儿童和看护者对哮喘药物使用所陈述和关注的问题
2010/09/14
摘要
目的：本文旨在描述哮喘患儿及其看护者对哮喘药物使用所陈诉和关心的问题，并探研儿童和其看护者的人口统计学和社会文化学特征与哮喘用药相关问题的关系。
方法：选取美国北卡罗来纳州5个非城区的儿童中心的年龄为8～16岁、患轻症、中度或重度持续哮喘的患儿及其看护者。对患儿进行面谈，看护者完成问卷调查，观察在哮喘药物使用上主诉和关心的问题。多元logistic回归对采集的数据进行分析。
结果：320名儿童入选。87％的儿童对其哮喘药物使用主诉存在一个问题。约40％的患儿主诉有不良反应，相似比率的患儿主诉对其药物说明较难理解。60％的患者主诉容易忘记何时服药。与白人男性患儿相比，非白人女性患儿更易主诉不能确定怎样使用吸入装置。与年长白人患儿相比，年轻非白人患儿更易主诉很难理解药物的使用指导。看护者（31％）更可能主诉其患儿受某些或诸多不良反应的困扰，类似比率的看护者（29％）不能确信其患儿是否能正确使用吸入装置。未纳入医疗补助计划的看护者更易主诉对其患儿治疗药物的支出存在困难。
结论：用药不良反应是患儿和看护者的一个重要问题，有必要对非白人患儿和看护者进行吸入器使用技术的培训。医疗服务提供者应该与患儿和看护者一起讨论有关哮喘药物使用中所遇到的和关心的问题。
（刘国梁 审校）
J Asthma. 2010 Jul 16. [Epub ahead of print]
Child- and Caregiver-Reported Problems and Concerns in Using Asthma Medications
Sleath B, Ayala GX, Davis S, Williams D, Tudor G, Yeatts K, Washington D, Gillette C.
1Department of Pharmaceutical Outcomes and Policy, University of North Carolina Eshelman School of Pharmacy.
Abstract
Objectives. The purpose of the study was to (a) describe the types of medication problems/concerns that asthmatic children and their caregivers reported and (b) examine the association between child and caregiver demographic and sociocultural characteristics and reported asthma medication problems/concerns.
Methods. Children ages 8 through 16 with mild, moderate, or severe persistent asthma and their caregivers were recruited at five pediatric practices in nonurban areas of North Carolina. Children were interviewed and caregivers completed questionnaires after their child’s medical visits about reported problems/concerns in using asthma medications. Multivariate logistic regression was used to analyze the data.
Results. Three hundred and twenty children were recruited. Eighty-seven percent of the children reported a problem or concern in using their asthma medications. Approximately 40% of children reported side effects and a similar percent stated that it was hard to understand the directions on their medicines; in addition 60% reported that it was hard to remember when to take their medicines. Females and non-White children were significantly more likely to report they were not sure how to use an inhaler than males and White children. Younger and non-White children were significantly more likely to report it was hard to understand the directions on their medicines than older and White children. Caregivers were most likely to report that their children were bothered a little or a lot by side effects (31%) and a similar percent (29%) were not sure their children were using their inhalers properly. Caregivers without Medicaid were significantly more likely to report difficulty paying for the asthma medications.
Conclusions. Medication side effects are a significant problem area for both children and their caregivers, and inhaler skill-based training is particularly needed for non-White children. Health care providers should discuss with children and their caregivers the types of problems/concerns that children may have when using their asthma medications.
J Asthma. 2010 Jul 16. [Epub ahead of print]
目的：本文旨在描述哮喘患儿及其看护者对哮喘药物使用所陈诉和关心的问题，并探研儿童和其看护者的人口统计学和社会文化学特征与哮喘用药相关问题的关系。
方法：选取美国北卡罗来纳州5个非城区的儿童中心的年龄为8～16岁、患轻症、中度或重度持续哮喘的患儿及其看护者。对患儿进行面谈，看护者完成问卷调查，观察在哮喘药物使用上主诉和关心的问题。多元logistic回归对采集的数据进行分析。
结果：320名儿童入选。87％的儿童对其哮喘药物使用主诉存在一个问题。约40％的患儿主诉有不良反应，相似比率的患儿主诉对其药物说明较难理解。60％的患者主诉容易忘记何时服药。与白人男性患儿相比，非白人女性患儿更易主诉不能确定怎样使用吸入装置。与年长白人患儿相比，年轻非白人患儿更易主诉很难理解药物的使用指导。看护者（31％）更可能主诉其患儿受某些或诸多不良反应的困扰，类似比率的看护者（29％）不能确信其患儿是否能正确使用吸入装置。未纳入医疗补助计划的看护者更易主诉对其患儿治疗药物的支出存在困难。
结论：用药不良反应是患儿和看护者的一个重要问题，有必要对非白人患儿和看护者进行吸入器使用技术的培训。医疗服务提供者应该与患儿和看护者一起讨论有关哮喘药物使用中所遇到的和关心的问题。
（刘国梁 审校）
J Asthma. 2010 Jul 16. [Epub ahead of print]
Child- and Caregiver-Reported Problems and Concerns in Using Asthma Medications
Sleath B, Ayala GX, Davis S, Williams D, Tudor G, Yeatts K, Washington D, Gillette C.
1Department of Pharmaceutical Outcomes and Policy, University of North Carolina Eshelman School of Pharmacy.
Abstract
Objectives. The purpose of the study was to (a) describe the types of medication problems/concerns that asthmatic children and their caregivers reported and (b) examine the association between child and caregiver demographic and sociocultural characteristics and reported asthma medication problems/concerns.
Methods. Children ages 8 through 16 with mild, moderate, or severe persistent asthma and their caregivers were recruited at five pediatric practices in nonurban areas of North Carolina. Children were interviewed and caregivers completed questionnaires after their child’s medical visits about reported problems/concerns in using asthma medications. Multivariate logistic regression was used to analyze the data.
Results. Three hundred and twenty children were recruited. Eighty-seven percent of the children reported a problem or concern in using their asthma medications. Approximately 40% of children reported side effects and a similar percent stated that it was hard to understand the directions on their medicines; in addition 60% reported that it was hard to remember when to take their medicines. Females and non-White children were significantly more likely to report they were not sure how to use an inhaler than males and White children. Younger and non-White children were significantly more likely to report it was hard to understand the directions on their medicines than older and White children. Caregivers were most likely to report that their children were bothered a little or a lot by side effects (31%) and a similar percent (29%) were not sure their children were using their inhalers properly. Caregivers without Medicaid were significantly more likely to report difficulty paying for the asthma medications.
Conclusions. Medication side effects are a significant problem area for both children and their caregivers, and inhaler skill-based training is particularly needed for non-White children. Health care providers should discuss with children and their caregivers the types of problems/concerns that children may have when using their asthma medications.
J Asthma. 2010 Jul 16. [Epub ahead of print]
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清除临床障碍：采用患者导向来增加哮喘治疗的社会支持
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美国哮喘患者季度性评价短效β2肾上腺素能激动剂的使用是后期卫生资源使用的一个预测因素
