Avaliação da eficácia do automanejo no controle da asma / Evaluation of self-management efficacy of asthma control

AUTOR(ES)
DATA DE PUBLICAÇÃO

2010

RESUMO

Background: Health education is considered essential in asthma control. The implementation of an education program (EP) with self-management has a positive impact on improving the quality of care in asthma. However, the benefits of an EP are still controversial according of structural barriers. Objective: Evaluate the clinical control of patients submitted a self-management program associated with selfmonitoring and self-treatment comparing with two groups during the routine outpatient visits with and without the EP application. Also, measure the disease knowledge and inhalation technique, the indices of quality of life, symptoms of anxiety and depression and functional health literacy. Methods: This was a randomized study, controlled, divided into three groups: control group (CG), education (EG) and self-management (AG) during twelve months. The study included 110 patients with moderate and severe persistent asthma. The EP was applied to small groups on outpatient visit days, consisted of lectures divided into three parts: (1) pathophysiology and environmental control; (2) asthma symptoms; (3) treatment and training in the inhalation technique. The AG also received a symptoms diary card and written personal asthma action plan. Disease control was measured by the score of asthma control test (ACT) and the percentage of patients with scores 20. Other questionnaires included: disease knowledge (UDQ), asthma quality of life (AQLQ-s), hospital anxiety and depression scale (HADS) and functional literacy health test (s- TOFHLA). Results: In two years, 84 patients completed the study. Groups were similar in baseline characteristics. The mean ACT increased from 14 to 18 points, with 48% of patients in the AG achieved better control of asthma. The AG and EG increased disease knowledge and inhalation technique up to 100%. And the anxiety symptoms decreased 14% and 12%, respectively. The AQLQ-s score was clinically relevant with a significant increase of more than 0.5 points in both groups. The s- TOFLHA was classified as adequate health literacy with a mean score of 76 points. Conclusions: EP associated with self-management during routine outpatient visit showed significant impact on the clinical improvement in patients with moderate to severe asthma. The EP increased knowledge about the disease and drug treatment, with improvement in quality of life and symptoms of anxiety. In this population patients had adequate functional health literacy.

ASSUNTO(S)

ansiedade asthma patient education as topic adult self-management qualidade de vida anxiety quality of life asma adulto depressão controle clínico depression automanejo clinical control educação de pacientes como assunto

ACESSO AO ARTIGO

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