1
|
Martínez-González CL, Camargo Fajardo MCC, Martínez-Ortiz EJ, Segura-Medina P. A soft systems approach of asthma management in children based on therapeutic education and e-learning. Respir Med 2024; 230:107691. [PMID: 38844003 DOI: 10.1016/j.rmed.2024.107691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 06/03/2024] [Indexed: 06/13/2024]
Abstract
One of the most common respiratory chronic diseases is asthma, with 5-16 % of world prevalence. In chronic disease, prevention, diagnosis, management, and palliation are the strategies for a care model; the patient-self management is fundamental with the so-called therapeutic education (TE) to train the patient in the necessary skills. The challenge of TE grows when the patient is a child or a person with special needs, even more in public health care in low- and middle-income countries. This is a problematic human situation, that needs soft system thinking. In this research, the analytic hierarchy process was used to determine the perceived importance of the factors that affect children's asthma health care in a public health institution in Mexico. The soft systems methodology (SSM) was applied to learn about the disease self-management, in order to obtain activities models and an action plan. According to AHP, human resources and education were percived as the most important among the factors that affect children health care within the institution. The perceived importance of two main subfactors (human resources training and TE) was around 34 %, which emphasizes the need to generate strategies for the improvement of the education of patients and health care providers. In MSS, the rich vision, the CATWOE, the root definition, and an activities model were proposed, including the application of an instructional design methodology (ADDIE) for the development of learning objects of asthma for children. Desirable and feasible actions and recommendations include the update of the national clinical practice guides, the use of control measures such as the Asthma Control Test, and a daily asthma diary to register the daily status of the breathing capacity, the drug administration, and the potential trigger events. The proposed model can be used as part of a systemic patient-and-family centered approach for chronic care model (CCM), particularly in diseases unsuitable for prevention interventions.
Collapse
Affiliation(s)
- C L Martínez-González
- Programa de Posgrado en Ingeniería de Sistemas, SEPI ESIME-Z, Instituto Politécnico Nacional, Av. IPN S/N, CP. 07738, Mexico.
| | - M C C Camargo Fajardo
- Programa de Posgrado en Ingeniería de Sistemas, SEPI ESIME-Z, Instituto Politécnico Nacional, Av. IPN S/N, CP. 07738, Mexico
| | - E J Martínez-Ortiz
- Programa de Posgrado en Ingeniería de Sistemas, SEPI ESIME-Z, Instituto Politécnico Nacional, Av. IPN S/N, CP. 07738, Mexico
| | - P Segura-Medina
- Departamento de Investigación en Hiperreactividad Bronquial, Instituto Nacional de Enfermedades Respiratorias, CP. 14080, Mexico; Escuela de Medicina y Ciencias de la Salud, ITESM-CCM, CP. 14380, Mexico
| |
Collapse
|
2
|
Vaquero-Lozano P, Lassaletta-Goñi I, Giner-Donaire J, Gómez-Neira MDC, Serra-Batlles J, García-García R, Álvarez-Gutiérrez FJ, Blanco-Aparicio M, Díaz-Pérez D. [Asthma 2020 Nursing Consensus Document]. OPEN RESPIRATORY ARCHIVES 2021; 3:100079. [PMID: 37497358 PMCID: PMC10369614 DOI: 10.1016/j.opresp.2020.100079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 11/30/2020] [Indexed: 02/07/2023] Open
Abstract
Asthma is a chronic respiratory disease which presents with a risk of exacerbations. Good patient management and continuous monitoring are crucial for good disease control, and pharmacological and non-pharmacological interventions are essential for proper treatment. Nurses specialised in asthma can contribute to the correct management of asthmatic patients. They play a key role in diagnostic tests, administration of medication, and patient follow-up and education. This consensus arose from the need to address an aspect of asthma management that does not appear in the specific recommendations of current guidelines. This document highlights and updates the role of specialized nurses in the care and management of asthma patients, offering conclusions and practical recommendations with the aim of improving their contribution to the treatment of this disease. Proposed recommendations appear as the result of a nominal consensus which was developed during 2019, and validated at the beginning of 2020.
Collapse
Affiliation(s)
- Paz Vaquero-Lozano
- Servicio de Neumología, CEP Hermanos Sangro, Hospital General Universitario Gregorio Marañón, Madrid, España
| | | | - Jordi Giner-Donaire
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | | | - Joan Serra-Batlles
- Servicio de Neumología, Hospital Universitario de Vic, Barcelona, España
| | - Rocío García-García
- Servicio de Neumología, Hospital Universitario 12 de Octubre, Madrid, España
| | | | | | - David Díaz-Pérez
- Servicio de Neumología y Cirugía Torácica, Hospital Universitario Nuestra Señora de Candelaria, Sta. Cruz de Tenerife, España
| |
Collapse
|
3
|
Martínez-González CL, Camargo-Fajardo MCC, Segura-Medina P, Quezada-Bolaños P. Therapeutic Patient Education with Learning Objects Improves Asthma Control in Mexican Children. J Med Syst 2020; 44:79. [PMID: 32128625 DOI: 10.1007/s10916-020-1539-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 02/07/2020] [Indexed: 10/24/2022]
Abstract
One of the most common chronic diseases that causes missed school days and workdays is pediatric asthma, producing education, health and economic delays in low and middle-income countries. A patient-centered remarkable therapeutic strategy in the prevention and treatment of chronic diseases is the Therapeutic Patient Education (TPE) which denotes an outstanding difference in the outcomes, from the awareness, to the personal treatment adaption to prevent crises. In this paper, an intervention of TPE with learning objects (LOs) of a pediatric asthma course, designed to train the uncontrolled patient and the caregiver as a team on the specific knowledge to self-control the disease, was carried out at a health facility in Mexico. The Asthma Control Test (ACT) was used and the learning performance was evaluated with formative quizzes. A randomized controlled trial was designed, with pairs of children patients and caregivers during 60 days; the control group was trained with the usual approach, receiving general information about the disease. ACT measures showed statistical significance for the TPE group after the use of the LOs, achieving a controlled state, while the control group did not show difference. Also, the intervention group obtained a higher score in learning performance assessment. The users learned how to avoid risks, the personal triggers of the patient, how to correctly use the different treatments and accessories, consequently, they learned how to self-manage the disease. Our study also confirmed that control of asthma is not only a matter of knowledge, but financial issues to afford the treatment.
Collapse
Affiliation(s)
- C L Martínez-González
- Programa de Posgrado en Ingeniería de Sistemas, SEPI ESIME-Z, Instituto Politécnico Nacional, Av. IPN S/N, 07738, México, Mexico.
| | - M C C Camargo-Fajardo
- Programa de Posgrado en Ingeniería de Sistemas, SEPI ESIME-Z, Instituto Politécnico Nacional, Av. IPN S/N, 07738, México, Mexico
| | - P Segura-Medina
- Departamento de Investigación en Hiperreactividad Bronquial, Instituto Nacional de Enfermedades Respiratorias, 14080, México, Mexico.,Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, 14380, México, Mexico
| | - P Quezada-Bolaños
- CECyT2 "Miguel Bernard", Instituto Politécnico Nacional, Lomas de Sotelo, 11200, México, Mexico
| |
Collapse
|
4
|
Folch-Ayora A, Orts-Cortés MI, Macia-Soler L, Andreu-Guillamon MV, Moncho J. Patient education during hospital admission due to exacerbation of chronic obstructive pulmonary disease: Effects on quality of life-Controlled and randomized experimental study. PATIENT EDUCATION AND COUNSELING 2019; 102:511-519. [PMID: 30279028 DOI: 10.1016/j.pec.2018.09.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 09/05/2018] [Accepted: 09/14/2018] [Indexed: 06/08/2023]
Abstract
UNLABELLED The objective of this study was to assess the effectiveness of an education program and telephone call follow-up at improving the health related quality of life (HRQL) of patients with chronic obstructive pulmonary disease (COPD). METHOD Experimental, controlled, randomized, single blind study, masked data analysis. Duration of 2 years and 3 months. Patients hospitalised for exacerbation. The effectiveness was evaluated by calculating the absolute and relative change (%) of the St. George questionnaire scores (total and by dimensions) before and after the intervention program. Calculation of the effect of the group variable on the absolute and relative changes of the variables, Multiple Analysis of Variance (MANOVA). RESULTS Completed study of 116 patients. Greater effects on their HRQL reported at admission (48.3 ± SD 20.0 years). Patients in the intervention group improved significantly in their total SGRQ scores (-6.83) in absolute and relative terms and more significantly in their activity dimension (-16.05). CONCLUSIONS The education program was effective at improving global HRQL, especially the activity dimension, in exacerbated COPD patients. PRACTICE IMPLICATIONS This research contributes to clarifying the benefits and contents of education programs for patients with COPD; hospital admission is the suitable moment to contact these patients.
Collapse
Affiliation(s)
- A Folch-Ayora
- Department of Nursing, University Jaume I, Castellón de la Plana, Spain
| | - M I Orts-Cortés
- Department of Nursing, Universidad de Alicante, Nursing and Healthcare Research Unit (Investén-isciii), Instituto de Salud Carlos III, CIBERFES, Grupo Balmis, ISABIAL, Alicante, Spain.
| | - L Macia-Soler
- Department of Nursing, Universidad de Alicante, Alicante, Spain
| | | | - J Moncho
- Research Unit for the Analysis of Mortality and Health Statistics, Universidad de Alicante, Alicante, Spain
| |
Collapse
|
5
|
Solís-Flores L, Acuña-Rojas R, López-Medina L, Meléndez-Mier G. [The counseling of nursing decreases symptomatology and relapses in pediatric patients with allergic rhinitis]. BOLETIN MEDICO DEL HOSPITAL INFANTIL DE MEXICO 2017; 74:349-356. [PMID: 29382478 DOI: 10.1016/j.bmhimx.2017.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 04/13/2017] [Accepted: 05/11/2017] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Allergic rhinitis (AR) is considered to be a public health problem, therefore it is essential to test health education strategies such as nursing counseling (NC) aimed at population groups such as children with allergic rhinitis and their tutors. This study aimed to measure the health benefits of children with this disease for a year. METHODS Longitudinal, randomized, comparative study with a sample of 100 pediatric patients of both sexes, aged 6 to 12 years, with diagnosis of allergic rhinitis, with counseling (study group) and without counseling (control group). In both groups, an informed consent letter signed by both tutors was obtained, in addition to knowledge and assessment papers; the latter included a scale of symptomatology and Morisky Green (adherence to treatment). The children in the study group received intervention based on personalized education, didactic material, support of the multidisciplinary group if necessary (doctor, dermatologist and psychologist). The control group received usual care. In both groups, telephone follow-up was performed, which allowed the number of relapses to be identified in one year. RESULTS The Wilcoxon rank-sum test (Mann-Whitney) was used to compare the results; the presence of relapses in the control group was statistically significant compared to the study group. CONCLUSIONS It was found that the infant population that receives NC, has as a better benefit the control of the symptomatology and decrease of relapses per year.
Collapse
Affiliation(s)
- Laura Solís-Flores
- Departamento de Educación, Capacitación e Investigación en Enfermería del Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
| | - Rosalinda Acuña-Rojas
- Servicio de Pediatría del Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
| | - Leobardo López-Medina
- Unidad 309 de Alergia, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México.
| | - Guillermo Meléndez-Mier
- Departamento de Registro y Seguimiento de proyectos de la Dirección de Investigación del Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
| |
Collapse
|
6
|
Gu C, Li C. Assessment of human respiration patterns via noncontact sensing using Doppler multi-radar system. SENSORS 2015; 15:6383-98. [PMID: 25785310 PMCID: PMC4435179 DOI: 10.3390/s150306383] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 03/07/2015] [Accepted: 03/09/2015] [Indexed: 11/20/2022]
Abstract
Human respiratory patterns at chest and abdomen are associated with both physical and emotional states. Accurate measurement of the respiratory patterns provides an approach to assess and analyze the physical and emotional states of the subject persons. Not many research efforts have been made to wirelessly assess different respiration patterns, largely due to the inaccuracy of the conventional continuous-wave radar sensor to track the original signal pattern of slow respiratory movements. This paper presents the accurate assessment of different respiratory patterns based on noncontact Doppler radar sensing. This paper evaluates the feasibility of accurately monitoring different human respiration patterns via noncontact radar sensing. A 2.4 GHz DC coupled multi-radar system was used for accurate measurement of the complete respiration patterns without any signal distortion. Experiments were carried out in the lab environment to measure the different respiration patterns when the subject person performed natural breathing, chest breathing and diaphragmatic breathing. The experimental results showed that accurate assessment of different respiration patterns is feasible using the proposed noncontact radar sensing technique.
Collapse
Affiliation(s)
- Changzhan Gu
- Marvell Technology Group Ltd., 5488 Marvell Lane, Santa Clara, CA 95054, USA.
- Department of Electrical and Computer Engineering, Texas Tech University, Lubbock, TX 79409, USA.
| | - Changzhi Li
- Department of Electrical and Computer Engineering, Texas Tech University, Lubbock, TX 79409, USA.
| |
Collapse
|
7
|
Urrutia Landa I, Cisneros Serrano C, Melero-Moreno C, López-Viña A. [Advances in asthma: review of publications in Archivos de Bronconeumología in the last year]. Arch Bronconeumol 2014; 47 Suppl 1:2-6. [PMID: 21300209 DOI: 10.1016/s0300-2896(11)70002-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Interest in asthma research among Spanish pneumologists is increasing. In the last year, 22 articles on asthma have been published in Archivos de Bronconeumología, six more than in the previous year. Furthermore, 56 communications were presented at the National Congress of the Spanish Society of Pneumology and Thoracic Surgery and were published in a supplement of the journal, representing 60% more than in the previous year's congress. A critical review of all these articles is provided. The original articles contribute further knowledge on epidemiological and clinical aspects of the disease and basic research. A notable contribution is the publication of two clinical practice guidelines, the Spanish Guideline for the Management of Asthma 2009 and the ALERTA-2 Guideline for the Management of Asthma Exacerbations. These two guidelines represent not only an update but also a change in the methodology used in their drafting, thus improving their scientific quality.
Collapse
|
8
|
Macián Gisbert V, Sánchez Gómez E. [Publications in respiratory nursing and physiotherapy]. Arch Bronconeumol 2011; 47 Suppl 1:16-8. [PMID: 21300212 DOI: 10.1016/s0300-2896(11)70005-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The Respiratory Nursing and Physiotherapy Section of the Spanish Society of Pneumology and Thoracic Surgery, established as a working group more than 19 years ago, has been characterized by a high degree of involvement and collaboration with all the research studies requiring nursing and physiotherapy techniques. However, publication of articles by this collective is scarce compared with that of the rest of the Society and the characteristics, attitudes and limitations of this section pose an obstacle to increasing the number of its publications. This article aims to explain some of the possible reasons that could have given rise to this situation. The new tendencies and the attitude of this collective and the rest of the Society are encouraging and suggest that the work of the Respiratory Nursing and Physiotherapy Section will be better reflected in the future.
Collapse
|