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Gestels T, Hauser B, Van de Vijver E. Complications of Gastrostomy and Gastrojejunostomy: The Prevalence in Children. Pediatr Gastroenterol Hepatol Nutr 2023; 26:156-164. [PMID: 37214169 PMCID: PMC10192589 DOI: 10.5223/pghn.2023.26.3.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/14/2022] [Accepted: 01/07/2023] [Indexed: 05/24/2023] Open
Abstract
Purpose This study aimed to provide an overview of the prevalence of the complications of a gastrostomy or a gastrojejunostomy with a low-profile gastric tube in children. The study also examined the effect of presence of the gastrostomy tube on the prevalence of complications. Methods In this cross-sectional study, parents were invited to complete an online questionnaire. Children aged 0-16 years with a low-profile gastrostomy or gastrojejunostomy tube were included in the study. Results A total of 67 complete surveys were conducted. The mean age of the included children was seven years. The most common complications during the past week, were skin irritation (35.8%), abdominal pain (34.3%), and the formation of granulation tissue (29.9%). The most common complications during the past six months were skin irritation (47.8%), vomiting (43.4%), and abdominal pain (38.8%). Most complications occurred within the first year after gastrojejunostomy placement and gradually decreased as the duration since the placement of the gastrojejunostomy tube increased. The prevalence of severe complications was rare. Parental confidence in caring for the gastrostomy positively correlated with increases in the duration of the gastrostomy tube. Even so, parental confidence in the care of the gastrostomy tube was reduced in some parents more than a year after its placement. Conclusion The prevalence of gastrojejunostomy complications in children is relatively high. The incidences of severe complications after the placement of a gastrojejunostomy tube were rare in this study. A lack of confidence in the care of the gastrostomy tube was noted in some parents more than a year after its placement.
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Affiliation(s)
- Thomas Gestels
- Department of Pediatrics, Antwerp University Hospital, Edegem, Belgium
| | - Bruno Hauser
- Department of Pediatric Gastroenterology, University Hospital Brussels, Jette, Belgium
| | - Els Van de Vijver
- Department of Pediatric Gastroenterology, Antwerp University Hospital, Edegem, Belgium
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Alreshidi N, Al-Kalaldeh M. The Impact of Asthma Education Programs on Children's Life Aspects: A Systematic Review. CURRENT RESPIRATORY MEDICINE REVIEWS 2021. [DOI: 10.2174/1573398x17666210129130547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective:
This Scoping review was conducted to explore the impact of education programs
on asthmatic children's knowledge of asthma, quality of life, school absenteeism, and selfmanagement.
Data sources:
The Scoping review was restricted to randomized controlled trials and quasi-experimental
designs. Studies published in the English language between 2000 and 2017 were retrieved
from CINAHL, MEDLINE, OvidSP, Cochrane Library, ProQuest, and Google Scholar databases.
Studies Selection:
Along with specific inclusion and exclusion criteria for selecting studies, an
evaluation for the quality of the experimental research based on the level of evidence was applied
to categorize studies into poor to good quality.
Results:
Of the 1256 items initially identified references, 18 studies were included in the review to
cover the impact of asthma education on four major areas: children's knowledge of asthma, quality
of life, school absenteeism, and self-management.
Conclusion:
Despite some inconsistencies between the reviewed studies, asthma education programs
demonstrated a positive effect on children's knowledge of asthma, quality of life, school absenteeism,
and self-management. Further research on the effect of asthma education on children's
activity level, symptoms, and emotional domains is warranted.
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Affiliation(s)
- Nashi Alreshidi
- Continuing Nursing Education Director, Regional Nursing Administration in Hail Region, Saudi Arabia
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Nageen Y, Asemoloye MD, Põlme S, Wang X, Xu S, Ramteke PW, Pecoraro L. Analysis of culturable airborne fungi in outdoor environments in Tianjin, China. BMC Microbiol 2021; 21:134. [PMID: 33932997 PMCID: PMC8088404 DOI: 10.1186/s12866-021-02205-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 04/16/2021] [Indexed: 11/14/2022] Open
Abstract
Background Fungal spores dispersed in the atmosphere may become cause of different pathological conditions and allergies for human beings. A number of studies have been performed to analyze the diversity of airborne fungi in different environments worldwide, and in particular in many urban areas in China. We investigated, for the first time, the diversity, concentration and distribution of airborne fungi in Tianjin city. We sampled 8 outdoor environments, using open plate method, during a whole winter season. Isolated fungi were identified by morphological and molecular analysis. Environmental factors which could influence the airborne fungi concentration (temperature, humidity, wind speed, and air pressure) were monitored and analyzed. The effect of different urban site functions (busy areas with high traffic flow and commercial activities vs. green areas) on airborne fungal diversity was also analyzed. Results A total of 560 fungal strains, belonging to 110 species and 49 genera of Ascomycota (80 %), Basidiomycota (18 %), and Mucoromycota (2 %) were isolated in this study. The dominant fungal genus was Alternaria (22 %), followed by Cladosporium (18.4 %), Naganishia (14.1 %), Fusarium (5.9 %), Phoma (4.11 %), and Didymella (4.8 %). A fungal concentration ranging from 0 to 3224.13 CFU m− 3 was recorded during the whole study. Permutational multivariate analysis showed that the month was the most influential factor for airborne fungal community structure, probably because it can be regarded as a proxy of environmental variables, followed by wind speed. The two analyzed environments (busy vs. green) had no detectable effect on the air fungal community, which could be related to the relatively small size of parks in Tianjin and/or to the study season. Conclusions Our study shed light on the highly diverse community of airborne fungi characterizing the outdoor environments of Tianjin, and clarified the role that different environmental factors played in shaping the analyzed fungal community. The dominant presence of fungi with potential hazardous effect on human health, such as Alternaria, Cladosporium and Naganishia, deserves further attention. Our results may represent a valuable source of information for air quality monitoring, microbial pollution control, and airborne diseases prevention. Supplementary Information The online version contains supplementary material available at 10.1186/s12866-021-02205-2.
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Affiliation(s)
- Yumna Nageen
- School of Pharmaceutical Science and Technology, Tianjin University, 92 Weijin Road, Nankai District, 300072, Tianjin, China
| | - Michael Dare Asemoloye
- School of Pharmaceutical Science and Technology, Tianjin University, 92 Weijin Road, Nankai District, 300072, Tianjin, China
| | - Sergei Põlme
- Institute of Ecology and Earth Sciences, University of Tartu, 14A Ravila, 50411, Tartu, Estonia
| | - Xiao Wang
- School of Pharmaceutical Science and Technology, Tianjin University, 92 Weijin Road, Nankai District, 300072, Tianjin, China
| | - Shihan Xu
- School of Pharmaceutical Science and Technology, Tianjin University, 92 Weijin Road, Nankai District, 300072, Tianjin, China
| | - Pramod W Ramteke
- Faculty of Life Sciences, Mandsaur University, 458001, Mandsaur, India
| | - Lorenzo Pecoraro
- School of Pharmaceutical Science and Technology, Tianjin University, 92 Weijin Road, Nankai District, 300072, Tianjin, China.
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Thompson D, Leach M, Smith C, Fereday J, May E. How nurses and other health professionals use learning principles in parent education practice: A scoping review of the literature. Heliyon 2020; 6:e03564. [PMID: 32211543 PMCID: PMC7082510 DOI: 10.1016/j.heliyon.2020.e03564] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 11/21/2019] [Accepted: 01/27/2020] [Indexed: 12/26/2022] Open
Abstract
Background Health Professionals (HPs) play an important role in supporting parents to care for their children, by facilitating parents' knowledge and skills development through parent education. This is achieved through teaching, whereby planned strategies, based on principles of how people learn, enable learning. Despite Learning Principles being the fundamental tenets of the learning process, how HPs perceive and use Learning Principles in their practice is neglected in the healthcare literature. Objective To identify, describe and map the existing literature on nurses' and HPs' perceptions and use of Learning Principles in parent education practice. Method A scoping review was performed using the Joanna Briggs Institute approach. A comprehensive search of 10 databases and the grey literature was undertaken between March and June 2017 to identify pertinent English-language publications. The search was limited to literature published between 1998 and 2017. Following a screening and inclusion criteria eligibility check, 89 articles were selected for inclusion. Results HPs' perceptions of Learning Principles were diverse, somewhat disorganised, divergent in meaning and implicit. This was until the Dimensions of Learning construct was applied to guide the analyses and mapping. This revealed that HPs, of whom 60.7% were nurses, used Learning Principles in parent education, but only referred to them in the context of Adult Learning. Enablers to HPs using Learning Principles included shared partnerships between parents and HPs, while barriers included parents' health beliefs, psychological issues and organisational assumptions about learning. Evaluation of parents' learning also represented implicit use of Learning Principles by HPs. Conclusion This scoping review is the first to examine HPs' perceptions and use of Learning Principles within parent education practice. The findings reveal a significant gap in this body of knowledge. The paucity of studies containing any explicit descriptions of Learning Principles strongly supports the need for further exploration and codification of Learning Principles, through qualitative methods, whereby a deeper understanding of what is happening in healthcare practice can be established.
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Affiliation(s)
- Deryn Thompson
- University of South Australia, North Terrace, Adelaide, 5000, Australia
| | | | | | - Jennifer Fereday
- Women's and Children's Health Network, University of South Australia, Australia
| | - Esther May
- University of South Australia, Dean Academic and Clinical Education, Health Sciences, Australia
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Welker K, Nabors L, Lang M, Bernstein J. Educational and home-environment asthma interventions for children in urban, low-income, minority families. J Asthma 2018; 55:1301-1314. [PMID: 29420110 DOI: 10.1080/02770903.2018.1424185] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This review examined the impact of environmental change and educational interventions targeting young children from minority groups living in urban environments and who were from low-income families. DATA SOURCES A scoping methodology was used to find research across six databases, including CINAHL, ERIC, PsycINFO, PubMed, MEDLINE, and EMBASE. STUDY SELECTION 299 studies were identified. Duplicates were removed leaving 159 studies. After reviewing for inclusion and exclusion criteria, 23 manuscripts were identified for this study: 11 featured home-environment change interventions and 12 emphasized education of children. RESULTS Studies were reviewed to determine key interventions and outcomes for children. Both environmental interventions and educational programs had positive outcomes. Interventions did not always impact health outcomes, such as emergency department visits. CONCLUSIONS Results indicated many of the environmental change and education interventions improved asthma management and some symptoms. A multipronged approach may be a good method for targeting both education and change in the home and school environment to promote the well-being of young children in urban areas. New research with careful documentation of information about study participants, dose of intervention (i.e., number and duration of sessions, booster sessions) and specific intervention components also will provide guidance for future research.
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Affiliation(s)
- Kristen Welker
- a Health Promotion and Education Program, School of Human Services, University of Cincinnati , Cincinnati , OH , USA
| | - Laura Nabors
- a Health Promotion and Education Program, School of Human Services, University of Cincinnati , Cincinnati , OH , USA
| | - Myia Lang
- a Health Promotion and Education Program, School of Human Services, University of Cincinnati , Cincinnati , OH , USA
| | - Jonathan Bernstein
- b Internal Medicine-Allergy, University of Cincinnati , Cincinnati , OH , USA
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Gibson-Young L, Turner-Henson A, Gerald LB, Vance DE, Lozano D. The relationships among family management behaviors and asthma morbidity in maternal caregivers of children with asthma. JOURNAL OF FAMILY NURSING 2014; 20:442-61. [PMID: 25351584 DOI: 10.1177/1074840714552845] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Numerous studies have identified the relationship of the family caregiver's perception regarding asthma management and the child's asthma outcomes, although few have examined family caregiver asthma management behaviors. The primary aim of this study was to examine the relationship among family management behaviors and asthma morbidity as perceived by maternal caregivers. The Family Management Style Framework was used to guide the research. Maternal caregivers (N = 101) with school-aged children diagnosed with persistent asthma and living in the United States were recruited from a specialty asthma clinic. When caregivers perceived they were expending much effort on their child's asthma management and were not confident in their ability to perform management activities, the child's asthma outcomes were worse. This is the first study to examine family management behaviors with maternal caregivers of school-aged children with asthma. Findings from this study encourage health care providers to tailor each educational opportunity with families to improve child asthma outcomes. An ongoing effort must be made to include families in asthma management. Health care partnerships between provider and family can lead to improved asthma management.
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Horner SD, Brown A. Evaluating the effect of an asthma self-management intervention for rural families. J Asthma 2013; 51:168-77. [PMID: 24188732 DOI: 10.3109/02770903.2013.855785] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To present outcomes of an asthma self-management educational intervention delivered to children (grades 2-5) at school and to parents in a home visit. METHODS The intervention effectiveness was tested in a 12-month longitudinal study with randomization by elementary schools into treatment and attention-control groups with 183 children who had a diagnosis of asthma. Data were collected at four time points. Change over time was examined with linear mixed models. RESULTS Quality of life (QOL), hospitalizations, and emergency department visits improved significantly for all the children. African American and Mexican American children had worse asthma-related QOL than did White children. Asthma management behaviors, asthma self-efficacy, and coping likewise improved with girls improving significantly more than the boys. Significant improvements in inhaler skill and asthma severity were seen in the treatment group children when compared to the control group. Treatment group parents showed significant improvements in home asthma management and self-efficacy. CONCLUSIONS The improvement in inhaler skill is an important finding for practitioners as this is a behavior that can be addressed in the clinical setting. The reduction in the treatment group's asthma severity scores may reflect the improvement in medication delivery as their inhaler skill improved. The differential improvement between boys and girls points to the need for testing other formats in asthma education that can address different learning styles. The individualized parent asthma education enabled the intervener to incorporate neighborhood and home environmental information thereby allowing for tailoring of parental instruction.
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Affiliation(s)
- Sharon D Horner
- School of Nursing, The University of Texas at Austin , Austin, TX , USA
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Ekim A, Ocakci AF. Perceptions of parents and children regarding asthma management responsibilities. J SPEC PEDIATR NURS 2013; 18:289-96. [PMID: 24094124 DOI: 10.1111/jspn.12037] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2012] [Revised: 04/28/2013] [Accepted: 04/29/2013] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this study was to examine perceptions of children and parents regarding shared responsibilities for asthma management. DESIGN AND METHODS The study included 72 children with asthma who were between the ages of 7 and 12 years and their parents. Asthma management responsibilities were assessed by the "Asthma Responsibility Questionnaire." RESULTS Disagreements occurred between parents and children on assuming responsibility. Children reported higher asthma management responsibility scores than reported by parents for them. PRACTICE IMPLICATIONS It is important that nurses provide education and counseling to both children and their families to ensure that children take responsibility for disease management.
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Affiliation(s)
- Ayfer Ekim
- Department of Pediatric Nursing, Faculty of Health Sciences, Marmara University, Turkey
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Fassl BA, Nkoy FL, Stone BL, Srivastava R, Simon TD, Uchida DA, Koopmeiners K, Greene T, Cook LJ, Maloney CG. The Joint Commission Children's Asthma Care quality measures and asthma readmissions. Pediatrics 2012; 130:482-91. [PMID: 22908110 PMCID: PMC4074621 DOI: 10.1542/peds.2011-3318] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/27/2012] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The Joint Commission introduced 3 Children's Asthma Care (CAC 1-3) measures to improve the quality of pediatric inpatient asthma care. Validity of the commission's measures has not yet been demonstrated. The objectives of this quality improvement study were to examine changes in provider compliance with CAC 1-3 and associated asthma hospitalization outcomes after full implementation of an asthma care process model (CPM). METHODS The study included children aged 2 to 17 years who were admitted to a tertiary care children's hospital for acute asthma between January 1, 2005, and December 31, 2010. The study was divided into 3 periods: preimplementation (January 1, 2005-December 31, 2007), implementation (January 1, 2008-March 31, 2009), and postimplementation (April 1, 2009-December 31, 2010) periods. Changes in provider compliance with CAC 1-3 and associated changes in hospitalization outcomes (length of stay, costs, PICU transfer, deaths, and asthma readmissions within 6 months) were measured. Logistic regression was used to control for age, gender, race, insurance type, and time. RESULTS A total of 1865 children were included. Compliance with quality measures before and after the CPM implementation was as follows: 99% versus 100%, CAC-1; 100% versus 100%, CAC-2; and 0% versus 87%, CAC-3 (P < .01). Increased compliance with CAC-3 was associated with a sustained decrease in readmissions from an average of 17% to 12% (P = .01) postimplementation. No change in other outcomes was observed. CONCLUSIONS Implementation of the asthma CPM was associated with improved compliance with CAC-3 and with a delayed, yet significant and sustained decrease in hospital asthma readmission rates, validating CAC-3 as a quality measure. Due to high baseline compliance, CAC-1 and CAC-2 are of questionable value as quality measures.
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Affiliation(s)
| | - Flory L. Nkoy
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Bryan L. Stone
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | | | - Tamara D. Simon
- Department of Pediatrics, University of Washington, Seattle, Washington; and
| | - Derek A. Uchida
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | | | - Tom Greene
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Lawrence J. Cook
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
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Abstract
BACKGROUND While guidelines recommend that children with asthma should receive asthma education, it is not known if education delivered in the home is superior to usual care or the same education delivered elsewhere. The home setting allows educators to reach populations (such as the economically disadvantaged) that may experience barriers to care (such as lack of transportation) within a familiar environment. OBJECTIVES To perform a systematic review on educational interventions for asthma delivered in the home to children, caregivers or both, and to determine the effects of such interventions on asthma-related health outcomes. We also planned to make the education interventions accessible to readers by summarising the content and components. SEARCH STRATEGY We searched the Cochrane Airways Group Specialised Register of trials, which includes the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED and PsycINFO, and handsearched respiratory journals and meeting abstracts. We also searched the Education Resources Information Center database (ERIC), reference lists of trials and review articles (last search January 2011). SELECTION CRITERIA We included randomised controlled trials of asthma education delivered in the home to children, their caregivers or both. In the first comparison, eligible control groups were provided usual care or the same education delivered outside of the home. For the second comparison, control groups received a less intensive educational intervention delivered in the home. DATA COLLECTION AND ANALYSIS Two authors independently selected the trials, assessed trial quality and extracted the data. We contacted study authors for additional information. We pooled dichotomous data with fixed-effect odds ratio and continuous data with mean difference (MD) using a fixed-effect where possible. MAIN RESULTS A total of 12 studies involving 2342 children were included. Eleven out of 12 trials were conducted in North America, within urban or suburban settings involving vulnerable populations. The studies were overall of good methodological quality. They differed markedly in terms of age, severity of asthma, context and content of the educational intervention leading to substantial clinical heterogeneity. Due to this clinical heterogeneity, we did not pool results for our primary outcome, the number of patients with exacerbations requiring emergency department (ED) visit. The mean number of exacerbations requiring ED visits per person at six months was not significantly different between the home-based intervention and control groups (N = 2 studies; MD 0.04; 95% confidence interval (CI) -0.20 to 0.27). Only one trial contributed to our other primary outcome, exacerbations requiring a course of oral corticosteroids. Hospital admissions also demonstrated wide variation between trials with significant changes in some trials in both directions. Quality of life improved in both education and control groups over time.A table summarising some of the key components of the education programmes is included in the review. AUTHORS' CONCLUSIONS We found inconsistent evidence for home-based asthma educational interventions compared to standard care, education delivered outside of the home or a less intensive educational intervention delivered at home. Although education remains a key component of managing asthma in children, advocated in numerous guidelines, this review does not contribute further information on the fundamental content and optimum setting for such educational interventions.
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Affiliation(s)
- Emma J Welsh
- St George's, University of LondonPopulation Health Research InstituteCranmer TerraceLondonUKSW17 0RE
| | | | - Patricia Li
- Montreal Children's Hospital, McGill University Health CentreDepartment of PediatricsMontrealQCCanada
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Kaul T. Helping African American children self-manage asthma: the importance of self-efficacy. THE JOURNAL OF SCHOOL HEALTH 2011; 81:29-33. [PMID: 21158863 DOI: 10.1111/j.1746-1561.2010.00554.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Asthma is the leading cause of chronic illness among children in the United States, with a disproportionately higher incidence among minority children. In an attempt to increase understanding of the factors that may influence self-management of chronic disease, the study examined the relationship between self-efficacy belief and asthma self-management in urban African American children. METHODS Using a descriptive correlational research design, the participants (81 African American children between 7 and 12 years old) completed the Asthma Inventory for Children (AIC), which measured asthma self-management behaviors, and Asthma Belief Survey (ABS), which measured asthma self-efficacy. RESULTS Results of this study demonstrated a statistically positive correlation (p < .01, r = .53) between the child's asthma self-management and the child's self-efficacy belief toward his or her asthma. The mean item scores for the AIC, which measures the number of asthma management behaviors utilized by the participants, ranged from 1.88 to 5.00 with a mean of 3.69 and a standard deviation of 0.59. The mean scores of the ABS, which measures the level of self-efficacy beliefs for asthma management among the participants, ranged from 1.73 to 5.00 with a standard deviation of 0.58. CONCLUSIONS In chronic illness such as asthma, self-management is key to the long-range personal, academic, and professional success of children and adults with such conditions. Implications are drawn for the preparation of health care providers, teachers, and counselors who work with school-age children with asthma.
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Affiliation(s)
- Teri Kaul
- Department of Graduate Nursing, Concordia University, 12800 N. Lake Shore Dr., Mequon, WI 53097, USA.
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Coffman JM, Cabana MD, Yelin EH. Do school-based asthma education programs improve self-management and health outcomes? Pediatrics 2009; 124:729-42. [PMID: 19651589 PMCID: PMC2875148 DOI: 10.1542/peds.2008-2085] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Asthma self-management education is critical for high-quality asthma care for children. A number of studies have assessed the effectiveness of providing asthma education in schools to augment education provided by primary care providers. OBJECTIVE To conduct a systematic review of the literature on school-based asthma education programs. METHODS As our data sources, we used 3 databases that index peer-reviewed literature: MEDLINE, the Cochrane Central Register of Controlled Trials, and the Cumulative Index to Nursing and Allied Health Literature. Inclusion criteria included publication in English and enrollment of children aged 4 to 17 years with a clinical diagnosis of asthma or symptoms consistent with asthma. RESULTS Twenty-five articles met the inclusion criteria. Synthesizing findings across studies was difficult because the characteristics of interventions and target populations varied widely, as did the outcomes assessed. In addition, some studies had major methodologic weaknesses. Most studies that compared asthma education to usual care found that school-based asthma education improved knowledge of asthma (7 of 10 studies), self-efficacy (6 of 8 studies), and self-management behaviors (7 of 8 studies). Fewer studies reported favorable effects on quality of life (4 of 8 studies), days of symptoms (5 of 11 studies), nights with symptoms (2 of 4 studies), and school absences (5 of 17 studies). CONCLUSIONS Although findings regarding effects of school-based asthma education programs on quality of life, school absences, and days and nights with symptoms were not consistent, our analyses suggest that school-based asthma education improves knowledge of asthma, self-efficacy, and self-management behaviors.
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Affiliation(s)
- Janet M. Coffman
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California, Department of Family and Community Medicine, University of California, San Francisco, California
| | - Michael D. Cabana
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California, Department of Pediatrics, University of California, San Francisco, California
| | - Edward H. Yelin
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California, Department of Medicine, University of California, San Francisco, California
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Dixon SL, Fowler C, Harris J, Moffat S, Martinez Y, Walton H, Ruiz B, Jacobs DE. An examination of interventions to reduce respiratory health and injury hazards in homes of low-income families. ENVIRONMENTAL RESEARCH 2009; 109:123-130. [PMID: 19038383 DOI: 10.1016/j.envres.2008.10.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2008] [Revised: 09/26/2008] [Accepted: 10/03/2008] [Indexed: 05/27/2023]
Abstract
We evaluated whether combining asthma trigger reduction with housing structural repairs, device disbursement and education in low-income households with children would improve self-reported respiratory health and reduce housing-related respiratory health and injury hazards (convenience sample of n=67 homes with 63 asthmatic and 121 non-asthmatic children). At baseline, a visual assessment of the home environment and a structured occupant interview were used to examine 29 potential injury hazards and 7 potential respiratory health hazards. A home-specific intervention was designed to provide the children's parents or caretakers with the knowledge, skills, motivation, supplies, equipment, and minimum housing conditions necessary for a healthy and safe home. The enrolled households were primarily Hispanic and owned their homes. On average, 8 injury hazards were observed in the homes at baseline. Four months following intervention, the average declined to 2.2 hazards per home (p<0.001), with 97% of the parents reporting that their homes were safer following the interventions. An average of 3.3 respiratory health hazards were observed in the homes at baseline. Four months following intervention, the average declined to 0.9 hazards per home (p<0.001), with 96% of parents reporting that the respiratory health of their asthmatic children improved. A tailored healthy homes improvement package significantly improves self-reported respiratory health and safety, reduces respiratory health and injury hazards, and can be implemented in concert with a mobile clinical setting.
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Affiliation(s)
- Sherry L Dixon
- The National Center for Healthy Housing, 10320 Little Patuxent Parkway, Suite 500, Columbia, MD 21044, USA.
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14
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Horner SD, Fouladi RT. Improvement of rural children's asthma self-management by lay health educators. THE JOURNAL OF SCHOOL HEALTH 2008; 78:506-513. [PMID: 18786043 PMCID: PMC2535850 DOI: 10.1111/j.1746-1561.2008.00336.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND The purpose of the present analysis is to examine changes in rural children's asthma self-management after they received lay health educator (LHE)-delivered classes. METHODS Elementary schools were randomly assigned to the treatment or attention-control condition and their participating students received either asthma education or general health promotion education, respectively. The triethnic sample was composed of 183 children (46% Hispanic, 29.5% non-Hispanic white, 22% African American, and 2.6% other categories) who had a mean age of 8.78 years (SD = 1.24). The time frame from baseline to postintervention was 12 weeks. RESULTS Repeated measures analysis of variance found main effects in changes in scores for children's asthma knowledge, asthma self-management, self-efficacy for managing asthma symptoms, and metered dose inhaler (MDI) technique and significant group interaction effects for the treatment intervention on the measures of children's asthma knowledge, asthma self-management, and MDI technique. CONCLUSIONS The delivery of an asthma health education intervention by trained LHEs to school-aged children was an effective means for improving children's knowledge and skills in asthma self-management.
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Affiliation(s)
- Sharon D Horner
- School of Nursing, The University of Texas at Austin, Austin, TX 78701-1499, USA.
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15
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DePue JD, McQuaid EL, Koinis-Mitchell D, Camillo C, Alario A, Klein RB. Providence school asthma partnership: school-based asthma program for inner-city families. J Asthma 2007; 44:449-53. [PMID: 17654131 DOI: 10.1080/02770900701421955] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Over 3 years, 972 families participated in an after-school asthma program at their child's school. Parents and children attended concurrent 2(1/2)-hour workshops. Parents were 74% Latino; 45% non-English speaking, with 77% of children on Medicaid. Asthma symptoms were significantly reduced, from multiple times per week to less than once per week on average. Oral steroid use decreased to one third of baseline use. Hospital days decreased from 11% to 2%; emergency visits decreased 35% to 4%; and school days missed decreased 48% to 20%. This program has now become sustainable with both private and Medicaid insurance coverage.
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Affiliation(s)
- Judith D DePue
- The Centers for Behavioral and Preventive Medicine, the Miriam Hospital/Brown Medical School, Providence, Rhode Island 02903, USA.
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16
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Horner SD. Home visiting for intervention delivery to improve rural family asthma management. J Community Health Nurs 2007; 23:213-23. [PMID: 17064231 PMCID: PMC2824896 DOI: 10.1207/s15327655jchn2304_2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The focus of this article is on the use of home visits in an asthma self-management intervention study with rural families who have a school-aged child with asthma. The study design involved randomization of the sample by elementary schools, then baseline (pretest) and postintervention data collection.(1) The purpose of this article is to describe challenges with, and pose solutions for, implementing home visits for asthma self-management in rural areas. Home visiting is a strategy for program delivery that takes advantage of the home context for tailoring services to address the family's individual needs. The advantages of intervening in the home include being able to (a) use actual home conditions for individualizing the asthma education to meet families' needs; (b) match home visitors with family in terms of ethnicity and language; (c) retain a high percentage of families over the year-long duration of the study; and (d) not add to family burden of managing asthma.
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Affiliation(s)
- Sharon D Horner
- The University of Texas at Austin, School of Nursing, Austin, TX, USA.
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17
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Abstract
PURPOSE To examine psychosocial care needs of children with recent-onset asthma. DESIGN/METHODS Data were collected over 2 years from 63 children ages 8-14 years. RESULTS Children's need for attention to specific aspects of their asthma care remained high over the 2 years, as did their perceived needs for information and support and their concerns and fears. PRACTICE IMPLICATIONS Children have many needs, and healthcare professionals may not be providing care that addresses these needs. The Child Report of Psychosocial Care can be used as a quick tool to assess and guide interventions related to specific areas of need.
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Affiliation(s)
- Angela M McNelis
- School of Nursing, University of Indiana, Indianapolis, IN, USA.
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18
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Butz A, Pham L, Lewis L, Lewis C, Hill K, Walker J, Winkelstein M. Rural children with asthma: impact of a parent and child asthma education program. J Asthma 2005; 42:813-21. [PMID: 16393717 PMCID: PMC2276310 DOI: 10.1080/02770900500369850] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The goal of this study was to determine the effectiveness of an asthma educational intervention in improving asthma knowledge, self-efficacy, and quality of life in rural families. Children 6 to 12 years of age (62% male, 56% white, and 22% Medicaid) with persistent asthma (61%) were recruited from rural elementary schools and randomized into the control standard asthma education (CON) group or an interactive educational intervention (INT) group geared toward rural families.Parent/caregiver and child asthma knowledge, self-efficacy, and quality of life were assessed at baseline and at 10 months post enrollment. Despite high frequency of symptom reports, only 18% children reported an emergency department visit in the prior 6 months. Significant improvement in asthma knowledge was noted for INT parents and young INT children at follow-up (Parent: CON = 16.3; INT = 17.5, p < 0.001; Young children: CON = 10.8, INT = 12.45, p < 0.001). Child self-efficacy significantly increased in the INT group at follow-up; however, there was no significant difference in parent self-efficacy or parent and child quality of life at follow-up. Asthma symptom reports were significantly lower for the INT group at follow-up. For young rural children, an interactive asthma education intervention was associated with increased asthma knowledge and self-efficacy, decreased symptom reports, but not increased quality of life.
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Affiliation(s)
- Arlene Butz
- The Johns Hopkins University, School of Nursing, Baltimore, Maryland 21287, USA.
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