医学教育对哮喘患者治疗依从性的影响

The role of the medical education in asthmatic patients's compliance to therapy

目的 评价住院期间医学教育对患者哮喘的知识、自我管理及治疗的影响。方法 对住院患者进行哮喘相关知识的问卷调查 ,将其随机分为教育组 35例 ,住院期间分别给予关于哮喘发病机制、治疗、诱发因素、自我管理计划等内容的医学教育 ;对照组 32例 ,给予常规的治疗与护理。 6个月后再次进行调查 ,了解患者哮喘相关知识的了解程度 ,并以激素使用情况作为依从性指标。结果 在接受哮喘教育之前 ,绝大多数患者 (95 5 % )对哮喘症状都有一定认识 ,但有关哮喘发病机制及治疗知识了解较少 ,大多数患者认为 β2 受体激动剂是最主要的治疗药物 ,将激素作为缓解症状用药 ,且多为不规则用药 ,吸入激素技术错误较多。 6个月后重新调查 ,教育组患者哮喘相关知识的掌握程度和治疗依从性明显好于对照组 (P <0 0 1)。结论 哮喘患者普遍存在哮喘知识不足 ,依从性较差 ;医学教育对改善患者的治疗依从性有重要意义。

Objective To evaluating the impact of medical education with disease knowledge,self-management and inhalation technique on hopsitalized asthma patients.Methods Patients during hospitalization due to acute exacerbation were investigated by a asthma guideline-based questionnaire.Then these subjects were randomly divided into education group (35 cases) received an education programme including basic mechanisms of asthma,cause and trigger,medications,self-management plan,et al and control group (32 cases) received routine treatment without specific education programme.After 6 months,the patients responded to the questionnaire again and the status of asthmatic knowledge and compliance to inhaled corticosteroids were evaluated.Results Our data revealed that before asthma education most of the patients (95.5%) known little about asthma mechanisms and medications although they were able to recognize asthma symptoms.Misunderstanding of β_ 2 -agonist and inhaled steroid was rather common.Otherwise fewer patients could use MDI correctly.After 6 months those patients in education group had a better knowledge of asthma and compliance to ICSs compared to control group.Conclusions Inadequate knowledge of asthma is a main obstacle in maintaining good compliance to therapy in asthma patients and medical education may exert positive impact.