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干咳和湿咳:家长报告有多可靠?

'Dry' and 'wet' cough: how reliable is parental reporting?

机构信息

Respiratory Medicine, Sheffield Children's Hospital, Sheffield, UK.

School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia.

出版信息

BMJ Open Respir Res. 2019 May 22;6(1):e000375. doi: 10.1136/bmjresp-2018-000375. eCollection 2019.

Abstract

INTRODUCTION

Chronic cough in childhood is common and causes much parental anxiety. Eliciting a diagnosis can be difficult as it is a non-specific symptom indicating airways inflammation and this may be due to a variety of aetiologies. A key part of assessment is obtaining an accurate cough history. It has previously been shown that parental reporting of 'wheeze' is frequently inaccurate. This study aimed to determine whether parental reporting of the quality of a child's cough is likely to be accurate.

METHODS

Parents of 48 'new' patients presenting to a respiratory clinic with chronic cough were asked to describe the nature of their child's cough. They were then shown video clips of different types of cough using age-appropriate examples, and their initial report was compared with the types of cough chosen from the video.

RESULTS

In a quarter of cases, the parents chose a video clip of a 'dry' or 'wet' cough having given the opposite description. In a further 20% parents chose examples of both 'dry' and 'wet' coughs despite having used only one descriptor.

DISCUSSION

While the characteristics of a child's cough carry important information that may be helpful in reaching a diagnosis, clinicians should interpret parental reporting of the nature of a child's cough with some caution in that one person's 'dry' cough may very well be another person's 'wet' cough.

摘要

介绍

儿童慢性咳嗽很常见,会引起家长的极大焦虑。由于这是一种表明气道炎症的非特异性症状,可能由多种病因引起,因此诊断较为困难。评估的一个关键部分是获取准确的咳嗽病史。先前已经表明,父母报告的“喘息”通常不准确。本研究旨在确定父母对孩子咳嗽质量的报告是否准确。

方法

向因慢性咳嗽到呼吸科就诊的 48 名“新”患者的家长询问其孩子咳嗽的性质。然后,向他们展示了不同类型咳嗽的视频剪辑,使用适合年龄的示例,并将他们的初始报告与视频中选择的咳嗽类型进行比较。

结果

在四分之一的情况下,父母选择了“干性”或“湿性”咳嗽的视频片段,而他们给出的描述却恰恰相反。在另外 20%的情况下,尽管父母只用了一个描述词,但他们选择了“干性”和“湿性”咳嗽的示例。

讨论

虽然孩子咳嗽的特征携带重要信息,有助于做出诊断,但临床医生在解释父母对孩子咳嗽性质的报告时应持谨慎态度,因为一个人的“干性”咳嗽可能是另一个人的“湿性”咳嗽。

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