Klein J J, van der Palen J, van den Hof S, Rovers M M
Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, The Netherlands.
Patient Educ Couns. 1997 Dec;32(1 Suppl):S61-6. doi: 10.1016/s0738-3991(97)00097-9.
Self-management plans are considered today an essential component of the management of asthma. The objective of the present study was (a) to explore patients' present practical knowledge of self-treatment of asthma, and (b) to provide an assessment of the effect of an educational program on this knowledge and self-treatment behaviour. Twenty four adults with asthma from the outpatient clinic of the Department of Pulmonary Medicine participated in a self-management program. They were provided with explanations on the symptoms and precipitating factors of their asthma, on its treatment with medication and their side-effects, and with personal written guidelines for self-adjustment of their medication. Prior to the program their practical knowledge of adequate self-treatment was investigated using a hypothetical scenario of a slow-onset asthma exacerbation. The effectiveness of the teaching and training program was evaluated by the change in knowledge prior to and 5 months after the program and self-reported behaviour of the participants at follow-up. (a) More than 60% of the patients lacked practical knowledge of self-treatment of a slow-onset exacerbation of asthma. (b) The educational program resulted in a significant increase (47%) of this knowledge. (c) Actual self-treatment behaviour, as recorded by the patients 5 months after completing the educational program, was adequate in only two of ten patients, who experienced an exacerbation during the study period. Many adults with asthma are deficient in practical knowledge of self-treatment of a slow-onset exacerbation. This knowledge was significantly augmented by an educational program. Nevertheless actual self-treatment behaviour at follow-up was inadequate in the majority of patients.
自我管理计划如今被视为哮喘管理的重要组成部分。本研究的目的是：（a）探究患者目前对哮喘自我治疗的实际知识；（b）评估一项教育计划对这些知识和自我治疗行为的效果。来自肺科门诊的24名成年哮喘患者参加了一项自我管理计划。他们得到了关于哮喘症状和诱发因素、药物治疗及其副作用的解释，以及个人用药自我调整的书面指南。在该计划实施前，通过一个缓慢发作的哮喘加重的假设情景来调查他们对充分自我治疗的实际知识。通过比较计划实施前和实施5个月后的知识变化以及参与者随访时自我报告的行为来评估教学和培训计划的效果。（a）超过60%的患者缺乏对缓慢发作的哮喘加重进行自我治疗的实际知识。（b）该教育计划使这方面的知识显著增加（47%）。（c）在完成教育计划5个月后，患者记录的实际自我治疗行为中，只有10名在研究期间病情加重的患者中的2名行为得当。许多成年哮喘患者在对缓慢发作的哮喘加重进行自我治疗的实际知识方面存在不足。一项教育计划显著增加了这方面的知识。然而，大多数患者随访时的实际自我治疗行为并不充分。
