ABSTRACT
BACKGROUND: For several years, educational programmes have been highlighted because care success depends on patient's knowledge and patient's asthma management. However, no tool is available to assess change in patient knowledge and behaviour before and after completing an educational programme. OBJECTIVE: To validate a questionnaire measuring the knowledge and behaviour of asthmatics participating in an educational programme and to gauge the benefit of such a programme. METHODS: The Asthma Behaviour Change (ABC) questionnaire was generated from literature, patient surveys and clinical situations. It was organized in eight dimensions assessing patient behaviour in seven different clinical situations and two assessing patient (pathophysiology and therapeutic) knowledge. A total of 139 asthmatics filled out the questionnaire before, during and after the educational programme. RESULTS: The principal component analysis confirmed the structure empirically made by clinical situations. Internal consistency analysis yielded high Cronbach's alpha values. Different dimensions and the two global scores were able to discriminate patients according to asthma severity. Finally, the effect size of difference before and after educational programme was at least 0.47, and was larger than 0.74 for both global behaviour and knowledge scores. The difference between visit 1 and 3 for global behaviour and knowledge scores reached 18.84 +/- 20.83 (P < 0.001, 95% CI: 13.18-24.43) and 11.06 +/- 14.98 (P < 0.001, 95% CI: 7.10-15.03), respectively. CONCLUSION: ABC questionnaire is a valid tool to assess asthmatics' knowledge and behaviour. Furthermore, this study confirmed that educational programmes lead to better awareness of asthma by patients.
Subject(s)
Asthma/psychology , Health Knowledge, Attitudes, Practice , Surveys and Questionnaires/standards , Adult , Aged , Female , Humans , Male , Middle Aged , Patient Education as Topic/standards , Severity of Illness IndexABSTRACT
A causal relationship between treatment with tricyclic antidepressant (TCA) at therapeutic doses and cases of dilated cardiomyopathy has been suspected, but not definitely evidenced. We present a case of a dilated cardiomyopathy, which seemed idiopathic, but occurred during treatment with imipramine and recovered after its withdrawal. For the first recorded time, the cardiomyopathy recurred 9 years later, after a 2-year period of treatment with amitriptyline and lithium, and recovered again 1 year after both psychotropic drugs withdrawal. New arguments for the existence of TCA-induced dilated cardiomyopathy are brought.
Subject(s)
Antidepressive Agents, Tricyclic/adverse effects , Cardiomyopathy, Dilated/chemically induced , Imipramine/adverse effects , Female , Humans , Middle Aged , RecurrenceABSTRACT
Malignant tumours of the heart and pericardium are rare. Secondary tumours are 20 to 40 times more common than primary tumours. The authors report the case of a cardiac metastasis of a myxoid liposarcoma of the inguinal region. Surgical ablation with chemotherapy significantly improved the patient' clinical and haemodynamic status. A review of the literature shows that postoperative survival does not exceed 2 years, but the prognosis is better when chemotherapy is associated with surgery. Transoesophageal echocardiography is an excellent diagnostic imaging method. It provides a better evaluation of the tumour and its location, compared to thoracic CT scan and transthoracic echocardiography.
