攀枝花市中心医院老年哮喘患者疾病自我管理能力现状分析

Current Status of Disease Self-management Ability in Elderly Patients With Asthma in Panzhihua Central Hospital

目的分析攀枝花市中心医院256例老年支气管哮喘患者疾病自我管理现状,建立疾病自我管理能力提高机制。方法选取2017-03/2018-02攀枝花市中心医院256例65~80岁老年支气管哮喘住院患者,在其知情同意情况下收集其一般资料,并且调查疾病控制水平、哮喘控制测试(Asthma Control Test,ACT)评分以及哮喘管理情况,按照ACT评分差异分为控制良好组与未控制组,比较两组一般资料与各调查指标,分析哮喘控制水平影响因素。结果疾病控制水平与ACT评分具有一致性(Kappa值为0.93);控制良好组BMI(23.05±2.46)低于未控制组(24.26±2.58)(t=3.704,P<0.05),疾病认知程度评分、本科及以上、无吸烟史、规律应用复合糖皮质激素患者所占比例高于未控制组(P<0.05);Logistic回归分析显示,有吸烟史(OR=3.191,95%CI:1.302~5.487)、未规律应用复合糖皮质激素(OR=4.223,95%CI:1.624~8.172)、疾病认知程度低(OR=4.406,95%CI:1.402~8.319)均为影响哮喘控制水平独立危险因素。结论256例老年支气管哮喘患者疾病自我管理情况并不理想,影响哮喘控制水平独立危险因素主要包括有吸烟史、未规律应用复合糖皮质激素以及疾病认知程度低。

Objective To analyze the current status of disease self-management ability in 256 elderly patients with bronchial asthma in Panzhihua Central Hospital,and establish a mechanism for improving disease self-management ability.Methods A total of 256 elderly inpatients aged 65 to 80 years old with bronchial asthma in Panzhihua Central Hospital from March 2017 to February 2018 were enrolled in the study.Their general information was collected under the condition that they knew about the situation and agreed with it.The level of disease control,score of Asthma Control Test(ACT)and asthma management were investigated.According to the scoring differences of ACT,they were divided into the well-controlled group and the uncontrolled group.The general data and each survey index were compared between the two groups.The influencing factors of asthma control level were analyzed.Results The level of disease control was consistent with the ACT score(Kappa value=0.93).The BMI of wellcontrolled group(23.05±2.46)was lower than that of uncontrolled group(24.26±2.58)(t=3.704,P<0.05).The disease cognitive degree score,proportions of patients with education level of undergraduate or above,without smoking history,patients regularly using complex glucocorticoids were higher than those of the uncontrolled group(P<0.05).Logistic regression analysis showed that smoking history(OR=3.191,95%CI:1.302-5.487),irregular application with complex glucocorticoids(OR=4.223,95%CI:1.624-8.172)and low cognitive degree of the disease(OR=4.406,95%CI:1.402-8.319)were independent risk factors for asthma control level(P<0.05).Conclusion The disease management in 256 elderly patients with bronchial asthma is not ideal.The independent risk factors affecting asthma control level mainly include smoking history,irregular application with complex glucocorticoids and low cognitive degree of the disease.