Complementary and alternative medicine use in children with asthma

Causal relationships among self-management behaviors, symptom control, health-related quality of life and the influencing factors among Thai adolescents with asthma

Objective

To examine causal relationships among asthma self-management behaviors, asthma symptom control, health-related quality of life and the influencing factors among Thai adolescents.

Methods

A cross-sectional study was conducted using convenience sampling. A total of 240 adolescent-caregiver dyads from three tertiary hospitals in Bangkok, Thailand was ultimately included. Interviews and self-administered questionnaires assessing health-related quality of life, asthma symptom control, asthma self-management behaviors, health literacy, depression, comorbidities, family support, peer support, home environmental management, and relationships with health care providers were administered between November 2020 and July 2021. A hypothesized model based on the revised self- and family-management framework was proposed. Data were analyzed using descriptive statistics and path analysis.

Results

It was shown that the proposed model was a good fit for the empirical data and accounted for 67.2% of the variance in health-related quality of life. Depression and asthma symptom control directly affected quality of life (β = -0.132, P < 0.05; and β = 0.740, P < 0.05, respectively), while asthma self-management behaviors did not. Both depression and asthma self-management behaviors had indirect effects on the quality of life through asthma symptom control (β = -0.382, P < 0.05; and β = 0.225, P < 0.05, respectively). Health literacy (β = 0.343, P < 0.05), family support (β = 0.167, P < 0.05), peer support (β = 0.163, P < 0.05), and relationships with health care providers (β = 0.181, P < 0.05) also showed direct effects on asthma self-management behaviors.

Conclusion

The findings confirmed the causal relationships among asthma symptom control, self-management behaviors, depression and health-related quality of life. Health literacy, support from family and peers, and relationships with health care providers were also found to influence asthma self-management behaviors. To achieve effective asthma control and good quality of life, a nursing intervention promoting asthma self-management for Thai adolescents should be developed. Early detection and intervention of depressive symptoms are also suggested.

Results of a national survey on knowledge and use of complementary and alternative medicine by paediatricians

INTRODUCTION

The use of certain Complementary and Alternative Medicines (CAM) in children has been documented in Spain. The main aim of this study is to estimate the knowledge, recommendations, and use of CAM by Spanish paediatricians.

MATERIAL AND METHODS

A national study was conducted from June to July 2020 using an online questionnaire. Two e-mails were sent to paediatricians who were members of the Spanish Association of Paediatrics (AEP).

RESULTS

Out of 1414 responses received, acupuncture was considered as a science by 31.8%. Homeopathy was recommended to parents by 28.1%. CAM was used by 21.3% of physicians, at least once, to improve their own health. Only 3.8% had ever replaced a conventional treatment with CAM. The following variables were associated with a greater disposition to prescribe homeopathy: female, age over 45 years old, paediatricians working in Primary Care, and paediatricians working in private healthcare.

CONCLUSIONS

This AEP Committee on Medicines questionnaire provides new data that should be considered alarming and should ask for a serious thinking on the use of CAM in Spain. Some paediatricians are recommending parents to give treatments not supported by scientific evidence to their children. This practice could be potentially harmful, especially when conventional treatment is being replaced.

Origin, distribution, and perspective health benefits of particulate matter in the air of underground salt mine: a case study from Bochnia, Poland

The composition and distribution of airborne particles in different locations in a salt mine were determined in terms of their origin, the distance from the air inlet, and the adaptation of post-mining chambers and corridors for tourists and general audience. The composition of aerosols in air was also evaluated from the perspective of human health. Air samples were collected on filters by using portable air pumps, in a historical underground salt mine in Bochnia (Poland), which is currently a touristic and recreation attraction and sanatorium. The particulate matter (PM) concentration was determined using the gravimetric method by weighing quartz filters. The content of carbon, water-soluble constituents, trace elements, and minerals was also determined. A genetic classification of the suspended matter was proposed and comprised three groups: geogenic (fragments of rock salt and associated minerals from the deposit), anthropogenic (carbon-bearing particles from tourist traffic and small amounts of fly ash, soot, and rust), and biogenic particles (occasional pollen). The total PM concentration in air varied between 21 and 79 μg/m³ (with PM₄ constituting 4-24 μg/m³). The amount of atmospheric dust components coming from the surface was low and decreased with the distance from the intake shaft, thus indicating the self-cleaning process. NaCl dominated the water-soluble constituents, while Fe, Al, Ag, Mn, and Zn dominated the trace elements, with the concentration of majority of them below 30 ng/m³. These metals are released into air from both natural sources and the wear or/and corrosion of mining and tourists facilities in the underground functional space. No potentially toxic elements or constituents were detected. The presence of salt particles and salty spray in the atmosphere of salt mine, which may have anti-inflammatory and antiallergic properties, is beneficial to human health. This study will allow for a broader look at the potential of halotherapy in underground salt mines from a medical and regulatory point of view.

Use of Complementary and Alternative Medicine in Pediatric Respiratory Diseases

In this study, our purpose was to determine prevalence of complementary and alternative medicine (CAM) in pediatric respiratory diseases and methods of CAM use accordingly. Each of the CAM treatment has a special risk/benefit combination and it is absolutely crucial for health care professionals to question those methods.

Complementary and alternative medicine use in children with asthma

OBJECTIVE

Complementary and Alternative Medicine (CAM) is increasingly used in the treatment of asthma in children. In the studies conducted, it was stated that there was a standardization problem in CAM methods. Moreover, this situation raises the question of "Which is the most widely used CAM method?" in asthma treatment. This study aimed to determine the use of CAM methods in children who are followed up with the diagnosis of asthma.

MATERIAL AND METHODS

The patients aged 4-10 years who were diagnosed with asthma by a physician in the past and who admitted to the Child Health and Diseases Polyclinic of a hospital issuing tertiary health service in Turkey were included in the study. The demographic data of patients and CAM methods used were examined.

RESULTS

The median age of a total of 164 asthmatic children included in the study was 6.3 (4-10) years, and 58.3% of them were observed to be male. The median time to diagnosis of the patients was 2.0 (1; 105) months, mostly having multiple cough attacks per day (33.1%), and the rate of children with cough attacks at least once a month to awaken from sleep at night was 47.6%. Honey (36.6%) was found to be one of the most preferred biological-based therapies for families and was followed by molasses (16.9%), which were derived from herbal and natural products.

CONCLUSIONS

There are varying rates of CAM use in asthmatic children all over the world, and it was found that honey was used the most in our study. Atopy can be found in the etiology of asthmatic patients. Therefore, it should not be forgotten that using different CAM methods at the same time may pose a risk.

[Results of a national survey on knowledge and use of complementary and alternative medicine by paediatricians]

INTRODUCTION

The use of certain Complementary and Alternative Medicines (CAM) in children has been documented in Spain. The main aim of this study is to estimate the knowledge, recommendations, and use of CAM by Spanish paediatricians.

MATERIAL AND METHODS

A national study was conducted from June to July 2020 using an online questionnaire. Two e-mails were sent to paediatricians who were members of the Spanish Association of Paediatrics (AEP).

RESULTS

Out of 1,414 responses received, acupuncture was considered as a science by 31.8%. Homeopathy was recommended to parents by 28.1%. CAM was used by 21.3% of physicians, at least once, to improve their own health. Only 3.8% had ever replaced a conventional treatment with CAM. The following variables were associated with a greater disposition to prescribe homeopathy: female, age over 45 years old, paediatricians working in Primary Care, and paediatricians working in private healthcare.

CONCLUSIONS

This AEP Committee on Medicines questionnaire provides new data that should be considered alarming and should ask for a serious thinking on the use of CAM in Spain. Some paediatricians are recommending parents to give treatments not supported by scientific evidence to their children. This practice could be potentially harmful, especially when conventional treatment is being replaced.

Questionnaires assessing the use of complementary health approaches in pediatrics and their measurement properties: A systematic review

OBJECTIVES

To identify questionnaires assessing the use of complementary health approaches (CHA) in pediatrics, describe their content, and appraise the methodological quality of the studies and the measurement properties of the questionnaires.

METHOD

Major electronic databases were searched from 2011 to 2020. Studies which aimed to assess the use of CHA and studies which reported developing and validating CHA questionnaires in pediatrics were included. Two reviewers independently screened the studies, extracted the data, and rated the methodological quality of the studies and measurement properties of the questionnaires using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. When consensus was not reached, a third reviewer was consulted.

RESULTS

Thirty-eight studies were included. From these studies, 35 CHA questionnaires with a variety of different items were identified. Only two studies aimed to evaluate the measurement properties of two questionnaires. One questionnaire, available as a self- and proxy-report, was initially validated in children with juvenile idiopathic arthritis, and the other, available as an interviewer-administered questionnaire, was validated in children with cancer. According to the COSMIN, the methodological quality of both studies was inadequate or doubtful, and both questionnaires was not thoroughly validated.

CONCLUSION

This systematic review showed a lack of a thoroughly validated CHA questionnaire in pediatrics. However, two questionnaires were found to hold promise. To address this gap, one of the existing questionnaires should be adapted and further validated.

A mindful yoga intervention for children with severe asthma: A pilot study

INTRODUCTION

Children with severe asthma may benefit from non-pharmacological approaches to symptom management, yet little is known regarding the impact of mind-body approaches such as mindful yoga in this population. This pilot study examined the tolerability, feasibility, acceptability and immediate effects of a mindful yoga intervention in children with severe asthma.

METHOD

Fifteen children ages 7-11 with severe asthma participated in a single mindful yoga session, followed by semi-structured interviews with the child and caregiver. Vital signs and pulmonary function tests were collected pre- and post-intervention.

RESULTS

All children reported positive experiences and caregivers were generally supportive of their participation. One child experienced self-limited bronchoconstriction with asthma symptoms. There was no significant change in lung function or vital signs after the mindful yoga session.

DISCUSSION

Our results warrant additional larger studies to evaluate the safety and benefits of mindful yoga in children with severe asthma.

The modification of three vulnerability theories to assist nursing practice for school-age children with severe asthma

PURPOSE

Severe asthma is an inflammatory illness associated with adverse health outcomes and behaviors in children, such as decreased quality of life, impaired sleep, and increased medical costs and morbidity.

CONCLUSIONS

Children with severe asthma frequently exhibit a cycle of health and behaviors which contribute to these adverse health outcomes, consisting of decreased physical activity, increased stress, and increased airway inflammation and asthma exacerbations. School-age children, in particular, are a vulnerable population because they not only rely on others for their care but also suffer from a chronic illness and are at risk for unequal healthcare access and health outcomes.

PRACTICE IMPLICATIONS

Currently, there is no one nursing theory that adequately addresses the vulnerability, cycle of health and behaviors, and adverse health outcomes of children with severe asthma. By integrating key concepts from three vulnerability theories and presenting a modified conceptual framework, this paper aims to demonstrate how the use of this new conceptual framework may assist nurses in evaluating the unique needs of school-age children with severe asthma to provide best practices and develop appropriate interventions.