Background:Since 1985, nurse-run asthma clinics have been developing and are now widespread in the United Kingdom, having been greatly stimulated by the New Contract for General Practice (1990). To date, there have been few definitive studies evaluating such clinics. This study, in two adjacent general practices in semi-rural Somerset, evaluates the effect of nurse-run clinics on patients' symptoms, pulmonary function, and healthcare utilisation over a four-month period. Methods:One hundred and twenty-nine subjects, aged 2-79 years, were recruited from the two practices over a one-year period (1991-1992). All patients identified in either practice who had used preventive therapy in the preceding 12 months were eligible and were included if they had a positive exercise or reversibility (20%) test and had not previously received formal asthma education. A pre- and post-experimental study design was used. Subjects' symptoms, pulmonary function, and health care in the preceding eight weeks were assessed at intake and at 16 weeks; the nurse education being delivered at intake, one and four weeks. Results:Both mean number of days off work/school and mean number of nights on which waking occurred fell (p < 0.001). Peak expiratory flow rates and forced expiratory volumes improved during the study period (p < 0.001 and p < 0.01 respectively). Use of antibiotics, oral steroids, and rescue bronchodilator use all improved significantly (p < 0.001). Physician attendances were also reduced. Conclusions:A nurse-run asthma clinic in general practice is an effective way to improve symptoms, pulmonary function, and health care utilisation for asthmatic patients.

译文

背景:自1985年以来,由护士执照的哮喘诊所一直在发展,并在英国得到广泛应用,这受到《新通用合同》(1990年)的大力推动。迄今为止,很少有明确的研究评估此类诊所。这项研究是在半农村萨默塞特郡的两个相邻常规实践中,评估了四个月内护士经营的诊所对患者症状,肺功能和医疗保健利用率的影响。
方法:在一年的时间里(1991-1992),从这两种实践中招募了129名2-79岁的受试者。两种做法中确定的在过去12个月中均使用过预防性治疗的所有患者均符合资格,并且如果他们的运动或可逆性测试阳性(20%)并且先前未接受过正规的哮喘教育,则将其包括在内。实验之前和之后的研究设计被使用。在进食时和第16周评估受试者在前八周的症状,肺功能和医疗保健;入学时分一,四个星期进行护士教育。
结果:平均下班天数/上学时间和平均醒来晚数均下降(p <0.001)。在研究期间,峰值呼气流速和强制呼气量有所改善(分别为p <0.001和p <0.01)。抗生素,口服类固醇和急救支气管扩张剂的使用均显着改善(p <0.001)。医师出勤率也有所降低。
结论:一般由护士经营的哮喘诊所是改善哮喘患者症状,肺功能和医疗保健利用率的有效方法。

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