Poor asthma education and medication compliance are associated with increased emergency department visits by asthmatic children.
Poor asthma education and medication compliance are associated with increased emergency department visits by asthmatic children.
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DOI：
10.4103/1817-1737.150735
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发表时间：
2015-04
影响因子：
2.3
通讯作者：
Al-Jahdali H
中科院分区：
文献类型：
--
作者：
Al-Muhsen S;Horanieh N;Dulgom S;Aseri ZA;Vazquez-Tello A;Halwani R;Al-Jahdali H
哮喘的急性加重仍然是儿科患者频繁到急诊科就诊的主要原因。然而，据报道，其他因素，包括心理社会、行为和教育，也与重复就诊急诊室有关。因此，有必要确定这种访问是否合理。这项横断面研究的目的是确定与哮喘儿童去急诊室就诊相关的危险因素。研究对象为1-17岁的哮喘儿童(n=297)，在两家大医院的急诊室就诊时收集信息。哮喘患者平均每年就诊ED3.93.2次。60.3%的患者认为哮喘控制不充分。大多数患者(56.4%)报告没有接受关于哮喘的教育。患者反映了对急诊科的误解，包括认为有更有效的治疗方法(40.9%)，或认为急诊科工作人员更有资格(27.8%)。约半数病人(48.2%)前往急症室就诊，是因为24小时开放方便，或因为即时接诊(38.4%)。未得到控制的哮喘与哮喘和/或药物使用方面的教育不足有关。接受过哮喘知识教育的患者在症状好转时不太可能停止皮质类固醇治疗(OR：0.55；95%CI：0.3~0.9；P=0.04)。这项研究报告，大多数患者对哮喘的知识缺乏，并且用药不当，这表明管理行动计划的应用效率低下。不必要和频繁地前往急诊室进行哮喘护理，与哮喘和药物使用方面的教育不足有关。发现了卫生系统在引导病人前往适当医疗设施方面的潜在缺陷，并强调有必要改进对病人及其父母/监护人关于疾病和服药依从性的教育。
Acute exacerbations of bronchial asthma remain a major cause of frequent Emergency Department (ED) visits by pediatric patients. However, other factors including psychosocial, behavioural and educational, are also reportedly associated with repetitive ED visits. Therefore, it is necessary to determine whether such visits are justifiable. The objective of this cross-sectional study was to identify risk factors associated with visits to ED by asthmatic children. Asthmatic children (n = 297) between 1-17 years old were recruited and information collected at the time of visiting an ED facility at two major hospitals. Asthmatic patients visited the ED 3.9 3.2 times-per-year, on average. Inadequately controlled asthma was perceived in 60.3% of patients. The majority of patients (56.4%) reported not receiving education about asthma. Patients reflected misconceptions about the ED department, including the belief that more effective treatments are available (40.9%), or that the ED staff is better qualified (27.8%). About half of patients (48.2%) visited the ED because of the convenience of being open 24 hours, or because they are received immediately (38.4%). Uncontrolled asthma was associated with poor education about asthma and/or medication use. Patients educated about asthma, were less likely to stop corticosteroid therapy when their symptoms get better (OR:0.55; 95% CI:0.3-0.9; P = 0.04). This study reports that most patients had poor knowledge about asthma and were using medications improperly, thus suggesting inefficient application of management action plan. Unnecessary and frequent visits to the ED for asthma care was associated with poor education about asthma and medication use. Potential deficiencies of the health system at directing patients to the proper medical facility were uncovered and underline the necessity to improve education about the disease and medication compliance of patients and their parents/guardians.
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影响因子：
1.9
作者：
Fuhrman, Claire;Dubus, Jean-Christophe;Delmas, Marie-Christine
通讯作者：
Delmas, Marie-Christine
影响因子：
9.6
作者：
Baren, JM;Boudreaux, ED;Camargo, CA
通讯作者：
Camargo, CA
影响因子：
4.4
作者：
Michelson, Kenneth A.;Monuteaux, Michael C.;Bachur, Richard G.
通讯作者：
Bachur, Richard G.
影响因子：
11.5
作者：
Mysore, Satya;Ruffin, Richard E.
通讯作者：
Ruffin, Richard E.
DOI：
10.1007/s11524-012-9774-7
发表时间：
2013-04-01
影响因子：
6.6
作者：
Patel, Minal R.;Brown, Randall W.;Clark, Noreen M.
通讯作者：
Clark, Noreen M.