Ashish Pradhan, Leah Jayes, Manpreet Bains, Matthew J Martin
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引用次数: 0
摘要
理由:哮喘发作(AA)是哮喘的潜在危及生命的并发症,与高发病率、高死亡率和不断上升的医疗费用相关。文献中对AA的患者经验、影响和理解描述甚少。加强了解将确定哮喘护理中未满足的需求,并支持制定管理和预防发作的改进的个性化策略。目的:探讨急性发作患者对急性发作的经历和认识、急性发作对患者生活的影响及发作时的自我管理策略。方法:对30例近期哮喘发作(≤4周)的患者进行单中心(英国)定性半结构化访谈研究。采用框架方法对数据进行分析。结果:AA患者的经历和影响各不相同,包括对即将发作的认知。在AAs期间,观察到患者自我管理行为的变化,并受到先前的攻击经历和对这些和其他生活重点的护理的影响。一些先前被认为是导致哮喘死亡的行为,包括短效β激动剂(SABA)的过度使用,不良后果风险的认识不足,以及寻求医疗帮助的延迟被发现和报告。大多数患者对急性胆管炎及其处理的认识较差。结论:本研究描述了AA对患者经历和理解哮喘发作的不同影响。这些差异,加上医疗保健因素和发作特征,影响了患者的自我管理方法。这些发现突出了哮喘发作护理的未满足需求。临床试验注册:ClinicalTrials.gov ID NCT04410120。
Patient experience, understanding and self-management of asthma attacks: a qualitative study.
Rationale: Asthma attacks (AA) are potentially life-threatening complications of asthma associated with high levels of morbidity, mortality and rising healthcare costs. Patient experience, impact and understanding of AA is poorly described in the literature. Enhanced understanding will identify unmet needs in asthma care and support the development of improved personalized strategies for managing and preventing attacks.
Objective: To explore patients' experiences and understanding of AAs, the impact of AAs on their lives and self-management strategies during attacks.
Methods: Single center (UK) qualitative semi-structured interview study with 30 patients who recently had asthma attacks (≤4 wk). Data were analyzed using the framework approach.
Results: The patient experience and impact of AA varied, including recognizing an impending attack. Variation in patients' self-management behaviors during AAs was observed and was influenced by prior experience of attacks and care received for these and other life priorities. Several behaviors previously recognized as contributory to asthma deaths, including short-acting β-agonist (SABA) overuse, poor recognition of the risk of adverse outcomes, and delay in seeking medical help were identified and reported. Most patients had a poor understanding of AAs and their management.
Conclusions: This study describes the differing impact of AA on patient experiences and understanding of asthma attacks. These differences, combined with healthcare factors and attack characteristics, affect patient self-management approaches. These findings highlight unmet needs in asthma attack care.
Clinical trial registration: ClinicalTrials.gov ID NCT04410120.
期刊介绍:
Providing an authoritative open forum on asthma and related conditions, Journal of Asthma publishes clinical research around such topics as asthma management, critical and long-term care, preventative measures, environmental counselling, and patient education.