Weinstein A G, Faust D
Jefferson Medical College, Division of Allergy and Clinical Immunology, Alfred I. duPont Institute, Newark, Delaware, USA.
Ann Allergy Asthma Immunol. 1997 Oct;79(4):311-8. doi: 10.1016/S1081-1206(10)63020-7.
Noncompliance with asthma therapy by asthmatic children and their families is a common cause of treatment failure. Psychologic factors have been reported to influence adherence patterns.
To evaluate the relationship of psychologic function of severely asthmatic children and families with theophylline compliance during a 1-year follow-up period after inpatient asthma rehabilitation.
Thirty-seven severely asthmatic children with a median age of 9 years (range, 2 to 17 years) were treated in an inpatient rehabilitation program (median, 15 days). Established clinical rating scales of psychologic adjustment were used for children (Child Global Assessment Scale) and families (Family Global Assessment Scale) at the time of admission. Patients were defined as noncompliant if 30% or more of theophylline levels obtained during the 1-year follow-up period were less than 5 mg/L (mumol/L).
Compliant children had higher scores on the Child Global Assessment Scale than noncompliant children (64 versus 48, P = .09). Families of compliant children had significantly higher scores on the Family Global Assessment Scale than did families with noncompliant children (63 versus 54, P < .05). There was no statistical relationship between compliance status and parent-reported behavior problems, demographic factors (age, race, sex, and number of parents at home), health insurance, specialty referral at admission, measures of medical morbidity (days hospitalized, number of emergency care visits, and number of corticosteroid bursts), or length of rehabilitation stay. Both compliant and noncompliant children had comparable reductions in morbidity (hospital and emergency care, number of corticosteroid bursts required).
Psychologic functioning of the child and family may be related to theophylline compliance.
哮喘儿童及其家庭不遵守哮喘治疗方案是治疗失败的常见原因。据报道，心理因素会影响依从模式。
评估重度哮喘儿童及其家庭的心理功能与住院哮喘康复后1年随访期内茶碱依从性之间的关系。
37名重度哮喘儿童，中位年龄9岁（范围2至17岁），接受住院康复治疗（中位时间15天）。入院时使用既定的儿童心理调适临床评定量表（儿童整体评定量表）和家庭心理调适临床评定量表（家庭整体评定量表）。如果在1年随访期内获得的茶碱水平30%或更多低于5mg/L（μmol/L），则患者被定义为不依从。
依从的儿童在儿童整体评定量表上的得分高于不依从的儿童（64对48，P = 0.09）。依从儿童的家庭在家庭整体评定量表上的得分显著高于不依从儿童的家庭（63对54，P < 0.05）。依从状态与家长报告的行为问题、人口统计学因素（年龄、种族、性别和家中父母数量）、医疗保险、入院时的专科转诊、医疗发病率指标（住院天数、急诊就诊次数和皮质类固醇冲击次数）或康复住院时间之间无统计学关系。依从和不依从的儿童在发病率降低方面（住院和急诊、所需皮质类固醇冲击次数）相当。
儿童和家庭的心理功能可能与茶碱依从性有关。
