强化行为干预对哮喘病儿家庭医嘱依从性及症状控制的影响

EFFECT OF INTENSIVE BEHAVIORAL INTERVENTION ON MEDICAL ORDER COMPLIANCE OF FAMILY IN CHILDREN WITH ASTHMA AND ITS SYMPTOM CONTROL

目的研究强化行为干预对哮喘病儿家庭医嘱依从性及症状控制的影响。方法将我院门诊62例初次诊断为哮喘的病儿随机分为实验组和对照组。对照组30例给予常规治疗、健康宣教、药物使用指导、指导填写哮喘儿童家庭自我管理量表及儿童哮喘控制测试(C-ACT)评分表,口头告知下次就诊时间。实验组32例强化行为干预,在对照组基础上预约下次就诊时间、发放哮喘日记及峰流速仪,期间电话随访一次。对两组病儿及时复诊率、家庭自我管理评分、C-ACT评分、每次就诊最大呼气峰流速(PEF)、哮喘发作次数及急诊治疗次数进行比较。结果随访3个月,实验组病儿及时复诊率、家庭自我管理量表评分提高值、C-ACT评分提高值、PEF变化值明显高于对照组(χ2=16.718,t=5.268~8.215,P<0.05),哮喘发作次数、急诊治疗次数明显低于对照组(t=9.923、10.260,P<0.05)。结论强化行为干预是提高哮喘病儿家庭医嘱依从性及自我管理能力、改善健康状况、减少哮喘发作及急诊治疗次数的有效措施。

Objective To study the effect of extensive behavioral intervention （EBI） on medical order compliance （MOC） of family of children with asthma and its symptom control. Methods Sixty-two outpatients initially diagnosed with asthma were divided into two groups as experimental and control The control group consisted of 30 sick children who were given conventional therapy, health education, drug-use instruction, guidance to fill in a self-management list of family of kids with asth- ma and childhood asthma control test （C-ACT）, and the time of next doctor＇s office visit was verbally informed. The experimental group consisted of 32 sick kids receiving EBI. They were offered an asthma diary and a peak expiratory flow （PEF） meter, and a phone follow-up once in period of time in addition to the same was conducted in the control group. A comparison was made between the two groups in terms of in time return visit rate, the score of family self-management and C-ACT, PEF at each visit, the fre quency of asthmatic attack and emergency treatment. Results A three-month follow up showed that in the experimental group, the in-time return-visit rate, scores of family sel^management and C-ACT, and changes of PEF were higher than that in the con- trol （X2 = 16.718,t = 5.268--8.215 ,P〈0.05）, and the frequency of asthma attack and emergency treatment were much less （t 9.923,10.260;P〈=0.05）. Conclusion Extensive behavioral intervention is an effective measure in raising compliance with medi- cal order and ability of self-management in family of children with asthma, in improving their health status and decreasing their asthma attacks and emergency treatment.