Eliciting fears and concerns and maximising consultation time: the use of a posted pre clinic questionnaire

niqwr. asthmahasrzmaincdthe mostfrequentcbnmicdie eareinehildbmdOncdlhcDDIsiblcrraRnaistklacliof sufficient generaledwtion al&t tbc disease and its man6gemuu We startedtk first Hen healtheducatim~ swam for asthmatic cbildrccl tn f&v. 1992.Until nav we ha&had 169pnkipmts klwccn 7-i6 yzan uf age(mean ge 11.6y6Sls.J. The aimscdtheprcgramweiv111 to prwide the cbitdrenwith rtdtableinfunnatkmamI tr&b~g so that they can remainwell and adjustthetr tnatmrnt to tbc waitytlfar~t2ltu~klluwledgc,cmWeqcr. self.esteem and mmfdiaw. Our teamconsists of a doctor. tw teachemand a pbyiutbcrapiat. l’bc pmyrn requires bapital admiSm for 3 weeksDuringthistimethechildra swim,takepari ia water-gymnastics aal taatbb~ gymnwia andgetacquintedwiththemetbuds of r&s&m. Everyday theybaw 3 mgqlarlesscaamithat, in the Iltermxms,they haveRI called‘asthma-ksom’aboutatways,&hmn, the pmpx we d mniaabnlatkdNg5,tbc management of acute @soda a-d tbe nwstimpmtantns+ctsuf a he&by life. lkfcw andatlertk pognm tmtgfulrlion tests(FEVI and FEVI/FVCt are neffomm4l. tk techniqvc of inlulationis evab&d andtheibmreticalkqowkdgc ibestimated withthe helpof qqatkmaim KesulttLrmgfuwtiundid not abcr sig&cady dwbtg the plogrm. Almostall of the pmticipamr hadmateredthe pmperti aerosol-wchhniquc. The cbagcr in tkoreticalbxwtedge.in particularthe iin thescores of thedistinction of revue andpreventer drugs, wxe &a sim We baw folkwedup 26childrenfor up ta 6-t2 monthx55% of tk cbildra shmed an inourcd pby&al activityand 65% of them gainedincleaed selfeecm~symprcmflccpaiods~melMgcrf165orclo n. 67 m&d and tk pniadr with asthmatic symptoms became sbmta (2.4daysn. 9.9day& tIImd~Dgpitethe~dcantmlgmm~tbcl6w numberof patentsin the followup bwiigation. and the shortperiodof tbne,it wouldseemthathe&b education for asthmatic childrenhasP sig&canttivcnce on outcome of tkir dirure andresults in an impmvemmt in qualityof life.

Swentysixpnecntofapticntsmainvmrriamaymtk mentimsdto tk dint&n duringa conrulpliotl.As a result in thisclbdc.asa6 adjunctto thecm~rultatbn itself.wehm for someyearsgivm to newp&a withasthma. on unival r5hatmitowbiitolistthcir amccrqsnndqwtimuTtw imp& xv= hat mnsl ltstcdseveralissues.A recent exienia of tbb -pt appeanto haveban lesssuccess(UL A 12pagebudder(rrsmplcrwillk shown)is IBOW xnt to all newaut-pal*ntsin advdlrcof their appuintmsnt. This contains adviceabmttlocationof the clink pmeedureqn animal. andincludes a 4 pagececiionto k campleted by the

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C. Nit. D. Morgan.U.K. Rnridgc, ‘ffu NafonafAs&ma Campa& LandonNI DNT, UK.

pm) on k&n; pmviacran &mst uniqueinrkghtinto the needsuf thosewithz&ma. la Ibe Ant 3 yean 22,911catlsweir reazied.Finy-rourploun cd tksccaUswrefmmaduttswithasbma,and43%fmm pnnu of chit with asthma.Thiifour parent bad heudobtheheldincvirtlu?mrdi~,~aalul*l praterawl2% f&x a healthpofcsebnal.The subjmsabout vddcbpet& tclepbulNmay dbca dlxto!s t6 dicit tbcse maocrm duriw &line cw<atitnts. Mastallm cowed mmrtbanunr@cabmwa8l%inquiredabouwediati.,,,aitb over31.6%being.spccifically aboutsideetTsls (A &seqwnt smalkr wvey uf spccinc RInDemsabuntride effects showed that53.5%concernalinhaledstemidsn596 oreI stemids, 32% km agcmkas and 16.2%tbcopljllina). Tiventy-nine pcmnt of callrm wantediqfqmiatkm6b661 preventiun,18.3% nebulkrs. 11.6% al*lm and 7.1% mwemed diet.innirm OTcumplementmy Ihesapks31.1% bad qucrtionsabout peak Bow msnitoiing FWlutionaccamtedfor 6.5%uf quaaaS andsubjectr swh a?.Mtda3x prcgnnn~y. bcrcdily.exercise, hypnnivlly andsrmkingacb aaoumedfur2-5*olulh.Allanditafurusbr5kml calkni ta k gawrallywll a&&d wfth their us 6f tk _____ =rv”=.