Wilson S R, Latini D, Starr N J, Fish L, Loes L M, Page A, Kubic P
American Institutes for Research, Palo Alto, California 94302, USA.
J Asthma. 1996;33(4):239-54. doi: 10.3109/02770909609055365.
A randomized control trial of the Wee Wheezers asthma education program was conducted with 76 children < 7 years of age, 31% of whom were on a medication regimen consistent with mild, 51% with moderate, and 18% with moderately severe/severe asthma. Treatment children showed improved morbidity at 3-month follow-up relative to the changes in the controls: increased symptom-free days in the preceding 2 weeks (mean change of +2.2 vs. -2.6 in the controls; p = .004) and month (+2.0 vs. -3.8; p < .02), fewer nights of parental sleep interruption in a typical week (+0.7 vs. +1.8; p < or = .05), and a trend toward fewer asthma sick days (-0.2 vs +0.7; p = ns). These improvements were accompanied by significantly better parental asthma management compared with controls (more consistent use of preventive medications, p < or = .01; early symptom intervention, [corrected] p < or = .05) and trends toward more restrictions on smoking in the home (p < .07) and decreased parental confusion about asthma treatment (p < .11). This study provides evidence that a multisession program of asthma education for parents can improve parental asthma management and clinical outcomes in very young children and provides information on the validity and sensitivity of various asthma outcome measures in this age group.
针对76名7岁以下儿童开展了一项关于“Wee Wheezers哮喘教育项目”的随机对照试验，其中31%的儿童采用的药物治疗方案符合轻度哮喘，51%符合中度哮喘，18%符合中度重度/重度哮喘。与对照组的变化相比，接受治疗的儿童在3个月随访时发病率有所改善：前两周无症状天数增加（治疗组平均变化为+2.2天，对照组为-2.6天；p = 0.004）以及当月无症状天数增加（治疗组平均变化为+2.0天，对照组为-3.8天；p < 0.02），典型一周内父母睡眠受干扰的夜晚数减少（治疗组为+0.7晚，对照组为+1.8晚；p ≤ 0.05），哮喘病假天数有减少趋势（治疗组为-0.2天，对照组为+0.7天；p = 无统计学意义）。与对照组相比，这些改善伴随着父母对哮喘的管理明显更好（预防性药物使用更一致，p ≤ 0.01；早期症状干预，[校正后] p ≤ 0.05），并且家庭中吸烟限制增多有趋势（p < 0.07）以及父母对哮喘治疗的困惑减少有趋势（p < 0.11）。本研究提供了证据表明，针对父母的多环节哮喘教育项目可改善幼儿父母对哮喘的管理及临床结局，并提供了关于该年龄组各种哮喘结局指标的有效性和敏感性的信息。
