哮喘联盟

   摘要
   目的：结果评估是呼吸道疾病管理的一个重要部分，但老年患者对于结果评估试验可能会感到困难和负担。本研究评价了老年患者对气道疾病评估试验的感受。
   资料来源：伴有气道阻塞性疾病的老年患者（>55岁）和健康对照者（N=56）进行吸入装置使用方法评估、皮肤过敏性试验、静脉穿刺术、呼出气中一氧化氮浓度（FENO）和气体扩散测定、运动测试、痰液诱导试验、和问卷评估。之后，受试者完成一份负担评估问卷，包括5个维度：困难、不适、疼痛、症状和试验持续时间。
   结果：受试者对试验总体感受良好。感到负担最大的是痰诱导试验，其负担评估问卷结果为感到更困难（平均0.83, P = 0.001）、更不适（平均1.3, P < 0.001）、更痛（0.46, P = 0.019）、更长的试验持续时间（0.84, P < 0.001）和更差的症状（0.55, P = 0.001）。老年患者对FENO测定的评价更好，但认为操作起来困难；其对吸入装置使用方法的评价最好。
   结论：老年呼吸道疾病患者对于其在疾病护理过程中可能遇到的检测试验总体感受良好。但对较新的痰诱导试验和FENO测定感到有一定难度，尤其是痰诱导试验。该研究结果为临床实践提供了有用的信息，这包括：给老年患者进行试验时需要注意试验细节和相关不良反应，并应清楚解释试验用处、以及试验结果对于患者有何帮助。
 

（刘国梁 审校）
Clin Respir J. 2013 Mar 20. doi: 10.1111/crj.12017. [Epub ahead of print]

 

Older peoples' perception of tests used in the assessment and management of COPD and asthma.

McDonald VM, Simpson JL, McElduff P, Gibson PG.

Source
Centre for Asthma and Respiratory Diseases, The University of Newcastle, Newcastle, NSW, Australia; Department of Respiratory and Sleep Medicine, Hunter Medical Research Institute John Hunter Hospital, Newcastle, NSW, Australia; School of Nursing and Midwifery, The University of Newcastle, Newcastle, NSW, Australia; School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia.

Abstract
OBJECTIVES:Outcome assessment is an important part of the management of airways disease, yet older adults may have difficulty with the burden of testing. This study evaluated the patient perception of tests used for the assessment of airways disease in older people.
DATA SOURCE:Older adults (>55 years) with obstructive airway disease and healthy controls (N = 56) underwent inhaler technique assessment, skin allergy testing, venepuncture, fractional exhaled nitric oxide (FENO) and gas diffusion measurement, exercise testing, sputum induction, and questionnaire assessment. They then completed an assessment burden questionnaire across five domains: difficulty, discomfort, pain, symptoms and test duration.
RESULTS:Test perception was generally favourable. Induced sputum had the greatest test burden perceived as being more difficult (mean 0.83, P = 0.001), associated with more discomfort (mean 1.3, P < 0.001), more painful (0.46, P = 0.019), longer test duration (0.84, P < 0.001) and worsening symptoms (0.55, P = 0.001) than the questionnaires. FENO had a more favourable assessment but was assessed to be difficult to perform. Inhaler technique received the most favourable assessment.
CONCLUSIONS:Older adults hold favourable perceptions to a range of tests that they might encounter in the course of their care for airway disease. The newer tests of sputum induction and FENO have some observed difficulties, in particular sputum induction. The results of this study can inform current practice by including details of the test and its associated adverse effects when conducting the test, as well as providing clear explanations of the utility of tests and how the results might aid in patient care.
 

Clin Respir J. 2013 Mar 20. doi: 10.1111/crj.12017. [Epub ahead of print]