Knowledge of crisis prevention strategies are highly effective, whereas vulnerability scores may elicit Addison’s disease crises

Ian Louiss Ross, Michelle Moya Anderson, Belene Demeke, Elza Louise Minnnie,Michelle Henry

Research Square (Research Square)(2022)

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摘要
Abstract Objective: The knowledge in patients with Addison’s disease (AD) to prevent an adrenal crisis and the degree to which patients feel vulnerable. Design: Telephonic interview of patients with AD in 47 patients, assessing knowledge of prevention of a crisis and vulnerability using a vulnerability scale. Methods: Knowledge of adrenal crisis (AC) and vulnerability score completed. Patients were compared based on having had a crisis or not. Factors associated with AC and the impact of knowledge, vulnerability were determined. Results: (64%) had an adrenal crisis in the previous five years, compared with 34% who never had a crisis. Crisis was associated with poorer knowledge prevention of an AC, especially having a cold (31.2% vs 71%; p=0.002) fever (44.7% vs 90.3%; p<0.001) infection (50% vs 93.5%; p<0.001) vomiting (50% vs 80.6%; p=0.007), and diarrhoea (37.5% vs 71%; p<0.001), respectively. The median proportion with vulnerability for each question was 41.5%. Disease duration was negatively correlated with vulnerability; (r=-0.426, p=0.003). Number of comorbidities was correlated with vulnerability (r=0.290, p=0.048). A negative correlation between knowledge score and number of crises in the previous five years (r=-0.530, p<0.001). Logistic regressions showed the only predictor for a crisis in the past year or past 5 years was patients’ knowledge (p<0.001). Predictors of knowledge were younger patients, more comorbidities, patients who had AC, scored higher on vulnerability questionnaire. Variables accounted for 52% of the variance (F=9.751, p<0.001). Conclusions: Education is critical in preventing AC, specifically cold, fever, infection, vomiting and diarrhoea. Health-care providers should provide psychological support, considering significant vulnerability burden.
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关键词
crisis prevention strategies,vulnerability scores,addisons
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