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Thach C, Lafont C, Epaud R, Tahiri K, Sauvage F, Sagorin V, Sérabian V, Delestrain C. Effectiveness of pediatric asthma education program in the context of a general hospital in France: A retrospective real-life study. Heliyon 2024; 10:e35356. [PMID: 39170434 PMCID: PMC11337717 DOI: 10.1016/j.heliyon.2024.e35356] [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] [Received: 04/21/2023] [Revised: 07/21/2024] [Accepted: 07/26/2024] [Indexed: 08/23/2024] Open
Abstract
Objective To assess the feasibility and effectiveness of a pediatric asthma education program delivered in the context of a French suburban general hospital. Design Monocentric retrospective study including children with asthma in Melun, Île-de-France, from January to December 2019. Data collected concerned asthma management, symptoms, education, and knowledge. Results We included 262 patients with a median age of 4.5 years. Asthma education (AE) was taught to 226 (86 %) children, 36 with minimal education (ME), 155 (69 %) with an unstructured asthma education program (USEP) and 71 (31 %) a structured asthma education program (SEP). Patients with an SEP had better knowledge of the disease and its treatment as compared with those with a USEP or ME (p < 0.05). Lung function was evaluated for 70 % of children with ME, 90 % with a USEP (p = 0.144) and 77 % an SEP (p = 0.455). Allergy testing was assessed for 42 % of children with ME, 69 % a USEP (p = 0.020) and 57 % an SEP (p = 0.185). Almost all children with USEP (93 %) and SEP (94 %) also had a written asthma action plan as compared with 49 % of the children with ME (p < 0.001). Also, 76 % of children with ME did not have an asthma follow-up as compared with 37 % with a USEP and 52 % an SEP. Overall, 69 % of children with ME had at least one hospitalization within the year as compared with 32 % with a USEP (p = 0.001) and 59 % an SEP (p = 0.506). Conclusions An asthma education program delivered in a general hospital resulted in increased disease knowledge for children and their caregivers, together with reduced acute interventions.
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Affiliation(s)
- Caroline Thach
- Service de pédiatrie, Groupe hospitalier Sud Ile de France, 77000 Melun, France
| | - Charlotte Lafont
- Univ Paris Est Creteil, INSERM, IMRB, F-94010 Creteil, France
- AP-HP, hôpital Henri-Mondor, Service de Santé Publique, F-94010, Créteil, France
| | - Ralph Epaud
- Univ Paris Est Creteil, INSERM, IMRB, F-94010 Creteil, France
- Service de pédiatrie, Centre intercommunal de Créteil, 94010 Créteil Cedex, France
| | - Kenza Tahiri
- Service de pédiatrie, Centre intercommunal de Créteil, 94010 Créteil Cedex, France
| | - Floriane Sauvage
- Service de pédiatrie, Centre intercommunal de Créteil, 94010 Créteil Cedex, France
| | - Virginie Sagorin
- Unité transversale d’Education thérapeutique du Patient, Groupe hospitalier Sud Ile de France, 77000 Melun, France
| | - Virginie Sérabian
- Unité transversale d’Education thérapeutique du Patient, Groupe hospitalier Sud Ile de France, 77000 Melun, France
| | - Céline Delestrain
- Univ Paris Est Creteil, INSERM, IMRB, F-94010 Creteil, France
- Service de pédiatrie, Centre intercommunal de Créteil, 94010 Créteil Cedex, France
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Beerthuizen T, Rikkers-Mutsaerts ERVM, Snoeck-Stroband JB, Sont JK. The Role of Education, Monitoring, and Symptom Perception in Internet-Based Self-management Among Adolescents With Asthma: Secondary Analysis of a Randomized Controlled Trial. JMIR Pediatr Parent 2021; 4:e17959. [PMID: 34879001 PMCID: PMC8693204 DOI: 10.2196/17959] [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: 01/24/2020] [Revised: 12/31/2020] [Accepted: 06/01/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Internet-based self-management programs improve asthma control and the asthma-related quality of life in adults and adolescents. The components of self-management programs include education and the web-based self-monitoring of symptoms; the latter requires adequate perception in order to timely adjust lifestyle or medication or to contact a care provider. OBJECTIVE We aimed to test the hypothesis that adherence to education and web-based monitoring and adequate symptom perception are important determinants for the improvement of asthma control in self-management programs. METHODS We conducted a subgroup analysis of the intervention group of a randomized controlled trial, which included adolescents who participated in the internet-based self-management arm. We assessed the impacts that attendance in education sessions, the frequency of web-based monitoring, and the level of perception had on changes in asthma control (Asthma Control Questionnaire [ACQ]) and asthma-related quality of life (Pediatric Asthma Quality of Life Questionnaire) from baseline to 12 months after intervention. RESULTS Adolescents who attended education sessions had significant and clinically relevant improvements in asthma control (ACQ score difference: -0.6; P=.03) and exhibited a nonsignificant trend of improvement in asthma-related quality of life (Pediatric Asthma Quality of Life Questionnaire score difference: -0.45; P=.15) when compared to those who did not adhere to education. Frequent monitoring alone did not improve asthma control (P=.07) and quality of life (P=.44) significantly, but its combination with education did result in improved ACQ scores (difference: -0.88; P=.02). There were no significant differences in outcomes between normoperceivers and hypoperceivers. CONCLUSIONS Education, especially in combination with frequent web-based monitoring, is an important determinant for the 1-year outcomes of asthma control in internet-based self-management programs for adolescents with partly controlled and uncontrolled asthma; however, we could not establish the effect of symptom perception. This study provides important knowledge on the effects of asthma education and monitoring in daily life.
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Affiliation(s)
- Thijs Beerthuizen
- Department of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Center, Leiden, Netherlands
| | | | - Jiska B Snoeck-Stroband
- Department of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Center, Leiden, Netherlands
| | - Jacob K Sont
- Department of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Center, Leiden, Netherlands
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Dall'Oglio I, Rosati GV, Biagioli V, Tiozzo E, Gawronski O, Ricci R, Garofalo A, Piga S, Gramaccioni S, Di Maria C, Vanzi V, Querciati A, Alvaro R, Biancalani L, Buonomo E, Doria M, Villani A. Pediatric nurses in pediatricians' offices: a survey for primary care pediatricians. BMC FAMILY PRACTICE 2021; 22:136. [PMID: 34187392 PMCID: PMC8243477 DOI: 10.1186/s12875-021-01457-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 05/12/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The role played by nurses in caring for children in pediatricians' officies in the community is crucial to ensure integrated care. In Italy, pediatricians are responsible for the health of children aged 0-14 years living in the community. This study aimed to describe Italian primary care pediatricians' opinions about the usefulness of several nursing activities that pediatric nurses could perform in pediatricians' offices. METHODS An online survey with pediatricians working in primary care in Italy was conducted between April-December 2018. A 40-item questionnaire was used to assess four types of nursing activities: clinical care, healthcare education, disease prevention, and organizational activities. The answers ranged from 1 (not useful at all) to 6 (very useful). Moreover, three open-ended questions completed the questionnaire. RESULTS Overall, 707 pediatricians completed the online survey. Participants were mainly female (63%), with a mean age of 57.74 (SD = 6.42). The presence of a pediatric nurse within the pediatrician's office was considered very useful, especially for healthcare education (Mean 4.90; SD 1.12) and disease prevention (Mean 4.82; SD 1.11). Multivariate analysis confirmed that pediatricians 'with less working experience', 'having their office in a small town', and 'collaborating with a secretary and other workers in the office' rated the nurse's activities significantly more useful. CONCLUSIONS A pediatric nurse in the pediatrician's office can significantly contribute to many activities for children and their families in the community. These activities include clinical care, healthcare education, disease prevention, and the organizational processes of the office. Synergic professional activity between pediatricians and pediatric nurses could ensure higher health care standards in the primary care setting.
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Affiliation(s)
- Immacolata Dall'Oglio
- Health Professionals Development, Continuing Education and Research Service; Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165, Rome, Italy.
| | - Giovanni Vitali Rosati
- Italian Pediatric Society, Rome, Italy
- Italian Federation of Pediatric Physicians, Rome, Italy
| | - Valentina Biagioli
- Health Professionals Development, Continuing Education and Research Service; Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Emanuela Tiozzo
- Health Professionals Development, Continuing Education and Research Service; Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Orsola Gawronski
- Health Professionals Development, Continuing Education and Research Service; Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Riccardo Ricci
- Health Professionals Development, Continuing Education and Research Service; Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Antonio Garofalo
- Health Professionals Development, Continuing Education and Research Service; Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Simone Piga
- Unit of Clinical Epidemiology, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Simone Gramaccioni
- Academic Department of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Claudio Di Maria
- Academic Department of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Valentina Vanzi
- Academic Department of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Alessandra Querciati
- Academic Department of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | - Ersilia Buonomo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Mattia Doria
- Italian Federation of Pediatric Physicians, Rome, Italy
| | - Alberto Villani
- Italian Pediatric Society, Rome, Italy
- Pediatric Emergency Department and General Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165, Rome, Italy
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Acute Asthma in the Pediatric Emergency Department: Infections Are the Main Triggers of Exacerbations. BIOMED RESEARCH INTERNATIONAL 2017; 2017:9687061. [PMID: 29159184 PMCID: PMC5660758 DOI: 10.1155/2017/9687061] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 08/21/2017] [Accepted: 08/29/2017] [Indexed: 01/13/2023]
Abstract
Background Asthma exacerbations are a common reason for Emergency Department (ED) visits in children. Aim To analyze differences among age groups in terms of triggering factors and seasonality and to identify those with higher risk of severe exacerbations. Methods We retrospectively revised the files of children admitted for acute asthma in 2016 in our Pediatric ED. Results Visits for acute asthma were 603/23197 (2.6%). 76% of the patients were <6 years old and 24% ≥6. Infections were the main trigger of exacerbations in both groups; 33% of the school-aged children had a triggering allergic condition (versus 3% in <6 years; p < .01). 191 patients had a previous history of asthma; among them, 95 were ≥6 years, 67% of whom were not using any controller medication, showing a higher risk of a moderate-to-severe exacerbation than those under long-term therapy (p < .01). Exacerbations peaked in autumn and winter in preschoolers and in spring and early autumn in the school-aged children. Conclusions Infections are the main trigger of acute asthma in children of any age, followed by allergy in the school-aged children. Efforts for an improved management of patients affected by chronic asthma might go through individualized action plans and possibly vaccinations and allergen-avoidance measures.
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