Amirav I, Goren A, Kravitz R M, Pawlowski N A
Division of General Pediatrics, Children's Hospital of Philadelphia, PA 19104-4399, USA.
J Allergy Clin Immunol. 1995 Apr;95(4):818-23. doi: 10.1016/s0091-6749(95)70124-9.
Inhaled medications are the mainstay of asthma therapy, but significant deficiencies exist in the knowledge and skills of physicians regarding use of metered-dose inhalers (MDI) and spacer devices.
We developed, implemented, and evaluated the effects of a physician-targeted educational program on inhaled therapy in a group of pediatric residents in our institution.
Patient-directed instruction sheets on aerosol therapy were developed on the basis of literature review and expert guidelines. These served to establish a consistent foundation for the educational curriculum. The program was delivered through one-on-two teaching sessions (45 minutes). Residents were provided with a summary of theoretical and practical information and with devices for practice (a placebo MDI, InspirEase and AeroChamber holding chambers, and the AeroChamber device with mask). Each session included review of an educational monograph, demonstration of proper technique, and practice with the different devices. The program was evaluated by a randomized-control design. Assessment of practical skills included number of correct steps for the use of MDI (maximum score, 7), InspirEase (maximum, 7) and AeroChamber (maximum, 6). Theoretical knowledge was assessed with 25 multiple-choice questions.
Pretest scores in the experimental group (n = 24) were 3.7 of 7, 1.9 of 7, and 0.3 of 6 steps correct for MDI, InspirEase, and AeroChamber devices, respectively, and 13 of 25 for the theoretical knowledge assessment. The control group (n = 26) had similar pretest scores. After the program the experimental group significantly improved in all parameters: 6.3 of 7, 5.9 of 7, and 4.5 of 6 steps correct for MDI, InspirEase, and AeroChamber devices, respectively, and 18 of 25 questions correct (p < 0.01 for all parameters).
Implementation of a simple educational program among pediatric residents can significantly increase their skills in the use of inhalational therapy.
吸入药物是哮喘治疗的主要手段，但医生在定量吸入器（MDI）和储雾罐装置使用方面的知识和技能存在显著不足。
我们针对本机构的一组儿科住院医师，制定、实施并评估了一项针对医生的吸入治疗教育计划的效果。
基于文献综述和专家指南，制定了患者指导的雾化治疗说明书。这些说明书为教育课程奠定了一致的基础。该计划通过一对一教学课程（45分钟）进行。为住院医师提供理论和实践信息总结以及练习设备（一个安慰剂MDI、InspirEase和AeroChamber储雾罐，以及带面罩的AeroChamber装置）。每次课程包括教育专著复习、正确技术演示以及不同设备的练习。该计划通过随机对照设计进行评估。实践技能评估包括MDI使用的正确步骤数量（满分7分）、InspirEase（满分7分）和AeroChamber（满分6分）。理论知识通过25道多项选择题进行评估。
实验组（n = 24）在MDI、InspirEase和AeroChamber装置使用的预测试分数分别为7分中的3.7分、7分中的1.9分和6分中的0.3分，理论知识评估的预测试分数为25分中的13分。对照组（n = 26）的预测试分数相似。课程结束后，实验组在所有参数上均有显著提高：MDI、InspirEase和AeroChamber装置使用的正确步骤分别为7分中的6.3分、7分中的5.9分和6分中的4.5分，25道问题中有18道回答正确（所有参数p < 0.01）。
在儿科住院医师中实施简单的教育计划可显著提高他们在吸入治疗方面的技能。
