Self-management skills in adolescents with chronic rheumatic disease: A cross-sectional survey
Self-management skills in adolescents with chronic rheumatic disease: A cross-sectional survey
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DOI：
10.1186/1546-0096-9-35
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发表时间：
2011-12-06
影响因子：
2.5
通讯作者：
von Scheven, Emily
中科院分区：
文献类型：
--
作者：
Lawson, Erica F.;Hersh, Aimee O.;von Scheven, Emily
背景资料：对于诊断为终身慢性病的青少年，掌握自我管理技能是向成人护理过渡的关键组成部分。本研究的目的是探讨自我报告的服药依从性和自我护理技能之间的青少年与慢性rheumatoid diseases.Methods：横断面调查的52例青少年患者在加州大学旧金山分校的儿科风湿病诊所。结果的措施是自我报告的药物治疗依从性，药物治疗方案的知识和独立的卫生保健任务。自我管理的预测因素包括年龄、疾病认知、自我护理能力、人口统计学和自我报告的健康状况。使用Student t检验、Wilcoxon秩和检验和Fisher精确检验（如适用）评估双变量相关性。在自我管理任务的独立性进行了比较，年龄在13-16岁和17-20岁之间使用卡方test.Results：受试者的年龄为13-20岁（平均15.9），79%是女性。诊断包括幼年特发性关节炎（44%），狼疮（35%）和其他风湿性疾病（21%）。平均病程为5.3年（SD 4.0）。54%的人报告说完全遵守药物治疗，40%的人报告说每周漏服1-2剂，6%的人报告说漏服3剂或更多剂。最常见的药物丢失原因是健忘。在医疗保健任务中，配药、预约、安排交通、向医生提问、管理保险和识别疾病症状的能力与年龄有关。能力采取药物治疗的指示，保持日历的约会，并保持个人医疗档案并没有随着年龄的增长而改善。结论：这项研究表明，青少年慢性风湿性疾病可能需要额外的支持，以实现独立的自我管理。
Background: For adolescents with a diagnosis of lifelong chronic illness, mastery of self-management skills is a critical component of the transition to adult care. This study aims to examine self-reported medication adherence and self-care skills among adolescents with chronic rheumatic disease.Methods: Cross-sectional survey of 52 adolescent patients in the Pediatric Rheumatology Clinic at UCSF. Outcome measures were self-reported medication adherence, medication regimen knowledge and independence in health care tasks. Predictors of self-management included age, disease perception, self-care agency, demographics and self-reported health status. Bivariate associations were assessed using the Student's t-test, Wilcoxon rank sum test and Fisher exact test as appropriate. Independence in self-management tasks were compared between subjects age 13-16 and 17-20 using the chi-squared test.Results: Subjects were age 13-20 years (mean 15.9); 79% were female. Diagnoses included juvenile idiopathic arthritis (44%), lupus (35%), and other rheumatic conditions (21%). Mean disease duration was 5.3 years (SD 4.0). Fifty four percent reported perfect adherence to medications, 40% reported 1-2 missed doses per week, and 6% reported missing 3 or more doses. The most common reason for missing medications was forgetfulness. Among health care tasks, there was an age-related increase in ability to fill prescriptions, schedule appointments, arrange transportation, ask questions of doctors, manage insurance, and recognize symptoms of illness. Ability to take medications as directed, keep a calendar of appointments, and maintain a personal medical file did not improve with age.Conclusions: This study suggests that adolescents with chronic rheumatic disease may need additional support to achieve independence in self-management.