Persaud D I, Barnett S E, Weller S C, Baldwin C D, Niebuhr V, McCormick D P
Division of Ambulatory Pediatrics, University of Texas Medical Branch, Galveston, USA.
J Asthma. 1996;33(1):37-43. doi: 10.3109/02770909609077761.
A randomized trial of an instructional method was conducted in which school nurses taught children asthma self-management principles and skills, including peak flow monitoring, in 20-min, individual sessions over an 8-week period. Thirty-six children participated. An intervention group of 18 children received the teaching sessions. A control group of 18 children received regular care by the nurses, but no teaching sessions. The sample included 64% boys, 69% African-Americans, and 69% Medicaid recipients. The average age of subjects was 10.2 years. The two groups were demographically similar, but despite random assignment, the control group had a significantly earlier age of onset of asthma and tended to have had more asthma attacks in the preceding year. These factors were statistically controlled in outcome analyses. Results of group comparisons showed no significant differences in the number of postintervention emergency room visits and days absent from school. However, nurses reported that children who practiced breathing exercises had less anxiety during exacerbations, and the nurses' knowledge of the children's baseline peak expiratory flow rates facilitated care of the children. Nurses expressed the opinion that the individual sessions with students might be useful in motivating them to participate effectively in later group sessions. The intervention was well accepted by students, parents, and nurses. We believe that this intervention is promising as a practical, low-cost approach to enhancing children's asthma self-management skills and warrants further testing in a larger sample, with the intervention conducted over a longer period.
开展了一项关于教学方法的随机试验，在试验中，学校护士在为期8周的时间里，通过20分钟的个别辅导课程，向儿童传授哮喘自我管理原则和技能，包括呼气峰流速监测。36名儿童参与了试验。18名儿童组成的干预组接受了辅导课程。18名儿童组成的对照组接受护士的常规护理，但未接受辅导课程。样本包括64%的男孩、69%的非裔美国人以及69%的医疗补助接受者。受试者的平均年龄为10.2岁。两组在人口统计学特征上相似，但尽管进行了随机分组，对照组哮喘发病年龄明显更早，且在前一年哮喘发作次数往往更多。在结果分析中对这些因素进行了统计学控制。组间比较结果显示，干预后急诊室就诊次数和缺课天数没有显著差异。然而，护士报告称，进行呼吸练习的儿童在病情加重时焦虑程度较低，而且护士对儿童基线呼气峰流速的了解有助于对儿童的护理。护士们认为，与学生进行的个别辅导课程可能有助于激励他们有效参与后续的小组课程。该干预措施得到了学生、家长和护士的认可。我们认为，作为一种提高儿童哮喘自我管理技能的实用、低成本方法，该干预措施很有前景，值得在更大样本中进行进一步测试，并在更长时间内实施该干预措施。
