搞好哮喘控制是一项长期而艰巨的任务

哮喘在全世界是一个严重的公共卫生问题.当哮喘未控制时,哮喘可以影响患者的日常生活质量,甚至可以致命.搞好哮喘控制工作是一项长期而艰巨的任务,在实际工作中应推广以"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.     

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。     

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.     

哮喘控制与医疗改革

达到并维持哮喘控制和减少未来风险是哮喘的管理目标,绝大多数患者通过药物治疗可以实现这一目标。但目前哮喘控制率很低,除与GINA和我国哮喘诊治规范实施不足有关外,还与传统医疗结构、医疗体制和医疗观念有关,加速医疗改革,人人享有基本医疗卫生服务是提高哮喘控制率的重要环节。     

哮喘控制与医疗改革

达到并维持哮喘控制和减少未来风险是哮喘的管理目标,绝大多数患者通过药物治疗可以实现这一目标.但目前哮喘控制率很低,除与GINA和我国哮喘诊治规范实施不足有关外,还与传统医疗结构、医疗体制和医疗观念有关,加速医疗改革,人人享有基本医疗卫生服务是提高哮喘控制率的重要环节.     

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.     

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     

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。     

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.     

Feasibility and impact of a school-based intervention for families of urban adolescents with asthma: results from a randomized pilot trial

The purpose of this study was to test the feasibility and short-term outcomes of Asthma: It's a Family Affair!, a school-based intervention for adolescents with asthma and their caregivers. Twenty-four ethnic minority families with a middle school student with asthma were randomized to immediate intervention or no-treatment control. Intervention students received six group sessions on prevention and management of asthma. Caregivers received five group sessions teaching child-rearing skills to support the youth's autonomy and asthma self-management. All students attended all sessions; caregivers attended an average of three. Two months post-intervention, relative to controls, intervention caregivers reported better problem-solving with children. Intervention students were more responsible for carrying medication, took more prevention steps, and woke fewer nights from asthma. The intervention resulted in positive short-term changes in family relations, asthma management by students, and health status.     

Norwegian versions of the Living with Asthma Questionnaire (LWAQ) and Asthma Bother Profile (ABP), validation and comparison of two asthma groups

The Living with Asthma Questionnaire (LWAQ) and the Asthma Bother Profile (ABP) were translated into Norwegian using conventional back translation procedures, and completed by 30 asthma outpatients and 30 asthma patients admitted to inpatient rehabilitation. Reliability (Cronbach's alpha and retest-reliability) was shown to be good for both scales. Validity was established by showing significantly poorer health in the rehabilitation sample, and correlations with state and trait anxiety. The Norwegian translations are reliable and valid versions of the original questionnaires.     

Illness-specific catastrophic thinking and overperception in asthma.

OBJECTIVE: This study investigated the role of illness-specific catastrophic thinking in symptom perception in asthma. DESIGN AND MAIN OUTCOME MEASURES: A total sample of 72 patients with intermittent to moderate persistent asthma completed the Catastrophizing about Asthma Scale and completed the Asthma Symptom Checklist to measure retrospective symptom reporting. In addition, symptoms were concurrently assessed during different respiratory challenges eliciting mild and ambiguous versus salient and pronounced symptoms. RESULTS: Catastrophic thinking in general, when patients are not having an exacerbation, is related to an increase in emotional symptoms, especially in ambiguous situations where respiratory difficulties could occur. Catastrophic thinking during exacerbations is related to an increase in emotional symptoms as well as in respiratory symptoms during respiratory challenges. CONCLUSION: These strong relationships between catastrophic thinking and increased perception of asthma symptoms suggest a link between illness-specific catastrophic thinking and overperception. Consequently, catastrophic thoughts are an important target for psychological interventions in support of drug treatment.     

Emotional competence and quality of life of children with asthma: The mediating effect of coping strategies

This study explored the mediating effect of coping strategies on the relationship between emotional competence (EC) and quality of life (QOL) among children with asthma. Participants were 87 children (M age?=?11.72, SD?=?2.58) with controlled and partially controlled asthma, undergoing everyday treatment. They filled in questionnaires assessing EC, coping strategies and QOL. Results showed that the association between some ECs and the QOL of children with asthma was fully mediated by two maladaptive cognitive coping strategies. Among children with asthma, a greater ability to differentiate their emotions, a reduced attention to bodily signals of emotions and a reduced analysis of their current emotional state were related to decreased engagement in two coping strategies (‘Ignoring Asthma’ and ‘Worrying about Asthma’), which in turn increased their QOL. These findings show that EC has an indirect effect on QOL through very specific coping strategies. They also emphasise the importance of screening EC in children with asthma and the importance of developing and using multidisciplinary interventions for them.     

解读2009年GINA——5岁及5岁以下儿童哮喘诊断与管理

2009年5月,全球哮喘防治创议组织（GINA）发布了“Global Strategy for the Diagnosis and Management of Asthma in Children 5 Years and Younger（5岁及5岁以下儿童哮喘诊断和管理的全球策略”。这是由GINA执行委员会所组织的儿科专家组,根据当前所能得到的循证医学证据为基础,并且考虑到5岁及5岁以下儿童哮喘管理所面临的特殊挑战（包括诊断困难、药物和药物输出装置的有效性和安全性、缺乏在该年龄段新疗法的数据等）,专门针对这个年龄组的儿童,所提出的哮喘诊断和管理方面的报告。     

应对策略和社会支持对提高哮喘患者生活质量的作用

探讨应对策略及社会支持在心理干预对哮喘患者生活质量提高中的作用。采用随机对照的方法,将374名哮喘患者分为实验组（228人）及对照组（146人）,实验组除进行常规的药物治疗外,配合以系统的心理干预方法。选用生活质量问卷、医用应对问卷及社会支持评定量表对治疗前后的生活质量状况、应对策略及社会支持水平进行测量。治疗后,在生活质量总分及各维度、社会支持总分以及对社会支持的利用度上,实验组和对照组得分都有所提高．但实验组提高的分值要显著大于对照组;在回避应对上,实验组和对照组都有所降低,但对照组的降低程度要显著大于实验组,在屈服应对上,实验组和对照组也都有所降低,但实验组的降低程度要显著大于对照组。多元逐步回归分析的结果显示,屈服的降低和对社会支持利用度的提高能够显著预测哮喘患者生活质量的提高。     

Review of Family Relational Stress and Pediatric Asthma: The Value of Biopsychosocial Systemic Models

Asthma is the most common chronic disease in children. Despite dramatic advances in pharmacological treatments, asthma remains a leading public health problem, especially in socially disadvantaged minority populations. Some experts believe that this health gap is due to the failure to address the impact of stress on the disease. Asthma is a complex disease that is influenced by multilevel factors, but the nature of these factors and their interrelations are not well understood. This paper aims to integrate social, psychological, and biological literatures on relations between family/parental stress and pediatric asthma, and to illustrate the utility of multilevel systemic models for guiding treatment and stimulating future research. We used electronic database searches and conducted an integrated analysis of selected epidemiological, longitudinal, and empirical studies. Evidence is substantial for the effects of family/parental stress on asthma mediated by both disease management and psychobiological stress pathways. However, integrative models containing specific pathways are scarce. We present two multilevel models, with supporting data, as potential prototypes for other such models. We conclude that these multilevel systems models may be of substantial heuristic value in organizing investigations of, and clinical approaches to, the complex social–biological aspects of family stress in pediatric asthma. However, additional systemic models are needed, and the models presented herein could serve as prototypes for model development.     

Incorporating family therapy into asthma group intervention: a randomized waitlist-controlled trial

Asthma psychoeducational programs have been found to be effective in terms of symptom-related outcome. They are mostly illness-focused, and pay minimal attention to systemic/familial factors. This study evaluated a novel asthma psychoeducation program that adopted a parallel group design and incorporated family therapy. A randomized waitlist-controlled crossover clinical trial design was adopted. Children with stable asthma and their parents were recruited from a pediatric chest clinic. Outcome measures included, for the patients: exhaled nitric oxide (eNO), spirometry, and adjustment to asthma; and for the parents: perceived efficacy in asthma management, Hospital Anxiety and Depression Scale anxiety subscale, Body Mind Spirit Well-being Inventory emotion subscale, and Short Form 12 health-related quality of life scale. Forty-six patients participated in the study. Attrition rates were 13.0% and 26.0% for the active and control groups, respectively. Repeated-measures ANOVA revealed a significant decrease in airway inflammation, as indicated by eNO levels, and an increase in patient's adjustment to asthma and parents' perceived efficacy in asthma management. Serial trend analysis revealed that most psychosocial measures continued to progress steadily after intervention. Significant improvements in both symptom-related measures and mental health and relationship measures were observed. The findings supported the value of incorporating family therapy into asthma psychoeducation programs.     

The effect of tape-recorded relaxation training on well-being,symptoms, and peak expiratory flow rate in adult asthmatics: A pilot study

Abstract

Evidence indicates that psychological stress plays a role in precipitating and exacerbating asthma symptoms and suggests that relaxation techniques aimed at reducing stress and autonomic arousal leads to symptom reduction. This study explored the effect of a tape-recorded relaxation intervention on well-being (mood and stresson). asthma symptoms, and a measure of pulmonary function (PEFR). Twenty adult asthmatics were studied for 21 days in their natural environment using a multiple baseline design. Self-administered relaxation training (including both breathing exercises and muscle relaxation) led to decreased negative mood and stressor report. Reporting of asthma symptoms decreased over time, and PEFR was increased by relaxation training. Asthma medication use was unchanged. Results suggest that tape–recorded relaxation training positively impacts well-being, asthma symptoms. and PEFR in a naturalistic setting. Further study of the potential use of inexpensive tape-recorded interventions in chronic illness is warranted.