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Markwat JV, van Leeuwen JC, Kamps AWA. Assessment of acute asthma in children: do parents and healthcare providers speak the same language? J Asthma 2024; 61:876-882. [PMID: 38265280 DOI: 10.1080/02770903.2024.2310184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/22/2024] [Indexed: 01/25/2024]
Abstract
OBJECTIVE Education and self-management plans enhance parents' self-efficacy in managing their child's asthma symptoms. By understanding how parents recognize and interpret acute asthma symptoms, we can compile patient information using terms that are familiar to parents. METHOD Semi-structured interviews were carried out with 27 parents of children with asthma aged 2-12 years. The interviewees were selected from three groups: parents of children admitted for acute asthma, parents of children receiving outpatient asthma care, and parents who had access to a self-management plan. Parents were invited to report symptoms they would associate with acute asthma. Subsequently, parents were queried about their recognition of symptoms from a predefined list and asked to explain how they would assess these symptoms in case their child would experience an attack of acute asthma. RESULTS The most frequently reported symptoms for acute asthma were shortness of breath (77.8%) and coughing (63%). Other signs such as retractions, nasal flaring, and wheezing were reported by less than 25% of the parents. All parents recognized shortness of breath, wheezing and gasping for breath from a predefined list of medical terms. Retractions and nasal flaring were recognized by 81.5% and 66.7% of the parents, respectively. Recognizing the medical terms did not necessarily translate into parents being able to explain how to assess these symptoms. CONCLUSION Parents and healthcare professionals do not always speak the same language concerning symptoms of acute asthma. This may hamper timely recognition and adequate self-management, highlighting the necessity to adjust current medical information about acute asthma.
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Affiliation(s)
- J V Markwat
- Department of Pediatrics, Martini Hospital, Groningen, The Netherlands
| | - J C van Leeuwen
- Department of Pediatrics, Martini Hospital, Groningen, The Netherlands
| | - A W A Kamps
- Department of Pediatrics, Martini Hospital, Groningen, The Netherlands
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Plaza Moral V, Alobid I, Álvarez Rodríguez C, Blanco Aparicio M, Ferreira J, García G, Gómez-Outes A, Garín Escrivá N, Gómez Ruiz F, Hidalgo Requena A, Korta Murua J, Molina París J, Pellegrini Belinchón FJ, Plaza Zamora J, Praena Crespo M, Quirce Gancedo S, Sanz Ortega J, Soto Campos JG. GEMA 5.3. Spanish Guideline on the Management of Asthma. OPEN RESPIRATORY ARCHIVES 2023; 5:100277. [PMID: 37886027 PMCID: PMC10598226 DOI: 10.1016/j.opresp.2023.100277] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023] Open
Abstract
The Spanish Guideline on the Management of Asthma, better known by its acronym in Spanish GEMA, has been available for more than 20 years. Twenty-one scientific societies or related groups both from Spain and internationally have participated in the preparation and development of the updated edition of GEMA, which in fact has been currently positioned as the reference guide on asthma in the Spanish language worldwide. Its objective is to prevent and improve the clinical situation of people with asthma by increasing the knowledge of healthcare professionals involved in their care. Its purpose is to convert scientific evidence into simple and easy-to-follow practical recommendations. Therefore, it is not a monograph that brings together all the scientific knowledge about the disease, but rather a brief document with the essentials, designed to be applied quickly in routine clinical practice. The guidelines are necessarily multidisciplinary, developed to be useful and an indispensable tool for physicians of different specialties, as well as nurses and pharmacists. Probably the most outstanding aspects of the guide are the recommendations to: establish the diagnosis of asthma using a sequential algorithm based on objective diagnostic tests; the follow-up of patients, preferably based on the strategy of achieving and maintaining control of the disease; treatment according to the level of severity of asthma, using six steps from least to greatest need of pharmaceutical drugs, and the treatment algorithm for the indication of biologics in patients with severe uncontrolled asthma based on phenotypes. And now, in addition to that, there is a novelty for easy use and follow-up through a computer application based on the chatbot-type conversational artificial intelligence (ia-GEMA).
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Affiliation(s)
| | - Isam Alobid
- Otorrinolaringología, Hospital Clinic de Barcelona, España
| | | | | | - Jorge Ferreira
- Hospital de São Sebastião – CHEDV, Santa Maria da Feira, Portugal
| | | | - Antonio Gómez-Outes
- Farmacología clínica, Agencia Española de Medicamentos y Productos Sanitarios (AEMPS), Madrid, España
| | - Noé Garín Escrivá
- Farmacia Hospitalaria, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | | | | | - Javier Korta Murua
- Neumología Pediátrica, Hospital Universitario Donostia, Donostia-San, Sebastián, España
| | - Jesús Molina París
- Medicina de familia, semFYC, Centro de Salud Francia, Fuenlabrada, Dirección Asistencial Oeste, Madrid, España
| | | | - Javier Plaza Zamora
- Farmacia comunitaria, Farmacia Dr, Javier Plaza Zamora, Mazarrón, Murcia, España
| | | | | | - José Sanz Ortega
- Alergología Pediátrica, Hospital Católico Universitario Casa de Salud, Valencia, España
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Overmann KM, Vukovic AA, Britto MT. A Content Analysis of Emergency Department Discharge Instructions for Acute Pediatric Febrile Illnesses: The Current State and Opportunities for Improvement. J Patient Exp 2021; 8:23743735211060773. [PMID: 34869843 PMCID: PMC8640326 DOI: 10.1177/23743735211060773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Quality emergency department (ED) discharge communication is critical to understanding of disease progression, home management, and return instructions. Addressing social aspects of disease burden are important to improving satisfaction and healthcare utilization. The objective of this study was to understand the extent to which written ED discharge instructions address multifaceted aspects of disease to meet the comprehensive needs of families with common childhood illnesses. We analyzed a national sample of 28 written discharge instructions from pediatric EDs using thematic and inductive content analysis. Seven themes were identified. Nearly all discharge instructions devoted a majority of content to themes related to disease physiology. Other themes common to instructions were related to parental instructions for caring for the child and when to return for further care. Content on caregiver reassurance, returning to daily activities, improving well-being, and promoting community health were not a focus of discharge instructions. Inclusion of multifaceted discharge materials which address both medical and social aspects of disease may help improve family-centered emergency care and the quality of care transitions for common childhood illnesses.
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Affiliation(s)
- Kevin M Overmann
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Adam A Vukovic
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Maria T Britto
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA.,Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Shulhan-Kilroy J, Elliott SA, Scott SD, Hartling L. Parents' self-reported experiences and information needs related to acute pediatric asthma exacerbations: A mixed studies systematic review. PEC INNOVATION 2021; 1:100006. [PMCID: PMC10194336 DOI: 10.1016/j.pecinn.2021.100006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/29/2021] [Accepted: 10/29/2021] [Indexed: 05/30/2023]
Abstract
Objective To systematically review the scientific literature examining parents' experiences and information needs for the management of their child's asthma exacerbations. Methods We searched five databases for quantitative and qualitative studies in Canada and the United States from 2002 onwards. A convergent integrated approach and the Mixed Method Appraisal Tool were used to analyze and appraise the evidence, respectively. Results We included 84 studies (27 quantitative, 54 qualitative, 3 mixed methods). Some parents lacked confidence in recognizing or managing exacerbations. A few parents were uncertain when and where to seek medical help. The main barrier to accessing care was cost. Impacts on parents included poor sleep, distress, and lifestyle disruptions. Parents felt they lacked information and wanted education on treatments and how to recognize and manage exacerbations via education sessions, written materials, community outreach and online resources. Conclusion Improved education for parents may help reduce parents' stress, asthma-related morbidities for children and use of urgent health services. Innovation The development of tailored interventions and knowledge translation strategies with input from target audiences (e.g. parents, health care providers) is necessary to meet their information needs and support adherence to clinical recommendations. 84 studies reviewed and analyzed using the convergent integrated approach Parents lacked confidence in recognizing, treating or seeking care for exacerbations Cost was a barrier to care; parents affected by psychosocial impacts Parent's desired education on treatments and how to recognize and manage exacerbations Interventions and knowledge translation strategies must be developed with parents
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Affiliation(s)
- Jocelyn Shulhan-Kilroy
- Alberta Research Centre for Health Evidence (ARCHE), Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Sarah A. Elliott
- Alberta Research Centre for Health Evidence (ARCHE), Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Shannon D. Scott
- Evidence in Child Health to Enhance Outcomes (ECHO), Faculty of Nursing, University of Alberta, Edmonton, Canada
| | - Lisa Hartling
- Alberta Research Centre for Health Evidence (ARCHE), Department of Pediatrics, University of Alberta, Edmonton, Canada
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Pade KH, Thompson LR, Ravandi B, Chang TP, Barry F, Halterman JS, Szilagyi PG, Okelo SO. Parental perception of a picture-based chronic asthma care management tool in an urban pediatric emergency department. J Asthma 2020; 58:1013-1023. [PMID: 32249659 DOI: 10.1080/02770903.2020.1753210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND National asthma guidelines recommend use of an asthma action plan (AAP) as part of chronic asthma care. Unfortunately, AAPs have not been tailored for use in acute care settings, where many patients at risk for poor chronic asthma care are seen, including those who are non-English-speaking or have low literacy levels. We previously developed a picture-based medication plan (PBMP), a unique type of AAP for use in an ambulatory setting and designed to increase patient use and understanding. However, little is known about how parents seeking emergency department (ED) asthma care would perceive the PBMP. OBJECTIVE To assess parental attitudes toward an asthma PBMP in the largest pediatric ED in Los Angeles County. METHODS We surveyed a consecutive sample of English- or Spanish-speaking parents of children 2-17 years seeking ED asthma care. Parents used a 5-point Likert scale for various statements regarding their perceptions of the PBMP. Responses were analyzed by sociodemographics, asthma control, and health literacy using Chi-squared and t-tests. RESULTS 90 parents provided feedback on the PBMP. The majority of parents endorsed the PBMP. Endorsement was 20%-30% higher among Spanish-speaking parents and those who did not complete high-school compared to English-speaking parents and parents with a high school education or higher (p < 0.05 for both comparisons). CONCLUSION Spanish-speaking parents and parents with less than a high-school education overwhelmingly endorsed the PBMP. It may be useful to consider incorporating the PBMP as part of patient-centered chronic asthma care strategies for populations seen in ED settings.
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Affiliation(s)
- K H Pade
- UCSD School of Medicine, Rady Children's Hospital San Diego, San Diego, CA, USA
| | - L R Thompson
- Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - B Ravandi
- Children's Hospital Los Angeles, University of Southern California, Los Angeles, CA, USA
| | - T P Chang
- Children's Hospital Los Angeles, University of Southern California, Los Angeles, CA, USA
| | - F Barry
- Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - J S Halterman
- Department of Pediatrics, University of Rochester School of Medicine, Rochester, NY, USA
| | - P G Szilagyi
- Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - S O Okelo
- Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
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