Osman L M, Russell I T, Friend J A, Legge J S, Douglas J G
Department of Public Health, University of Aberdeen.
Thorax. 1993 Aug;48(8):827-30. doi: 10.1136/thx.48.8.827.
Studies of patient attitudes to asthma and its control have focused on crisis action, and little attention has been paid to attitudes to regular preventive medication. It is not clear whether attitudes to regular medication are related to the degree of distress or interference with life perceived by patients as being caused by their asthma. For this reason this study examined how far dislike of medication related to dislike of other aspects of interference of asthma with daily life.
Three hundred and ninety one patients were surveyed with a questionnaire which assessed their dislike of the interference of asthma with their physical, social, and emotional functioning, together with dislike of regular asthma medication. A response was received from 320 patients (82%).
Four attitude clusters were identified. Recorded in descending factor order, these were (1) dislike of asthma medication, (2) dislike of disability, (3) dislike of public life interference, and (4) dislike of social and emotional interference. The attitude clusters were not related: in particular, dislike of asthma medication could not be predicted from other dislikes, or from asthma best function ratio (ratio of best recorded peak expiratory flow rate in the previous year to predicted value), age, or sex. The most significant predictors of the patients' dislike of taking their own inhaled steroid were (1) dislike of using bronchodilator, (2) dislike of steroids generally, and (3) dislike of taking medicine every day.
Patient attitudes to regular asthma medication are not related to general anxieties and dislikes about asthma, nor to the potential for asthma control as judged by the best function ratio. Patients were not always consistent in their attitude to inhaled steroids in general, nor to their own named inhaled steroid in particular. A general cluster of antimedication attitudes existed, independent of whether the medication was for prophylaxis or relief. Attitudes to asthma medication may be helpful in predicting patient behaviour.
关于患者对哮喘及其控制的态度的研究主要集中在危机应对方面，而对常规预防性药物治疗的态度关注较少。目前尚不清楚患者对常规药物治疗的态度是否与他们认为哮喘所导致的痛苦程度或对生活的干扰程度相关。因此，本研究探讨了对药物治疗的厌恶与对哮喘干扰日常生活其他方面的厌恶之间的关联程度。
对391名患者进行问卷调查，评估他们对哮喘干扰其身体、社交和情感功能的厌恶程度，以及对常规哮喘药物治疗的厌恶程度。共收到320名患者（82%）的回复。
确定了四个态度群组。按照因素顺序从高到低排列，分别为：（1）对哮喘药物治疗的厌恶，（2）对残疾的厌恶，（3）对公共生活干扰的厌恶，（4）对社交和情感干扰的厌恶。这些态度群组之间没有关联：特别是，无法从其他厌恶因素、哮喘最佳功能比率（前一年记录的最佳呼气峰值流速与预测值的比率）、年龄或性别来预测对哮喘药物治疗的厌恶。患者厌恶自行吸入类固醇药物的最显著预测因素为：（1）对使用支气管扩张剂的厌恶，（2）对类固醇药物总体的厌恶，（3）对每日服药的厌恶。
患者对常规哮喘药物治疗的态度与对哮喘的总体焦虑和厌恶无关，也与通过最佳功能比率判断的哮喘控制潜力无关。患者对吸入类固醇药物的总体态度，尤其是对自己指定的吸入类固醇药物的态度并不总是一致的。存在一个普遍的反药物治疗态度群组，与药物是用于预防还是缓解无关。对哮喘药物治疗的态度可能有助于预测患者行为。
