| Objective: Asthma is a common chronic disease. It is estimated that there arenearly30million asthmatic patients in the world. Because many patients didn’t takein standard asthma education and management, their asthma condition became worseprogressively which brought the family and whole society heavy burden. The purposeof the study was to evaluate the impact of standard asthma education and managementmodel on asthma control and quality of life in the asthmatic patients so that we couldget sufficient evidence for popularization of this model.Methods:157outpatients with asthma were selected in the second hospital ofDalian medical university during Jul,2011to Mar,2012. The managed group (78cases) took part in the standard asthma education and management model of ourhospital. The asthma education and management model developed by our hospitalwas composed of a clinic service for asthma, asthma lecture and the asthmatic patientassociation. They participated in one time primary education and at least two timesstrengthened education. The control group (79cases) didn’t take part in this asthmaeducation and management model. The two groups were in accord with the diagnosisstandard of Chinese guide for asthma in2008. The graduate student and doctorinterviewed157cases with asthma in the form of face-to-face. The level of asthmacontrol and the quality of life were evaluated. The questionnaire was designed withreferences, the contents of questionnaire were as follows:1. The basic data includedname, sex, age, education degree of the patients, the classification and course ofasthma.2. The current situation of asthma control included the level of controlledasthma according to the GINA criteria in2009and the level of well-controlled asthmaand complete controlled according to the asthma control test (ACT values≥20points).3. The assessment of future risk included ever admission to critical care or hospitalization in the past year, low FEV1, high dose of glucocorticoids medications,exposure to cigarette smoke. The standard of high dose glucocorticoids medicationsrefered to the standard which defined by GINA criteria in2009. We defined theexposure to cigarette smoke as initiative and often passive cigarette smoke. Thequestionnaire of life quality was the adult questionnaire designed by Li Fan, includedconfined activity, symptoms of asthma, the mentality of asthma, the reaction tostimulus, the personal health concerns. One point was the worst, five points was thebest. The total score was between35and175. The higher the score was, the better thequality of life was. The questionnaires of157cases were completed and analyzed bySPSS13.0statistical analysis software, P<0.05was considered statisticallysignificant.Results:1. In the current situation of asthma control, according to the GINAcriteria in2009, the rate of controlled asthma for the two groups was62.8%and20.3%，respectively (χ2=29.314, P<0.01). The result of the managed group was betterthan that of the control group, also better than the result of AIRE study in1999(5.1%).Compared with domestic research, the result of the managed group was better thanthose of Chinese ten provincial cities surveyed in2006(28.7%) and Shanxi provincein2007(26.4%), also better than those of three teaching hospitals in Beijing urbanarea surveyed in2006(30.6%) and Shenyang in2007(13.68%). While according tothe asthma control test, the rate of well-controlled and complete controlled for the twogroups was74.4%and44.3%, respectively (χ2=14.682, P<0.01). The result of themanaged group was better than those in the control group and in Shanxi province in2007(36.7%), also better than those in the six different urban districts of Beijing in2006(46.3%) and in Shenyang in2007(59.43%), but worse than that of the People’sHospital of Peking University in2006(85%).2. The assessment of future risk.(1)During the past year, the rate of the emergency treatments and hospitalization due toexacerbation of asthma were significantly lower in the managed group than that in thecontrol group（15.4%,5.1%vs35.4%,21.5,respectively; χ2=8.317，9.100，and P＜0.01for both). The result of the managed group was lower than the Chinese data ofAIRIAP study in2000(33.6%,16.0%) and the result of Chinese ten provincial citiesin2006(33.9%,20.0%), but higher than the data of educated group took in theeducation and management model developed by People’s Hospital of PekingUniversity in2006(7.1%,3.6%).(2) In lung function, the rate of FEV1%pred≥80%forthe two groups was66.7%and25.3%, respectively (χ2=27.029，P＜0.01).(3) In the therapy of high dose glucocorticoids medications, the rate of the two groups was2.6%and15.2%, respectively（χ2=7.703，P＜0.01), the rate of the managed group waslower than that of the control group.(4) In the exposure to cigarette smoke, the rate ofthe two groups was6.4%and27.8%, respectively（χ2=12.677，P＜0.01). Comparedwith the overseas studies, the rate of the managed group was lower than that of theAIRIAP study in2000(19.1%) and that of AIRE study in1999(17.5%). Comparedwith the domestic studies, the rate of the managed group was lower than that ofShenyang in2007(29.41%).3. In the quality of life. for the limitation of activity, the score of the two groupswas49.95±5.61and39.99±7.64, respectively (t=9.3，P＜0.01). The sore of themanaged group was higher than that of the control group. In the symptoms of asthma,the score of the two groups was36.54±3.61and26.38±5.50, respectively (t=13.7，P＜0.01). The sore of managed group was higher than that of the control group. In thementality of asthma, the score of the two groups was27.03±3.15and21.16±5.66,respectively (t=8.0，P＜0.01). The sore of managed group was higher than that of thecontrol group. In the reaction of stimulus, the score of the two groups was23.35±2.36and18.32±4.13, respectively (t=9.4，P＜0.01). The sore of managed group was higherthan that of the control group. In the personal health concerns, the score of the twogroups was15.00±3.79and11.42±4.90, respectively (t=12.7，P＜0.01). The sore ofmanaged group was higher than that of the control group. the total score of the twogroups was151.82±12.83and116.87±20.66, respectively (t=12.7，P＜0.01). The soreof managed group was higher than that of the control group.Conclusions: The standard asthma education and management model cansignificantly improve asthma control and quality of life, reducing future risk. Thismodel is worth of being spread. |
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