小児気管支喘息の施設入院療法と退院1年後の追跡調査

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One hundred and fifity five asthmatic children out of a total number of 188 hospitalized chidren who had been hospitalized for the first time between the ages of one and fifteen during the 7 year period between 1980-1987 and were treated by institutional therapy with the duration of more than 1 month, were studied. One year after their discharge, a questionnaire was sent out to them asking about asthmatic attacks, daily life and parental attitudes. Our findings and conclusions are as follows; 1) With regard to asthma itself, the frequency of asthmatic attacks (95%), the severity of attacks (96%), various self-control techniques to control asthma (88%), and the fear of asthma (94%), were markedly improved. In terms of the daily life of those chidren, absenteeism (96%), independence (66%), confidence (76%) and peace of mind (71%) were also improved. As to parental attitudes, fear of asthma (97%), and over-protection in daily life (73-76%) were improved as well. 2) With respect to the difference in age groups, improvement (in both asthma itself and daily life) was greater in the infant group as compared to older groups. Infants with asthma, however, must be treated on an indevidual basis and greater care must be administered when hospitalized. Although the degree of improvement was a little lower both in the early school-aged group and in the later school-aged group, School aged childeren as a whole are considered to be suitable for institutional therapy partially due to the psycho-socianl development of asthmatic children.While the results show a greater improvement in the puberty group as against the school aged group, it is speculated that oder chilren tend to show lass improvement in their disease, as there were few older patients who responded to the questionnaire. It is therefore advisable that asthmatic chidren who had severe or intractable asthma in their early years be hospitalized for institutional therapsy during early years in school. 3) The transition of morbid improvement in ashtmatic chidren was correlated to the level of medical care, and to the presence or absece of some form of mutual reliance beween the patient, his or her family, and the doctor. To ensure thesuccessful performance of appropriate institutional therapy, a mutually cooperative team led by a physician should be utilized. Additionally, team members should try not only to educate the patient and his or her jamily, but also accept them encouraging the development of their mutual reliance. 4) Those cases which produced unexpected results, those who did not respond to the survey, as well as readmission cases should be investigated further and in more detail.
日本心身医学会の論文
1991-08-01

著者

渋谷信治
国立療養所西奈良病院

小児気管支喘息の施設入院療法と退院1年後の追跡調査

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