CAJ | 학술논문

目的评价北京朝阳医院“健康呼吸中心”五年来成人支气管哮喘(简称哮喘)规范化管理与教育对哮喘控制的效果.方法对就诊“健康呼吸中心”,参加过“哮喘之家”活动的572例患者进行问卷调查,了解其对哮喘的认知水平、长期用药情况、哮喘日记、ACT评分和病情控制水平等,并比较哮喘患者教育前、教育后6个月、教育后1年、教育后3年时的生活质量评分的变化.结果 572例被调查哮喘患者的病情控制水平未控制、部分控制、完全控制的分别占46.2％、38.7％和15.1％,其中,了解哮喘发作的诱因占89％,认识哮喘炎症本质占89％,了解哮喘的症状和诊断占72％,认识哮喘的危害并建立起慢性疾病理念占78％,哮喘药物以吸人为主占90％,了解病情的自我监测方法并坚持记录哮喘日记占28％,了解控制水平的分级占38％,了解哮喘临床控制的定义占52％,认识哮喘防治中存在的误区占62％,了解长期治疗的目标占58％,了解哮喘控制测试占68％,近一年内因哮喘急诊就医、住院、因哮喘误工患者分别占9.5％、3.6％和9.6％,定期行肺功能检查者占75.7％.以上结果均显著优于2008年亚太地区哮喘现状研究(AIRIAP)报道的平均水平.572例哮喘患者治疗6个月后,患者的哮喘症状得到较好的控制,活动受限、避免暴露危险因素以及对危险因素的反应均较教育前有所改善(P＜0.05),同时对疾病有了正确的认识,心理情绪、对疾病的担心得到改善,与教育前比较差异均有统计学意义(P＜0.05);3年后再次评价改善更加明显,与教育后1年比较差异有非常显著统计学意义(P＜0.01).结论通过“健康呼吸中心”的活动教育哮喘患者,促进患者的规范治疗,增强患者的认知能力和自我监测、自我管理能力,实现医患之间的伙伴式、互动式关系,减少急性发作、住院率及病死率,从而提高哮喘患者的生活质量,并最终达到控制哮喘的目的. 目的評價北京朝暘醫院“健康呼吸中心”五年來成人支氣管哮喘(簡稱哮喘)規範化管理與教育對哮喘控製的效果.方法對就診“健康呼吸中心”,參加過“哮喘之傢”活動的572例患者進行問捲調查,瞭解其對哮喘的認知水平、長期用藥情況、哮喘日記、ACT評分和病情控製水平等,併比較哮喘患者教育前、教育後6箇月、教育後1年、教育後3年時的生活質量評分的變化.結果 572例被調查哮喘患者的病情控製水平未控製、部分控製、完全控製的分彆佔46.2％、38.7％和15.1％,其中,瞭解哮喘髮作的誘因佔89％,認識哮喘炎癥本質佔89％,瞭解哮喘的癥狀和診斷佔72％,認識哮喘的危害併建立起慢性疾病理唸佔78％,哮喘藥物以吸人為主佔90％,瞭解病情的自我鑑測方法併堅持記錄哮喘日記佔28％,瞭解控製水平的分級佔38％,瞭解哮喘臨床控製的定義佔52％,認識哮喘防治中存在的誤區佔62％,瞭解長期治療的目標佔58％,瞭解哮喘控製測試佔68％,近一年內因哮喘急診就醫、住院、因哮喘誤工患者分彆佔9.5％、3.6％和9.6％,定期行肺功能檢查者佔75.7％.以上結果均顯著優于2008年亞太地區哮喘現狀研究(AIRIAP)報道的平均水平.572例哮喘患者治療6箇月後,患者的哮喘癥狀得到較好的控製,活動受限、避免暴露危險因素以及對危險因素的反應均較教育前有所改善(P＜0.05),同時對疾病有瞭正確的認識,心理情緒、對疾病的擔心得到改善,與教育前比較差異均有統計學意義(P＜0.05);3年後再次評價改善更加明顯,與教育後1年比較差異有非常顯著統計學意義(P＜0.01).結論通過“健康呼吸中心”的活動教育哮喘患者,促進患者的規範治療,增彊患者的認知能力和自我鑑測、自我管理能力,實現醫患之間的夥伴式、互動式關繫,減少急性髮作、住院率及病死率,從而提高哮喘患者的生活質量,併最終達到控製哮喘的目的.
목적 평개북경조양의원“건강호흡중심”오년래성인지기관효천(간칭효천)규범화관리여교육대효천공제적효과.방법 대취진“건강호흡중심”,삼가과“효천지가”활동적572례환자진행문권조사,료해기대효천적인지수평、장기용약정황、효천일기、ACT평분화병정공제수평등,병비교효천환자교육전、교육후6개월、교육후1년、교육후3년시적생활질량평분적변화.결과 572례피조사효천환자적병정공제수평미공제、부분공제、완전공제적분별점46.2％、38.7％화15.1％,기중,료해효천발작적유인점89％,인식효천염증본질점89％,료해효천적증상화진단점72％,인식효천적위해병건립기만성질병이념점78％,효천약물이흡인위주점90％,료해병정적자아감측방법병견지기록효천일기점28％,료해공제수평적분급점38％,료해효천림상공제적정의점52％,인식효천방치중존재적오구점62％,료해장기치료적목표점58％,료해효천공제측시점68％,근일년내인효천급진취의、주원、인효천오공환자분별점9.5％、3.6％화9.6％,정기행폐공능검사자점75.7％.이상결과균현저우우2008년아태지구효천현상연구(AIRIAP)보도적평균수평.572례효천환자치료6개월후,환자적효천증상득도교호적공제,활동수한、피면폭로위험인소이급대위험인소적반응균교교육전유소개선(P＜0.05),동시대질병유료정학적인식,심리정서、대질병적담심득도개선,여교육전비교차이균유통계학의의(P＜0.05);3년후재차평개개선경가명현,여교육후1년비교차이유비상현저통계학의의(P＜0.01).결론 통과“건강호흡중심”적활동교육효천환자,촉진환자적규범치료,증강환자적인지능력화자아감측、자아관리능력,실현의환지간적화반식、호동식관계,감소급성발작、주원솔급병사솔,종이제고효천환자적생활질량,병최종체도공제효천적목적.
Objective To evaluate the effectiveness of systematic bronchial asthma (asthma) patient education programs and self-management in health respiratory center in Beijing Chaoyang Hospital over 5 years.Methods 572 patients who had taken part in the asthma education and management program were surveyed by questionnaire to estimate their knowledge about asthma,long-term utility of medication,possession and using peak flow meter daily,the Asthma Control Test scores were recorded and asthma controlled level were assessed.Results Among 572 patients,the percentages of uncontrolled,partly controlled,controlled asthma assessed by current symptom were 46.2％,38.7％,and 15.1％,respectively.Among these patients,understanding the inflammatory nature of asthma accounted for 89％,knowing the cause of asthma and taking precautionary measures 89％,and taking down a asthma diary account for 28％,within the past year,the percentage of patients with emergency department visit,hospital admission and work miss due to asthma were 9.5％,3.6％,9.6％,respectively 75.7％ of the patients had underwent lung function test were measured at regular intervals.All these results were significantly better than those reported in 2008 AIRIAP.At the end of 6 months treatment,asthma quality of life scores were improved significantly ( P ＜0.05),and at the end of 3 years treatment which showed significant difference with the first year ( P ＜ 0.01 ).Conclusions After long term systematic education and management asthmatic patients understanding of the disease has been improved greatly,and the efficacy of guided self-management has been demonstrated for patients with asthma.As a result the disease gets better control.