患儿及其父母关于医生开展哮喘宣教的报告
2011/10/13
摘要
目的：临床实践指南要求医生对患者及其家属进行哮喘方面的健康教育。医生到底做得怎么样？我们通过考察以下指标来了解患儿及其父母的看法：（1）父母和患儿报告医生曾讨论过哮喘宣教主题的比例；（2）儿童报告中的年龄段差异；（3）儿童和父母报告中的场所差异；（4）与儿童报告相关的社会人口统计学和疾病特征；（5）患儿报告与日常哮喘控制治疗依从性的关系。
方法： 共有125名哮喘患儿（平均年龄11.3岁；62%为男性）及其父母入选本横断面研究。人口统计学数据和疾病相关数据由父母提供。患儿报告医生是否与其讨论过与哮喘宣教相关的16个主题。采用logistic回归分析对患儿报告中医生参与交流的各个主题进行年龄组差异和场所差异考察。利用多变量线性回归分析来判别人口统计学（如儿童年龄、种族）、疾病（如症状严重程度）变量与讨论主题之间的相关性。
结果：平均34.7%的患儿主诉医生与其至少讨论1个主题；与11岁或以上患儿相比，8～10岁患儿报告讨论的主题要少（P<0.05）。父母的报告存在诊疗场所差异，而患儿报告则无此差异。多变量分析显示，患儿年龄（β = 0.46 (SE: 0.17); p < .01）、持续性症状（β = 1.59 (SE: 0.80); p < .05）和门诊哮喘就诊次数（β = 0.19 (SE: 0.08); p < .05）与讨论的主题数量显著相关。
结论：这些结果显示，大部分哮喘患儿未曾受到过医生有关哮喘处理方面的基础知识宣教，或者已经忘记。患者来医院就诊时是开展教育的绝佳机会，医生应该充分利用这一机会，帮助哮喘患儿树立战胜疾病的信息，掌握照顾自己的能力。
（苏楠 审校）
J Asthma. 2011 Aug 22. [Epub ahead of print]
Children’s and Parents’ Report of Asthma Education Received from Physicians.
Orrell-Valente JK, Jones K, Manasse S, Thyne SM, Shenkin BN, Cabana MD.
Source
Department of Pediatrics, University of California , San Francisco, CA , USA.
Abstract
OBJECTIVE： Clinical practice guidelines recommend that physicians provide asthma education to patients and their families. To characterize parents’ and children’s perception of physician practice, we examined: (i) proportion of parents and children reporting physician discussion of asthma education topics; (ii) age-group differences in children’s report; (iii) site differences in children’s and parents’ report; (iv) sociodemographic and disease characteristics associated with children’s report; and (v) the relation between children’s report and adherence to daily controller medications.
METHODS： We conducted a cross-sectional study of 125 children with asthma (mean age = 11.3 years; 62% were male) and their parents. Parents provided demographic and disease data. Children reported whether physicians had ever discussed each of 16 asthma education topics with them. We used logistic regression to examine age-group and site differences in children’s report of physician discussion of each topic. Multivariate linear regression was used to determine associations between demographic (e.g., child age, race) and disease (e.g., symptom severity) variables and topics discussed. RESULTS： On average, 34.7% of children reported physician discussion of a topic; 8-10-year-olds reported significantly fewer topics discussed than children aged 11 and older (p < .05). Whereas parents’ report differed by practice setting, children’s report did not. In multivariate analyses, child age (β = 0.46 (SE: 0.17); p < .01), persistent symptoms (β = 1.59 (SE: 0.80); p < .05), and number of outpatient asthma visits (β = 0.19 (SE: 0.08); p < .05) remained significantly associated with number of topics discussed.
CONCLUSION： These results suggest that the majority of children either may not receive, or may not recall receiving, information from their physicians about the fundamentals of asthma management. Physicians have an invaluable teaching opportunity in the medical office visit and should consider capitalizing on this opportunity to build children’s sense of self-efficacy and competence in their self-care.
J Asthma. 2011 Aug 22. [Epub ahead of print]
目的：临床实践指南要求医生对患者及其家属进行哮喘方面的健康教育。医生到底做得怎么样？我们通过考察以下指标来了解患儿及其父母的看法：（1）父母和患儿报告医生曾讨论过哮喘宣教主题的比例；（2）儿童报告中的年龄段差异；（3）儿童和父母报告中的场所差异；（4）与儿童报告相关的社会人口统计学和疾病特征；（5）患儿报告与日常哮喘控制治疗依从性的关系。
方法： 共有125名哮喘患儿（平均年龄11.3岁；62%为男性）及其父母入选本横断面研究。人口统计学数据和疾病相关数据由父母提供。患儿报告医生是否与其讨论过与哮喘宣教相关的16个主题。采用logistic回归分析对患儿报告中医生参与交流的各个主题进行年龄组差异和场所差异考察。利用多变量线性回归分析来判别人口统计学（如儿童年龄、种族）、疾病（如症状严重程度）变量与讨论主题之间的相关性。
结果：平均34.7%的患儿主诉医生与其至少讨论1个主题；与11岁或以上患儿相比，8～10岁患儿报告讨论的主题要少（P<0.05）。父母的报告存在诊疗场所差异，而患儿报告则无此差异。多变量分析显示，患儿年龄（β = 0.46 (SE: 0.17); p < .01）、持续性症状（β = 1.59 (SE: 0.80); p < .05）和门诊哮喘就诊次数（β = 0.19 (SE: 0.08); p < .05）与讨论的主题数量显著相关。
结论：这些结果显示，大部分哮喘患儿未曾受到过医生有关哮喘处理方面的基础知识宣教，或者已经忘记。患者来医院就诊时是开展教育的绝佳机会，医生应该充分利用这一机会，帮助哮喘患儿树立战胜疾病的信息，掌握照顾自己的能力。
（苏楠 审校）
J Asthma. 2011 Aug 22. [Epub ahead of print]
Children’s and Parents’ Report of Asthma Education Received from Physicians.
Orrell-Valente JK, Jones K, Manasse S, Thyne SM, Shenkin BN, Cabana MD.
Source
Department of Pediatrics, University of California , San Francisco, CA , USA.
Abstract
OBJECTIVE： Clinical practice guidelines recommend that physicians provide asthma education to patients and their families. To characterize parents’ and children’s perception of physician practice, we examined: (i) proportion of parents and children reporting physician discussion of asthma education topics; (ii) age-group differences in children’s report; (iii) site differences in children’s and parents’ report; (iv) sociodemographic and disease characteristics associated with children’s report; and (v) the relation between children’s report and adherence to daily controller medications.
METHODS： We conducted a cross-sectional study of 125 children with asthma (mean age = 11.3 years; 62% were male) and their parents. Parents provided demographic and disease data. Children reported whether physicians had ever discussed each of 16 asthma education topics with them. We used logistic regression to examine age-group and site differences in children’s report of physician discussion of each topic. Multivariate linear regression was used to determine associations between demographic (e.g., child age, race) and disease (e.g., symptom severity) variables and topics discussed. RESULTS： On average, 34.7% of children reported physician discussion of a topic; 8-10-year-olds reported significantly fewer topics discussed than children aged 11 and older (p < .05). Whereas parents’ report differed by practice setting, children’s report did not. In multivariate analyses, child age (β = 0.46 (SE: 0.17); p < .01), persistent symptoms (β = 1.59 (SE: 0.80); p < .05), and number of outpatient asthma visits (β = 0.19 (SE: 0.08); p < .05) remained significantly associated with number of topics discussed.
CONCLUSION： These results suggest that the majority of children either may not receive, or may not recall receiving, information from their physicians about the fundamentals of asthma management. Physicians have an invaluable teaching opportunity in the medical office visit and should consider capitalizing on this opportunity to build children’s sense of self-efficacy and competence in their self-care.
J Asthma. 2011 Aug 22. [Epub ahead of print]
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提高城市青少年哮喘防治水平的初步研究
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哮喘患者日常生活中体力活动、肺功能及气短情况研究
