哮喘自我管理和生活质量中的知识、态度、自我效能
2010/11/04
摘要
背景：认知变量，如知识、态度和自我效能能够影响哮喘患者的有效自我管理能力。
目的：本项横断面研究旨在分析与这些认知变量有关的患者及临床因素，评价这些认知变量对临床状态的影响。
方法：采用包含三个域的知识、态度和自我效能哮喘问卷调查（KASE）对初级医疗机构哮喘患者进行面谈，建立量表以检测社会支持、抑郁症状和哮喘治疗等级。临床哮喘状态采用哮喘生活质量问卷调查（AQLQ）检测。
结果：共计180名患者入选本研究，平均年龄43岁，84%的女性。入选者哮喘知识水平较低，仅50%的患者半数以上问题回答正确（平均评分=52；可能范围：0-100，高值代表知识丰富）、哮喘态度总体来说呈正面（平均评分=82，可能范围：20～100；高值代表更为正面的态度）、自我效能中等（平均评分=76，可能范围：20～100；高值代表自我效能高）。多变量分析显示，年龄小、较高的教育水平与更多的哮喘知识相关（p ≤0.005）；更多的社会支持、较少的抑郁症状、更多的哮喘护理有利结果，与更为正面的态度相关（p ≤0 .05）；有利的结果、更为满意的哮喘状态、无应激相关触发物、无近期哮喘急诊就诊与更高效能相关（所有指标均p ≤0.07）。其他多变量分析显示，更多的知识（p =0.0005）、更为积极的态度（p =0.02）和更高的自我效能（p =0.01）与更好的AQLQ评分相关。
结论：不同患者特征哮喘临床特征与认知变量相关，后者与哮喘的自我管理相关。这些变量又与哮喘状态独立相关。因此，有必要采取干预措施，改善上述任何变量，以有利于哮喘控制。
（陈欣 审校）
J Asthma. 2010 Sep 13. [Epub ahead of print]
Knowledge, Attitude, and Self-Efficacy in Asthma Self-Management and Quality of Life.
Mancuso CA, Sayles W, Allegrante JP.
Hospital for Special Surgery, New York, New York, U.S.A.
Abstract
Background. Cognitive variables such as knowledge, attitude, and self-efficacy affect asthma patients’ abilities to be effective self-managers.
Objective. The objective of this cross-sectional analysis was to determine what patient and clinical factors were associated with these cognitive variables and to assess the contributions of these cognitive variables to clinical status.
Methods. Primary care asthma patients were interviewed using the three domains of the Knowledge, Attitude, and Self-Efficacy Asthma Questionnaire (KASE), as well as established scales to measure social support, depressive symptoms, and ratings of asthma care. Clinical asthma status was measured with the Asthma Quality of Life Questionnaire (AQLQ).
Results. In total, 180 patients were enrolled, with a mean age of 43 years and 84% were women. Knowledge was low, with only 50% of patients answering half or more questions correctly (mean score = 52, possible range 0-100, higher is more knowledge). Attitude toward asthma was generally positive (mean score = 82, possible range 20-100, higher is more positive attitude) and self-efficacy was moderate (mean score = 76, possible range 20-100, higher is more self-efficacy). In separate multivariate analyses, younger age and higher education level were associated with more knowledge (p ≤ .005); more social support, fewer depressive symptoms, and more favorable prior results of asthma care were associated with more positive attitude (p ≤ .05); and favorable prior results, more satisfaction with asthma status, not having stress-related triggers, and not having had a recent emergency department visit for asthma were associated with more self-efficacy (p ≤ .07 for all variables). In additional multivariate analyses, more knowledge (p = .0005), more positive attitude (p = .02), and more self-efficacy (p = .01) were associated with better AQLQ scores.
Conclusions. Different patient and clinical characteristics were associated with cognitive variables pertinent to self-management. These variables, in turn, were independently associated with asthma status. Thus, although fostering improvement in all three variables would be desirable, interventions that improve any of these variables potentially could be beneficial.
J Asthma. 2010 Sep 13. [Epub ahead of print]
背景：认知变量，如知识、态度和自我效能能够影响哮喘患者的有效自我管理能力。
目的：本项横断面研究旨在分析与这些认知变量有关的患者及临床因素，评价这些认知变量对临床状态的影响。
方法：采用包含三个域的知识、态度和自我效能哮喘问卷调查（KASE）对初级医疗机构哮喘患者进行面谈，建立量表以检测社会支持、抑郁症状和哮喘治疗等级。临床哮喘状态采用哮喘生活质量问卷调查（AQLQ）检测。
结果：共计180名患者入选本研究，平均年龄43岁，84%的女性。入选者哮喘知识水平较低，仅50%的患者半数以上问题回答正确（平均评分=52；可能范围：0-100，高值代表知识丰富）、哮喘态度总体来说呈正面（平均评分=82，可能范围：20～100；高值代表更为正面的态度）、自我效能中等（平均评分=76，可能范围：20～100；高值代表自我效能高）。多变量分析显示，年龄小、较高的教育水平与更多的哮喘知识相关（p ≤0.005）；更多的社会支持、较少的抑郁症状、更多的哮喘护理有利结果，与更为正面的态度相关（p ≤0 .05）；有利的结果、更为满意的哮喘状态、无应激相关触发物、无近期哮喘急诊就诊与更高效能相关（所有指标均p ≤0.07）。其他多变量分析显示，更多的知识（p =0.0005）、更为积极的态度（p =0.02）和更高的自我效能（p =0.01）与更好的AQLQ评分相关。
结论：不同患者特征哮喘临床特征与认知变量相关，后者与哮喘的自我管理相关。这些变量又与哮喘状态独立相关。因此，有必要采取干预措施，改善上述任何变量，以有利于哮喘控制。
（陈欣 审校）
J Asthma. 2010 Sep 13. [Epub ahead of print]
Knowledge, Attitude, and Self-Efficacy in Asthma Self-Management and Quality of Life.
Mancuso CA, Sayles W, Allegrante JP.
Hospital for Special Surgery, New York, New York, U.S.A.
Abstract
Background. Cognitive variables such as knowledge, attitude, and self-efficacy affect asthma patients’ abilities to be effective self-managers.
Objective. The objective of this cross-sectional analysis was to determine what patient and clinical factors were associated with these cognitive variables and to assess the contributions of these cognitive variables to clinical status.
Methods. Primary care asthma patients were interviewed using the three domains of the Knowledge, Attitude, and Self-Efficacy Asthma Questionnaire (KASE), as well as established scales to measure social support, depressive symptoms, and ratings of asthma care. Clinical asthma status was measured with the Asthma Quality of Life Questionnaire (AQLQ).
Results. In total, 180 patients were enrolled, with a mean age of 43 years and 84% were women. Knowledge was low, with only 50% of patients answering half or more questions correctly (mean score = 52, possible range 0-100, higher is more knowledge). Attitude toward asthma was generally positive (mean score = 82, possible range 20-100, higher is more positive attitude) and self-efficacy was moderate (mean score = 76, possible range 20-100, higher is more self-efficacy). In separate multivariate analyses, younger age and higher education level were associated with more knowledge (p ≤ .005); more social support, fewer depressive symptoms, and more favorable prior results of asthma care were associated with more positive attitude (p ≤ .05); and favorable prior results, more satisfaction with asthma status, not having stress-related triggers, and not having had a recent emergency department visit for asthma were associated with more self-efficacy (p ≤ .07 for all variables). In additional multivariate analyses, more knowledge (p = .0005), more positive attitude (p = .02), and more self-efficacy (p = .01) were associated with better AQLQ scores.
Conclusions. Different patient and clinical characteristics were associated with cognitive variables pertinent to self-management. These variables, in turn, were independently associated with asthma status. Thus, although fostering improvement in all three variables would be desirable, interventions that improve any of these variables potentially could be beneficial.
J Asthma. 2010 Sep 13. [Epub ahead of print]
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基于社区药房的哮喘服务-患者的偏好如何？
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在哮喘患儿中，医疗之家的质量与校内外活动间的关系
