Self-management behaviors in World Trade Center rescue and recovery workers with asthma.
Self-management behaviors in World Trade Center rescue and recovery workers with asthma.
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世贸中心哮喘救援人员的自我管理行为。
DOI：
10.1080/02770903.2018.1462377
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发表时间：
2019-04
期刊：
影响因子：
--
通讯作者：
Wisnivesky JP
中科院分区：
文献类型：
--
作者：
Rojano B;West E;Goodman E;Weiss JJ;de la Hoz RE;Crane M;Crowley L;Harrison D;Markowitz S;Wisnivesky JP
哮喘是世界贸易中心(WTC)救援和恢复工作人员发病率的主要来源。虽然身心健康并存与哮喘控制不佳有关，但WTC救援和恢复人员坚持自我管理行为(SMB)的潜在作用和决定因素尚不清楚。确定WTC救援和康复人员中坚持哮喘自我管理行为的可改变的决定因素，这些因素可能是未来干预的潜在目标。我们招募了381名患有哮喘的WTC救援和恢复人员。社会人口学数据和哮喘史是在面对面访谈中收集的。基于自我调节模型的框架，我们测量了对哮喘和控制性药物的信念。结果包括服药依从性、吸入器技术、行动计划的使用和触发回避。分别有44%、78%、83%和47%的参与者报告了服药依从性、适当的吸入器技术、使用行动计划和避免触发事件。调整后的分析显示，WTC救援和恢复人员认为他们一直患有哮喘(优势比[OR]：2.37；95%可信区间[CI]：1.38-4.08)，WTC相关哮喘更严重(OR：1.73；95%CI：1.02-2.93)，药物很重要(OR：12.76；95%CI：5.51-29.53)，目前的健康依赖于药物(OR：2.39；95%CI：1.39-4.13)更有可能坚持他们的哮喘药物。疾病信念也与对其他SMB的更高依从性相关。在WTC救援和恢复工作人员中，对SMB的低依从性可能导致哮喘失控。关于哮喘慢性化、控制性药物的重要性和WTC相关哮喘的严重程度的特定可改变信念是该人群中SMB的独立预测因素。针对这些信念的认知行为干预可能会改善WTC救援和恢复人员的哮喘自我管理和结果。改善与世贸中心相关的哮喘结果将需要多因素的方法，如支持遵守控制者的药物和其他自我管理行为。这项研究确定了几种可修改的信念，这些信念可能是未来支持这一患者群体自我管理的目标。
Asthma is a major source of morbidity among World Trade Center (WTC) rescue and recovery workers. While physical and mental health comorbidities have been associated with poor asthma control, the potential role and determinants of adherence to self-management behaviors (SMB) among WTC rescue and recovery workers is unknown. To identify modifiable determinants of adherence to asthma self-management behaviors in WTC rescue and recovery worker that could be potential targets for future interventions. We enrolled a cohort of 381 WTC rescue and recovery workers with asthma. Sociodemographic data and asthma history were collected during in-person interviews. Based on the framework of the Model of Self-regulation, we measured beliefs about asthma and controller medications. Outcomes included medication adherence, inhaler technique, use of action plans, and trigger avoidance. Medication adherence, adequate inhaler technique, use of action plans, and trigger avoidance were reported by 44%, 78%, 83%, and 47% of participants, respectively. Adjusted analyses showed that WTC rescue and recovery workers who believe that they had asthma all the time (odds ratio [OR]: 2.37; 95% confidence interval [CI]: 1.38–4.08), that WTC-related asthma is more severe (OR: 1.73; 95% CI: 1.02–2.93), that medications are important (OR: 12.76; 95% CI: 5.51–29.53), and that present health depends on medications (OR: 2.39; 95% CI: 1.39–4.13) were more likely to be adherent to their asthma medications. Illness beliefs were also associated with higher adherence to other SMB. Low adherence to SMB likely contributes to uncontrolled asthma in WTC rescue and recovery workers. Specific modifiable beliefs about asthma chronicity, the importance of controller medications, and the severity of WTC-related asthma are independent predictors of SMB in this population. Cognitive behavioral interventions targeting these beliefs may improve asthma self-management and outcomes in WTC rescue and recovery workers. Improving World Trade Center-related asthma outcomes will require multifactorial approaches such as supporting adherence to controller medications and other self-management behaviors. This study identified several modifiable beliefs that may be the target of future efforts to support self-management in this patient population.
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影响因子：
4.3
作者：
Boulet, Louis-Philippe;Boulay, Marie-Eve;Cote, Patricia
通讯作者：
Cote, Patricia
影响因子：
4.7
作者：
Horne, R;Weinman, J
通讯作者：
Weinman, J
影响因子：
5.4
作者：
Adams, S;Pill, R;Jones, A
通讯作者：
Jones, A
影响因子：
24.3
作者：
Giraud, V;Roche, N
通讯作者：
Roche, N
哮喘中吸入技术：它与患者对吸入器的偏好和态度有何关系？
DOI：
10.1089/jamp.2016.1287
发表时间：
2017-02
影响因子：
3.4
作者：
Jahedi L;Downie SR;Saini B;Chan HK;Bosnic-Anticevich S
通讯作者：
Bosnic-Anticevich S