: 10.1177/01945998221120188. Epub 2023 Jan 29.
Acute exacerbations of chronic rhinosinusitis (AECRS) are currently defined as a transient worsening of symptoms that return to baseline. This definition is narrow and can only be made retrospectively. The literature has studied this phenomenon from the physician perspective, yet a key stakeholder's-the patient's perspective is not well elucidated in the literature. To understand AECRS from the patient's perspective, we performed this study to further clarify this phenomenon.
Basic qualitative study via patient interviews using constant comparative methodology was conducted.
Tertiary care academic center.
Two of the authors served as coders, and via group discussion, a common codebook was created and used to identify recurrent themes. The themes were analyzed for meaning and conclusions were summarized.
Ten interviews were conducted with chronic rhinosinusitis (CRS) patients. Recurring themes included the following: (1) patients identify with the term flare or sinus infection more than exacerbation; (2) consistent with the current definition, patients identify AECRS by worsening sinonasal symptoms but also relate secondary symptoms, including poor sleep, fatigue, exacerbation of lower respiratory tract symptoms, and malaise to AECRS; and (3) patients are greatly affected by AECRS via decreased quality of life (QOL), worsening of general health, and decreasing productivity.
Beyond worsening of sinonasal symptoms, the concept of AECRS reflects a more complex construct to patients with associated extranasal symptoms and systemic manifestations. In addition, AECRS have a large impact on patients, and therefore, understanding this component of CRS is pivotal in improving disease control and QOL in this patient population.
慢性鼻-鼻窦炎急性加重（AECRS）目前被定义为症状短暂恶化后恢复至基线水平。这一定义较为狭窄，且只能进行回顾性判定。文献多从医生角度研究这一现象，然而，作为关键利益相关者的患者视角在文献中并未得到充分阐释。为从患者角度理解AECRS，我们开展了本研究以进一步阐明这一现象。
采用持续比较法通过患者访谈进行基础定性研究。
三级医疗学术中心。
两位作者担任编码员，通过小组讨论创建了一个通用编码手册，并用于识别反复出现的主题。对这些主题进行意义分析并总结结论。
对慢性鼻-鼻窦炎（CRS）患者进行了10次访谈。反复出现的主题包括：（1）患者更认同“发作”或“鼻窦感染”这一说法，而非“加重”；（2）与当前定义一致，患者通过鼻窦症状恶化来识别AECRS，但也将包括睡眠不佳、疲劳、下呼吸道症状加重和不适等继发症状与AECRS联系起来；（3）AECRS通过降低生活质量（QOL）、恶化总体健康状况和降低生产力对患者产生极大影响。
除鼻窦症状恶化外，AECRS的概念对伴有鼻外症状和全身表现的患者而言反映了一个更为复杂的情况。此外，AECRS对患者有很大影响，因此，了解CRS的这一组成部分对于改善该患者群体的疾病控制和生活质量至关重要。
