对哮喘患者进行教育管理的内容和方法

目前尚不能根治哮喘,然而长期管理有助于达到哮喘控制,哮喘教育是其重要组成部分.哮喘教育内容应包括哮喘的诊断、预防及治疗相关的知识、技能.应当采取个体化、循序渐进的教育方式,集体教育是个体化教育重要的补充.     

个体化概念辨析

个体化过程是当代儿童青少年发展与教育研究中的重要课题。然而,由于该研究领域处于持续发展变化之中,目前研究者关于个体化概念的看法存在着诸多分歧。文章从个体化理论及概念涵义的发展、个体化测量及操作性定义的发展两个角度对目前研究中的个体化概念进行了分析和总结,在此基础上对现有概念进行了整合：个体化是个体在认知与情感等领域中,在逐渐形成亲子联结的新形式的同时,不断发展独立自主品质的过程。文章还对个体化与相关概念之间的关系进行了辨析。     

哮喘防控模式的几点思考

简单介绍了在支气管哮喘患者教育和管理工作中的若干体会。结果表明,我们所采取的哮喘教育管理体系(包括哮喘患者门诊、哮喘患者协会和哮喘宣教中心)是一种先进的医疗服务模式,不仅可以有效地改善医患关系,还可以显著提高哮喘患者对哮喘认知水平和防治疾病的依从性,提高哮喘控制水平、生命质量,减少非预约门诊、急诊、住院次数,降低医疗费用。     

哮喘防控模式的几点思考

简单介绍了在支气管哮喘患者教育和管理工作中的若干体会.结果表明,我们所采取的哮喘教育管理体系(包括哮喘患者门诊、哮喘患者协会和哮喘宣教中心)是一种先进的医疗服务模式,不仅可以有效地改善医患关系,还可以显著提高哮喘患者对哮喘认知水平和防治疾病的依从性,提高哮喘控制水平、生命质量,减少非预约门诊、急诊、住院次数,降低医疗费用.     

哮喘教育与管理：临床医学与公共卫生结合的探索

支气管哮喘是一种慢性呼吸道疾病,因而不仅需要对患者进行规范的治疗,而且需要对其进行系统教育和管理,我们经历了15年的实践,最终形成了一种有效的哮喘教育管理模式——三位一体哮喘教育和管理模式,哮喘有效控制率达80％以上,这是弥合临床医学与公共卫生学之间裂痕的有益尝试,值得推广。     

哮喘教育与管理:临床医学与公共卫生结合的探索

支气管哮喘是一种慢性呼吸道疾病,因而不仅需要对患者进行规范的治疗,而且需要对其进行系统教育和管理,我们经历了15年的实践,最终形成了一种有效的哮喘教育管理模式--三位一体哮喘教育和管理模式,哮喘有效控制率达80%以上,这是弥合临床医学与公共卫生学之间裂痕的有益尝试,值得推广.     

导言:搞好哮喘教育管理 提高哮喘控制水平

<正>支气管哮喘是一种常见的慢性呼吸系统疾病,严重危害广大人民的身体健康和生活质量,并造成沉重的经济负担。如何有效控制哮喘是我国医学上的一大难点。我们在多年的临床实践中认识到,只有把防控哮喘的相关知识传递给患者并认真进行哮喘的教育和管理工作才可能全面     

支气管哮喘伴发抑郁与人格、应对和社会支持的关系分析

研究分析支气管哮喘伴发抑郁与人格、应对和社会支持的关系。对216例支气管哮喘患者应用自评抑郁量表、大五人格量表、特质应对方式问卷和社会支持评定量表进行调查,对收集到的数据进行Pearson相关分析、多元逐步回归分析和路径分析。结果显示49．1％的支气管哮喘患者存在不同程度的抑郁情绪;哮喘患者的抑郁程度、人格、应对方式和社会支持之间存在着不同程度的显著相关;人格、应对和社会支持都是影响支气管哮喘伴发抑郁的影响因素,人格的神经质是其重要的预测因素,它除了能直接影响哮喘患者的抑郁程度,还能通过社会支持和应对方式对其起间接的作用。研究提示人格的神经质、公正严谨性和消极应对方式是支气管哮喘伴发抑郁的直接的预测因素。     

哮喘教育和管理工作中的一些新的启示与思考

简要叙述了目前哮喘防治中存在的问题,提出必须彻底转变哮喘防控模式,简单介绍了我们自己的哮喘教育和管理的具体做法及其效果,最后就哮喘的防控和管理提出一些值得思考的问题,包括建立和谐医患关系,减轻医疗经济负担,建立新型疾病防控模式和医疗服务体系等。     

小儿支气管哮喘和胃食管返流关系的哲学思考

支气管哮喘是当今世界上最常见的气道慢性炎症性疾病,运用哲学的观点认识小儿支气管哮喘与胃食管返流之间的关系,对于支气管哮喘合并胃食管返流的临床治疗非常重要.     

Emotion and adherence to treatment in people with asthma: An application of the emotional Stroop paradigm

This study explored whether an emotional Stroop paradigm might represent an appropriate means of assessing individuals' emotional representations of asthma. In addition, the opportunity was taken to investigate whether emotional representations of asthma, as assessed by this method, were associated with adherence to inhaled preventative medication. An asthma Stroop task was devised which comprised three sets of stimuli: asthma symptom words, general negative words, and neutral words. Three groups of participants were compared on their performance on this task: individuals with asthma, individuals without asthma, and individuals without asthma who had been primed about the condition. It was found that individuals with asthma experienced significantly more interference when colour‐naming the asthma symptom words, but not when colour‐naming the general negative words. Furthermore, their performance on the asthma Stroop task was associated with self‐reported adherence levels. Specifically, individuals who reported the highest and lowest levels of adherence displayed more interference when colour‐naming the asthma symptom words than individuals with intermediate levels of adherence. It is concluded that the emotional Stroop paradigm might provide an objective and sensitive means of assessing individuals’ emotional representations of illness. Additionally, it is proposed that emotional responses to illness should be assessed and included in research designed to explain health behaviours and, furthermore, that such research should not assume that any relationship between emotional representations and health behaviours will be linear.     

A Randomized Controlled Pilot Study of Motivational Interviewing to Change Attitudes about Adherence to Medications for Asthma

The day-to-day management of asthma relies on patient self-care practices; in particular, adherent use of asthma medications is fundamental for asthma management. However, most persons with asthma do not use their medications to clinically acceptable standards. The purpose of this study was to test the efficacy of a brief educational intervention to enhance knowledge and skills relevant to asthma self-care, and the efficacy of motivational interviewing to improve attitudes toward taking medications as prescribed. Twenty-five adults with asthma were randomly assigned to receive a brief educational intervention alone, or education plus motivational interviewing. Over time, all participants improved their knowledge of asthma and skills using a metered dose inhaler. Participants who received education alone showed a decreased level of readiness to adhere with their medications over time, whereas participants who received motivational interviewing were more likely to show a stable or increased level of readiness to adhere over time. Among participants who described themselves as not consistently adhering with their medications at the first evaluation, those who received motivational interviewing endorsed more positive attitudes toward taking medications over time. The results are supportive of the utility of motivational interviewing in enhancing participants' attitudes toward adherent medication use. Future research should test if attitude change is reflected in change in medication use.     

儿童支气管哮喘诊断的几点思考

支气管哮喘（以下简称哮喘）是小儿常见的慢性气道疾病。5岁及以下儿童哮喘的诊断极为困难,是富有挑战性的;因为诊断只能依靠临床判断、症状评价和体征分析。病毒感染所至的喘息在婴幼儿期很常见,与哮喘鉴别较困难。目前还没有诊断婴幼儿期哮喘的特异检测手段和方法,因此诊断需要综合考虑,包括反复喘息的类型、特异体质病史、哮喘危险因素、长期随访、广泛鉴别诊断和观察对支气管舒张剂及抗炎治疗的反应。     

我国城镇社区医疗单位如何进行哮喘防控

哮喘防控工作是一项长期而艰巨的任务,城镇社区医疗单位在工作中应推广以"哮喘临床控制"为核心的哮喘治疗循环模式,即评估患者的哮喘控制水平、治疗并达到哮喘控制、监测并维持哮喘控制。当患者出现哮喘急性发作时,应遵循哮喘急性发作的治疗流程规范处理,尽快有效控制患者的症状。     

Reexamining the familial association between asthma and ADHD in girls

The objective of this study is to further evaluate the association between asthma and ADHD, addressing issues of familiality in female probands. A case control study of referred ADHD proband girls, controls, and relatives are used. Participants include 140 ADHD proband girls and 122 non-ADHD comparisons, with 417 and 369 first-degree biological relatives, respectively. Relatives are stratified into four groups according to proband ADHD and asthma status. The authors compare rates of asthma and ADHD in relatives. ADHD does not increase the risk for asthma in probands. Patterns of familial aggregation are mostly consistent with independent transmission of ADHD and asthma in families of girl probands. The results extend to female probands' previously reported findings that asthma and ADHD are independently transmitted in families. These findings further support the conclusion that ADHD symptoms should not be dismissed as part of asthma symptomatology or a consequence of its treatment.     

Comorbidity in allergic asthma and allergic rhinitis: functional somatic syndromes

Based on the concept of central sensitisation, the present study tested the hypothesis of comorbidity in allergic asthma and allergic rhinitis with diagnoses of functional somatic syndromes (FSSs), including fibromyalgia, irritable bowel syndrome and migraine. Data were used from the population-based Västerbotten Environmental Health Study (n = 3406). The participants consisted of 164 individuals with allergic asthma and 298 individuals with allergic rhinitis as well as 2876 individuals without allergic or non-allergic asthma, allergic rhinitis or atopic dermatitis. Diagnoses were based on self-reports of having been diagnosed by a physician. Odds ratios (ORs) were calculated from binary logistic regression analysis, both crude and adjusted for age and education. The adjusted ORs (1.87–4.00) for all FSSs differed significantly from unity for both allergic asthma and rhinitis. The results provide support for the hypothesis of comorbidity in allergic asthma and rhinitis with FSSs. Since central sensitisation is likely to underlie FSSs, the present findings raises the question as to whether central sensitisation may also be involved in allergic asthma and rhinitis.     

做好哮喘控制工作利国又利民

本文结合我院哮喘教育管理工作的成绩和经验,系统地阐述了做好哮喘控制工作的重要意义,包括减少哮喘发作减轻患者痛苦;提高哮喘患者生命质量;降低医疗费用;减轻社会和家庭负担;减少误工误学,保护社会生产力;有助于解决"看病贵"问题和构建和谐的医患关系等。     

Asthma severity, child security, and child internalizing: using story stem techniques to assess the meaning children give to family and disease-specific events

Children with persistent asthma are at increased risk for mental health problems. Although mechanisms of effect are not yet known, it may be that children are less trusting of the family as a source of support and security when they have more severe asthma. This study tested whether asthma severity is related to children's perceptions of insecurity in the family, and whether insecurity is in turn associated with child adjustment. Children (N = 168; mean age = 8 years) completed story stems pertaining to routine family events (e.g., mealtimes) and ambiguous but potentially threatening asthma events such as tightness in the chest. Responses were evaluated for the extent to which appraisals portrayed the family as responding in cohesive, security-provoking ways. Asthma severity was assessed by both objective lung function testing and primary caregiver report. Caregivers reported child symptomatology. Beyond medication adherence, caregiver education, and child age and gender, greater asthma severity predicted more internalizing and externalizing symptoms. Greater asthma severity, assessed using spirometry (but not parent report), was related to less secure child narratives of the family, which in turn related to more child internalizing symptoms. Results suggest that asthma can take a considerable toll on children's feelings of security and mental health. Furthermore, given the difficulty in assessing young children's perceptions, this study helps demonstrate the potential of story stem techniques in assessing children's appraisals of illness threat and management in the family.     

The Association of Disease Severity, Functional Status, and Medical Utilization with Relationship Satisfaction among Asthma Patients and Their Partners

The association of relationship satisfaction to asthma-related illness factors was examined among 46 couples in which one person had asthma of mild-to-moderate severity. The asthma-related illness factors included measures of disease severity, functional status, and medical utilization. More asthma severity and greater use of asthma medications accounted for 27% of the variance in relationship satisfaction. These results diverge from the general notion that more illness should be associated with more relationship distress. The findings are discussed in the context of the potentially buffering effects of the relationship satisfaction among the couples in the present sample against the stress of a chronic illness.