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患者对慢性鼻-鼻窦炎疾病控制国际多学科共识标准的看法。

Patient perspectives on international multidisciplinary consensus criteria for chronic rhinosinusitis disease control.

作者信息

Cotter Ryan A, Houssein Firas A, Reinert Rebecca K, Phillips Katie M, Sedaghat Ahmad R

机构信息

Department of Otolaryngology-Head and Neck Surgery University of Cincinnati College of Medicine Cincinnati Ohio USA.

出版信息

Laryngoscope Investig Otolaryngol. 2024 Sep 14;9(5):e70005. doi: 10.1002/lio2.70005. eCollection 2024 Oct.

Abstract

OBJECTIVES

Recently, a set of consensus criteria and near-consensus criteria for the evaluation of chronic rhinosinusitis (CRS) disease control was identified by an international multidisciplinary panel of key stakeholders. The objective of this study is to evaluate patient perspectives on these disease control criteria.

METHODS

This is a qualitative phenomenological study using constant comparative methodology. Twenty-one one-on-one interviews, ranging from 6 to 15 min and based on a standardized semi-structured script, with CRS patients from diverse backgrounds were performed. The authors analyzed transcripts of the interviews to identify recurrent themes in patient responses. Conclusions were drawn based on these themes.

RESULTS

All participants agreed with the consensus criteria (overall symptom severity, nasal obstruction severity, patients' self-assessed CRS control, and need for CRS-related oral corticosteroids), and most participants agreed with near-consensus criteria (nasal endoscopy, smell loss and nasal drainage severities, impairment of day-to-day activities, and overall quality of life) identified by the international multidisciplinary panel. Some patients disagreed with inclusion of smell loss due to common etiologies-such as post-viral or iatrogenic causes-that would not necessarily be an indicator of active sinonasal inflammation. One theme that emerged was the need for a facial pain/pressure criterion to be added.

CONCLUSIONS

CRS patients overwhelmingly affirmed recently described consensus and near-consensus criteria for CRS disease control with the caveat that a question asking about facial pain/pressure should be included as well. Recently, identified consensus criteria for CRS disease control should be interpreted within the context of patient perspectives.

摘要

目的

最近,一个由关键利益相关者组成的国际多学科小组确定了一套用于评估慢性鼻-鼻窦炎(CRS)疾病控制的共识标准和近乎共识的标准。本研究的目的是评估患者对这些疾病控制标准的看法。

方法

这是一项采用持续比较法的定性现象学研究。对来自不同背景的CRS患者进行了21次一对一访谈,访谈时长6至15分钟,基于标准化的半结构化脚本进行。作者分析了访谈记录,以确定患者回答中反复出现的主题,并基于这些主题得出结论。

结果

所有参与者都认同共识标准(总体症状严重程度、鼻塞严重程度、患者自我评估的CRS控制情况以及对CRS相关口服糖皮质激素的需求),大多数参与者认同国际多学科小组确定的近乎共识的标准(鼻内镜检查、嗅觉丧失和鼻分泌物严重程度、日常活动受限以及总体生活质量)。一些患者不同意将因常见病因(如病毒感染后或医源性原因)导致的嗅觉丧失纳入其中,因为这些情况不一定是鼻窦活动性炎症的指标。出现的一个主题是需要增加一个关于面部疼痛/压痛的标准。

结论

CRS患者压倒性地肯定了最近描述的CRS疾病控制的共识标准和近乎共识的标准,但有一项附加条件,即也应纳入一个关于面部疼痛/压痛的问题。最近确定的CRS疾病控制共识标准应在患者观点的背景下进行解读。

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本文引用的文献

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Chronic rhinosinusitis disease control: a review of the history and the evidence.慢性鼻-鼻窦炎疾病控制:历史和证据的回顾。
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