Percepción de mejoría en los pacientes con asma
Perception of improvement in asthma patients
a Servicios de Neumología. Hospital de Sagunto y Hospital Universitario La Fe. Valencia
b Servicios de Neumología. Departamento de Personalidad, Evaluación y Tratamientos Psicológicos de la Facultad de Psicología. Universidad de Valencia
M. Perpiñá, A. De Diego, M.E. Martínez-Francés
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"apellidos" => "Belloch" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicios de Neumología. Hospital de Sagunto y Hospital Universitario La Fe. Valencia" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicios de Neumología. Departamento de Personalidad, Evaluación y Tratamientos Psicológicos de la Facultad de Psicología. Universidad de Valencia" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondencia: Avda. Pérez Galdós, 12–10. 46007 Valencia" ] ] ] 1 => array:2 [ "autoresLista" => "M. Perpiñá, A. De Diego, M.E. Martínez-Francés" "autores" => array:3 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Perpiñá" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "De Diego" ] 2 => array:2 [ "nombre" => "M.E." "apellidos" => "Martínez-Francés" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Perception of improvement in asthma patients" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2002-03-11" "fechaAceptado" => "2002-06-04" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec190660" "palabras" => array:5 [ 0 => "Disnea" 1 => "Asma" 2 => "Percepción" 3 => "Mejoría" 4 => "Broncodilatación aguda" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec190659" "palabras" => array:5 [ 0 => "Dyspnea" 1 => "Asthma" 2 => "Perception" 3 => "Improvement" 4 => "Acute bronchodilation" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Investigar la capacidad de los pacientes con asma estable de reconocer la mejoría de su obstrucción bronquial con el tratamiento</p> <span class="elsevierStyleSectionTitle">Método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Seleccionamos a 75 asmáticos estables (44 mujeres y 31 varones, con una media de edad de 43 ± 17 años), que referían sentir disnea basal en la escala modificada de Borg, y les provocamos en el laboratorio una broncodilatación aguda del 15%; en esta situación los pacientes fueron interrogados acerca del cambio de disnea experimentado</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">1. Globalmente, 19 asmáticos (25%) no percibieron mejoría de su disnea con la broncodilatación. 2. La media del cambio en el nivel de disnea fue de 1,17 ± 1,11; sin embargo, este cambio fue mayor en los pacientes con asma más grave: 0,60 ± 0,5 en los asmáticos leves, 1,05 ± 1,07 en los moderados y 1,93 ± 1,4 en los graves (p < 0,0001). 3. La percepción de mejoría se correlacionó significativamente con el nivel de equilibrio emocional del paciente (ansiedad-depresión), la calidad de vida, la educación, el nivel económico, la edad, la edad de inicio de la enfermedad, la gravedad del asma, disnea y obstrucción basales, la opresión torácica y el número de consultas médicas realizadas en el año precedente. 4. Las variables introducidas en el modelo de regresión (pasos sucesivos) fueron: disnea basal, depresión, opresión torácica y edad. 5. En general, los asmáticos jóvenes cuya asma se inició a una edad más temprana y que, además, tienen menor obstrucción ventilatoria y mejor calidad de vida, presentan tendencia a infravalorar el efecto beneficioso del tratamiento broncodilatador. Además, cuando el asma es grave, estos individuos no perceptores de mejoría presentan significativamente más ingresos en cuidados intensivos por agudizaciones asmáticas</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El 25% de nuestros asmáticos no es capaz de reconocer que sus bronquios se dilatan como resultado del tratamiento, motivo por el cual ante una agudización podrían retrasar el inicio de la medicación de rescate. Es aconsejable identificar a estos pacientes para establecer las pautas terapéuticas en función de criterios domiciliarios meramente objetivos (monitorización picoflujo)</p>" ] "en" => array:1 [ "resumen" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The objective of this study was to investigate the ability of patients with stable asthma to recognize improvement in bronchial obstruction with treatment. We enrolled 75 stable asthmatics (44 women and 31 men, mean age 43 ± 17 years) who reported baseline dyspnea on a modified Borg scale. Acute bronchodilation of 15% was provoked in the laboratory, after which the patients were asked if there was a change in dyspnea. Our results were as follows. 1) Overall, 19 asthmatics (25%) failed to perceive improvement in dyspnea with bronchodilation. 2) The mean change in dyspnea was 1.17 ± 1.11, although the change was greater in patients with more severe asthma (0.60 ± 0.5 for mild asthmatics, 1.05 ± 1.07 for moderate asthmatics and 1.93 ± 1.4 for severe asthmatics; p < 0.0001). 3) Perception of improvement was significantly related to level of the patient's emotional balance (anxiety-depression), quality of life, education, socioeconomic level, age, age of onset, severity, baseline dyspnea and obstruction, thoracic pressure and number of visits to the doctor in the preceding year. 4) The variables entered into the stepwise regression model were baseline dyspnea, depression, thoracic pressure and age. 5) Generally, young asthmatics whose disease appeared at a younger age and who also had less ventilatory obstruction and greater quality of life, showed a tendency to underestimate the beneficial effect of bronchodilator treatment. Moreover, when asthma was severe, non-perceptive individuals had significantly more admissions to intensive care units due to asthma exacerbation</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">In conclusion, 25% of our asthmatics are unable to recognize whether their bronchia dilate as a result of treatment, meaning that they would delay the start of rescue medication during an exacerbation. Such patients should be identified in order to establish therapeutic guidelines in function of objective home criteria (peak-flow monitoring)</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:16 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Perception of asthma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.R. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 2 | 5 |
| 2024 October | 55 | 15 | 70 |
| 2024 September | 36 | 17 | 53 |
| 2024 August | 55 | 33 | 88 |
| 2024 July | 36 | 24 | 60 |
| 2024 June | 60 | 27 | 87 |
| 2024 May | 56 | 37 | 93 |
| 2024 April | 34 | 20 | 54 |
| 2024 March | 41 | 30 | 71 |
| 2024 February | 35 | 32 | 67 |
| 2024 January | 0 | 3 | 3 |
| 2023 December | 0 | 2 | 2 |
| 2023 November | 0 | 3 | 3 |
| 2023 October | 0 | 24 | 24 |
| 2023 September | 0 | 2 | 2 |
| 2023 August | 0 | 1 | 1 |
| 2023 July | 0 | 4 | 4 |
| 2023 June | 0 | 10 | 10 |
| 2023 March | 4 | 7 | 11 |
| 2023 February | 38 | 18 | 56 |
| 2023 January | 24 | 35 | 59 |
| 2022 December | 32 | 25 | 57 |
| 2022 November | 43 | 19 | 62 |
| 2022 October | 23 | 29 | 52 |
| 2022 September | 22 | 25 | 47 |
| 2022 August | 40 | 80 | 120 |
| 2022 July | 26 | 70 | 96 |
| 2022 June | 26 | 36 | 62 |
| 2022 May | 28 | 33 | 61 |
| 2022 April | 35 | 23 | 58 |
| 2022 March | 41 | 41 | 82 |
| 2022 February | 23 | 30 | 53 |
| 2022 January | 30 | 32 | 62 |
| 2021 December | 14 | 37 | 51 |
| 2021 November | 24 | 43 | 67 |
| 2021 October | 23 | 34 | 57 |
| 2021 September | 16 | 50 | 66 |
| 2021 August | 16 | 34 | 50 |
| 2021 July | 15 | 26 | 41 |
| 2021 June | 23 | 40 | 63 |
| 2021 May | 15 | 20 | 35 |
| 2021 April | 37 | 67 | 104 |
| 2021 March | 46 | 21 | 67 |
| 2021 February | 39 | 30 | 69 |
| 2021 January | 22 | 27 | 49 |
| 2020 December | 30 | 13 | 43 |
| 2020 November | 20 | 15 | 35 |
| 2020 October | 33 | 17 | 50 |
| 2020 September | 20 | 7 | 27 |
| 2020 August | 15 | 19 | 34 |
| 2020 July | 50 | 17 | 67 |
| 2020 June | 15 | 8 | 23 |
| 2020 May | 21 | 11 | 32 |
| 2020 April | 30 | 18 | 48 |
| 2020 March | 27 | 18 | 45 |
| 2020 February | 22 | 18 | 40 |
| 2020 January | 31 | 27 | 58 |
| 2019 December | 26 | 20 | 46 |
| 2019 November | 11 | 11 | 22 |
| 2019 October | 31 | 12 | 43 |
| 2019 September | 9 | 25 | 34 |
| 2019 August | 20 | 2 | 22 |
| 2019 July | 22 | 17 | 39 |
| 2019 June | 21 | 7 | 28 |
| 2019 May | 25 | 28 | 53 |
| 2019 April | 21 | 33 | 54 |
| 2019 March | 12 | 15 | 27 |
| 2019 February | 7 | 11 | 18 |
| 2019 January | 6 | 5 | 11 |
| 2018 December | 12 | 10 | 22 |
| 2018 November | 18 | 18 | 36 |
| 2018 October | 40 | 15 | 55 |
| 2018 September | 24 | 7 | 31 |
| 2018 May | 13 | 1 | 14 |
| 2018 April | 4 | 4 | 8 |
| 2018 March | 11 | 11 | 22 |
| 2018 February | 8 | 11 | 19 |
| 2018 January | 6 | 2 | 8 |
| 2017 December | 9 | 12 | 21 |
| 2017 November | 7 | 10 | 17 |
| 2017 October | 6 | 8 | 14 |
| 2017 September | 9 | 12 | 21 |
| 2017 August | 12 | 12 | 24 |
| 2017 July | 13 | 15 | 28 |
| 2017 June | 13 | 24 | 37 |
| 2017 May | 9 | 6 | 15 |
| 2017 April | 7 | 7 | 14 |
| 2017 March | 6 | 26 | 32 |
| 2017 February | 3 | 5 | 8 |
| 2017 January | 7 | 7 | 14 |
| 2016 December | 17 | 6 | 23 |
| 2016 November | 16 | 15 | 31 |
| 2016 October | 19 | 17 | 36 |
| 2016 September | 18 | 11 | 29 |
| 2016 August | 10 | 8 | 18 |
| 2016 July | 11 | 5 | 16 |
| 2016 June | 18 | 11 | 29 |
| 2016 May | 17 | 6 | 23 |
| 2016 April | 10 | 4 | 14 |
| 2016 March | 9 | 3 | 12 |
| 2016 February | 11 | 4 | 15 |
| 2016 January | 24 | 14 | 38 |
| 2015 December | 26 | 16 | 42 |
| 2015 November | 32 | 4 | 36 |
| 2015 October | 52 | 1 | 53 |
| 2015 September | 59 | 0 | 59 |
| 2015 August | 82 | 0 | 82 |
| 2015 July | 46 | 0 | 46 |
| 2015 June | 52 | 0 | 52 |
| 2015 May | 74 | 0 | 74 |
| 2015 April | 36 | 0 | 36 |
| 2015 March | 52 | 0 | 52 |
| 2015 February | 45 | 0 | 45 |
| 2015 January | 38 | 0 | 38 |
| 2014 December | 33 | 0 | 33 |
| 2014 November | 36 | 0 | 36 |
| 2014 October | 73 | 0 | 73 |
| 2014 September | 58 | 0 | 58 |
| 2014 August | 48 | 0 | 48 |
| 2014 July | 35 | 0 | 35 |
| 2014 June | 68 | 0 | 68 |
| 2014 May | 50 | 0 | 50 |
| 2014 April | 39 | 0 | 39 |
| 2014 March | 58 | 0 | 58 |
| 2014 February | 52 | 0 | 52 |
| 2014 January | 39 | 0 | 39 |
| 2013 December | 38 | 0 | 38 |
| 2013 November | 40 | 0 | 40 |
| 2013 October | 50 | 0 | 50 |
| 2013 September | 51 | 0 | 51 |
| 2013 August | 62 | 0 | 62 |
| 2013 July | 79 | 0 | 79 |
| 2013 June | 48 | 0 | 48 |
| 2013 May | 54 | 0 | 54 |
| 2013 April | 41 | 0 | 41 |
| 2013 March | 11 | 0 | 11 |
| 2000 January | 2552 | 0 | 2552 |
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