A randomized clinical trial to reduce asthma morbidity among inner-city children: Results of the National Cooperative Inner-City Asthma Study
A randomized clinical trial to reduce asthma morbidity among inner-city children: Results of the National Cooperative Inner-City Asthma Study
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DOI：
10.1016/s0022-3476(99)70130-7
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发表时间：
1999-09-01
影响因子：
5.1
通讯作者：
Wedner, HJ
中科院分区：
文献类型：
--
作者：
Evans, R;Gergen, PJ;Wedner, HJ
目的：评价一种以家庭为中心的哮喘干预措施，适用于市中心5至11岁患有中重度哮喘的儿童。研究设计：随机、多点、对照试验，以最大限度地减少症状天数(喘息、失眠、游戏活动减少)，通过两周的回忆来衡量，每隔两个月在两年的随访期内进行评估。干预措施是针对每个家庭的哮喘风险量身定做的。结果：在前12个月中，干预组(n=515)参与者在每次随访前2周的平均症状天数为3.51天，而对照组(n=518)为4.06天，差异为0.55(95%CI，0.18至0.92，P=0.004)。严重哮喘儿童的减少量约为前者的3倍(1.54d/2wk)。对照组儿童在干预期间住院的比例(18.9%)明显高于对照组。干预组为14.8%，下降4.19%(CI，-8.75~0.36，P=0.071)。在第二年的随访中，干预组保持了这些改善，在此期间，他们无法获得哮喘顾问的帮助。结论：我们证明了进行了个性化的、多方面的干预。通过受过哮喘管理培训的大师级社会工作者，可以减少市中心儿童的哮喘症状。
Objective: To evaluate a family-focused asthma intervention designed for inner-city children 5 to 11 years old with moderate to severe asthma.Study design: Randomized, multisite, controlled trial to minimize symptom days (wheeze, loss of sleep, reduction in play activity) measured by a 2-week recall assessed at 2-month intervals over a 2-year follow-up period. The intervention was tailored to each family's individual asthma risk. profile assessed at baseline.Results: Averaged over the first 12 months, participants in the intervention group (n = 515) reported 3.51 symptom days in the 2 weeks before each follow-up interview compared with 4.06 symptom days far the control group (n = 518), a difference of 0.55 (95% CI, 0.18 to 0.92, P = .004). The reduction among children with severe asthma was approximately 3 times greater (1.54 d/2 wk). More children in the control group (18.9%) were hospitalized during the intervention compared with. children in the intervention group (14.8%), a decrease of 4.19% (CI, -8.75 to 0.36, P = .071). These improvements were maintained in the intervention group during the second year of follow-up, during which they did not have access to the asthma counselorConclusions: We demonstrated that an individually tailored, multifaceted intervention carried out. by Masters-level social workers trained in asthma management can reduce asthma symptoms among children in the inner city.