Luciene Angelini

Avaliação de dois anos de um programa educacional para pacientes ambulatoriais adultos com asma

OBJETIVO: Avaliar o conhecimento da doenca e a melhora clinica de portadores de asma persistente moderada e grave antes e apos a sua participacao em um programa de educacao realizado durante as visitas ambulatoriais de rotina. METODOS: Trata-se de um estudo piloto, prospectivo que envolveu 164 pacientes durante um periodo de dois anos. O programa de educacao, oferecido para pequenos grupos nos dias de consulta, consistiu de aulas expositivas divididas em tres modulos: fisiopatologia, controle ambiental e tratamento, incluindo o treinamento da tecnica inalatoria. Para a avaliacao do programa, foram utilizados questionarios padronizados sobre a melhora clinica e conhecimento da doenca. RESULTADOS: Em um ano, 120 pacientes completaram tres visitas, e 51 pacientes foram reavaliados em dois anos. A media de idade dos pacientes foi de 44 anos, 70% eram do sexo feminino, e 43% tinham ate oito anos de educacao formal. A intervencao educacional aumentou o conhecimento da doenca de forma significativa (p < 0,001) e possibilitou melhora clinica (p < 0,05) com a diminuicao do uso de corticosteroide oral, reducao de visitas ao servico de emergencia e menor numero de faltas ao trabalho ou escola. CONCLUSOES: O programa de educacao expositivo oferecido durante a rotina de atendimento ambulatorial de adultos asmaticos de nosso servico mostrou um crescente e progressivo aprendizado em longo prazo. Paralelamente, promoveu melhora clinica.OBJECTIVE To evaluate the understanding of asthma and the clinical improvement in patients with moderate or severe persistent asthma prior to and after their participation in an educational program presented during the routine outpatient visits. METHODS This was a prospective pilot study involving 164 patients over a two-year period. The educational program, presented to small groups on outpatient visit days, consisted of lectures divided into three parts: pathophysiology; environmental control; and treatment, including training in the inhalation technique. The program was evaluated using standardized questionnaires on clinical improvement and understanding of the disease. RESULTS By the end of the first year, 120 patients had completed three visits, and 51 of those patients were re-evaluated at the end of the second year. The mean age of the patients was 44 years, 70% were female, and 43% had up to eight years of schooling. The educational intervention significantly increased the understanding of the disease (p < 0.001), and allowed greater clinical improvement (p < 0.05) with a decrease in the use of oral corticosteroids, fewer visits to the emergency room and fewer days missed from work or school. CONCLUSIONS The educational program offered during the routine outpatient visits of adult patients with asthma at our clinic resulted in a progressive long-term increase in knowledge, as well as in clinical improvement.

Validation of the Brazilian-Portuguese Version of the European Community Respiratory Health Survey in Asthma Patients

Background. The European Community Respiratory Health Survey (ECRHS) questionnaire was planned to answer questions about the distribution of asthma. Our objective was to determine the cultural equivalence of the ECRHS into the Brazilian-Portuguese language. Methods. We translated the ECRHS according to international criteria. Results. Small cultural adaptations were necessary. Among the 80 participating patients, the Cronbach indices were higher (0.98–1.00) and the Kappa indices varied from 0.77 to 1.00. Conclusion. The study suggests that the Brazilian version of the ECRHS is conceptually equivalent to the original and similarly reliable and may be used in international studies involving Portuguese-speaking respiratory patients.

Prevalência de tabagismo ativo e passivo em uma população de asmáticos

Smoking causes an intense inflammatory reaction in the airways and is associated with worse clinical outcomes in patients with asthma. The objective of this study was to determine the prevalence of active and passive smoking in a population of patients with asthma. The sample of asthma patients (n = 100) consisted of 47 nonsmokers, 33 former smokers, 17 passive smokers and 3 active smokers. Most had moderate or severe asthma. Mean exhaled CO was 9.34 ppb in smokers, 4.19 ppb in passive smokers, 3.98 ppb in nonsmokers and 3.98 ppb in former smokers. We conclude that the prevalence of exposure to tobacco smoke is high among asthma patients.