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Omara HA, Mansour MG, Badr RM. Asthma education and its impact on pediatric asthma severity: a prospective cohort study. J Asthma 2023; 60:588-599. [PMID: 35616052 DOI: 10.1080/02770903.2022.2082306] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Asthma education has been shown to improve asthma control. Our goal was to evaluate the efficacy of asthma education on the frequency of utilization of health-care services, lung function results, degree of asthma severity, and quality of life (QOL) level in children with asthma. METHODS A single-arm prospective interventional trial was conducted in a tertiary facility. Thirty children with asthma and their parents were recruited for the research. Following an assessment of the participants' and caregivers' knowledge about asthma using an asthma knowledge questionnaire, degree of asthma control using asthma control test, inhaler technique using standardized inhaler technique checklists, and QOL using pediatric asthma QOL questionnaires, they participated in a three-month education program in the form of monthly live interactive sessions followed by weekly phone interviews. Measures taken before and after the intervention were compared. RESULTS The educational intervention improved asthma control dramatically including daytime asthma symptoms, night awakenings, and frequency of use of short-acting beta2- adrenergic receptor agonists. Furthermore, the number of emergency department visits and hospitalizations fell considerably after the intervention (p < 0.001 for all). Asthma education was also linked to better inhalation technique and lung function (p < 0.001). Furthermore, all quality-of-life measures increased (p < 0.001 for all). CONCLUSIONS Implementing an asthma education program that included both children with asthma and their parents improved asthma control levels, lung function measures, and overall quality of life. Furthermore, it increased asthma awareness, decreased the use of health-care resources, and reduced asthma severity, resulting in better asthma management.
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Affiliation(s)
- Heba A Omara
- Department of Pediatrics, Pulmonology Division, Faculty of Medicine, Ain Shams University Children's Hospital, Cairo, Egypt
| | - Mervat G Mansour
- Department of Pediatrics, Faculty of Medicine, Ain Shams University Children's Hospital, Cairo, Egypt
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Fawcett R, Porritt K, Stern C, Carson-Chahhoud K. Experiences of parents and carers in managing asthma in children: a qualitative systematic review. ACTA ACUST UNITED AC 2020; 17:793-984. [PMID: 31090652 DOI: 10.11124/jbisrir-2017-004019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of the review was to identify, critically appraise and synthesize the best available qualitative evidence to understand the lived experiences of parents and carers caring for a child aged 0-18 years with asthma in any setting and managing their condition. INTRODUCTION Asthma affects around 14% of children and despite the availability of effective therapies, asthma control is suboptimal and hospitalization rates remain high. Mothers predominantly manage their child's asthma and experience stress and exhaustion due to complex treatments and balancing work and family life. This review provides an understanding of the barriers parents and carers face in managing their child's asthma and highlights the needs of families throughout their asthma journey. INCLUSION CRITERIA The review considered qualitative studies examining the experiences of parents and carers caring for a child with asthma, wheeze or bronchiolitis and managing their condition. Research designs included, but were not limited to, phenomenology, grounded theory, ethnography, and action and feminist research. METHODS A comprehensive search using PubMed, CINAHL, Embase, PsycINFO, Web of Science and ProQuest for published and unpublished studies was undertaken in June 2017 and December 2017. Studies published in English from 1972 to 2017 were included. The recommended Joanna Briggs Institute approach to critical appraisal, study selection, data extraction and data synthesis was used. RESULTS Seventy-seven qualitative studies were included in this review, including grounded theory, phenomenology and ethnography methodologies. From these 77 studies, 1655 participants from a variety of cultural backgrounds and socio-economic status groups were represented. The methodological quality of included articles was sound and participants' voices were strong. A total of 1161 findings (966 unequivocal and 195 credible) were extracted and grouped into 41 categories, based on similarity in meaning. From the 41 categories, seven synthesized statements were produced: i) Negotiating the meaning of having a child with asthma, ii) Impact on family life, iii) The process of getting a diagnosis and learning about asthma, iv) Relationships with healthcare professionals and the emergency department experience, v) Medication beliefs, concerns and management strategies, vi) With time, parents and carers become more comfortable managing their child's asthma, vii) The need for support. CONCLUSIONS This review highlights the difficulties parents and carers face when caring for a child with asthma and managing their child's condition. Attaining a definitive diagnosis of asthma can be challenging, and parents and carers express uncertainty and fear due to continuing symptoms and repeated hospitalizations. Healthcare professionals should ensure that a clear diagnostic strategy and treatment plan are communicated so parents and carers have an understanding of the pathway to receiving an actual diagnosis. Comprehensive asthma education is essential at the onset of asthma symptoms, with accurate, easy to understand and culturally relevant information. Supportive relationships, with healthcare professionals taking a partnership approach, ensuring adequate time, continuity of care, regular follow-up, and addressing the psychosocial and cultural needs and concerns of parents and carers, are recommended. Support groups and training for education staff is imperative to ensure they can support parents and carers, provide asthma friendly environments and respond appropriately in an asthma emergency.
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Affiliation(s)
- Robyn Fawcett
- Joanna Briggs Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Kylie Porritt
- Joanna Briggs Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Cindy Stern
- Joanna Briggs Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Kristin Carson-Chahhoud
- Australian Centre for Precision Health, School of Health Sciences, University of South Australia, Adelaide, Australia.,School of Medicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
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Abdelbasset WK, Alsubaie SF, Tantawy SA, Abo Elyazed TI, Kamel DM. Evaluating pulmonary function, aerobic capacity, and pediatric quality of life following a 10-week aerobic exercise training in school-aged asthmatics: a randomized controlled trial. Patient Prefer Adherence 2018; 12:1015-1023. [PMID: 29942118 PMCID: PMC6007206 DOI: 10.2147/ppa.s159622] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND It has been documented that aerobic exercise may increase pulmonary functions and aerobic capacity, but limited data has evaluated a child's satisfaction and pediatric quality of life (PQoL) with exercise training. OBJECTIVES This study aimed to investigate the effects of moderate-intensity exercise training on asthmatic school-aged children. SUBJECTS AND METHODS This study included 38 school-aged children with asthma (23 males and 15 females) aged between 8-12 years. They were randomly assigned to two groups, aerobic exercise (AE) and conventional treatment (Con ttt) groups. The AE group received a program of moderate-intensity aerobic exercise for 10 weeks with asthma medications and the Con ttt group received only asthma medications without exercise intervention. A home respiratory exercise was recommended for the two groups. Aerobic capacity was investigated using maximal oxygen uptake (VO2max), 6-minute walk test (6MWT), and fatigue index. PQoL was evaluated using Pediatric Quality of Life Questionnaire (PQoLQ). Also, pulmonary function tests were performed, and the results recorded. RESULTS The findings of this study showed significant improvements in pulmonary functions and VO2max in the two groups; however, this improvement was significantly higher in the AE group than in the Con ttt group (p<0.05). The 6MWT and fatigue index improved in the AE group (p<0.05) but not in the Con ttt group (p>0.05). All dimensions of PQoL significantly improved in the AE group (p<0.05), but there was no significant improvement in the Con ttt group after the 10-week intervention period (p>0.05). CONCLUSION Ten weeks of physical exercise had beneficial effects on pulmonary functions, aerobic capacity, and PQoL in school-aged children with asthma. Effort and awareness should be dedicated to encouraging the active lifestyle among different populations, especially asthmatic children.
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Affiliation(s)
- Walid K Abdelbasset
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
- Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt
| | - Saud F Alsubaie
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Sayed A Tantawy
- Department of Physiotherapy, College of Medical and Health Sciences, Ahlia University, Manama, Kingdom of Bahrain
| | - Tamer I Abo Elyazed
- Department of Physical Therapy for Internal Medicine, Faculty of Physical Therapy, Beni-Suef University, Beni-Suef, Egypt
| | - Dalia M Kamel
- Department of Physiotherapy, College of Medical and Health Sciences, Ahlia University, Manama, Kingdom of Bahrain
- Department of Physiotherapy for Womens Health, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Al Aloola NA, Nissen L, Alewairdhi HA, Al Faryan N, Saini B. Parents' asthma information needs and preferences for school-based asthma support. J Asthma 2017; 54:946-956. [PMID: 28095117 DOI: 10.1080/02770903.2017.1281296] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study sought to investigate parents' needs and preferences for school-based asthma support in Saudi Arabian primary schools. METHODS Semi-structured qualitative interviews were conducted in the period between November 2015 and February 2016, with a convenience sample that comprised Saudi parents and carers of children with asthma. Recruitment of participants was primarily driven through Saudi primary schools; passive snowballing and social networks were used to boost participation rates further. Interviews were audio-recorded, transcribed verbatim, translated and data were thematically organised using a latent content analysis approach. RESULTS Twenty interviews were conducted. Six themes emerged from the interviews and were grouped into three major categories: (1) general asthma management issues; (2) school-based asthma management issues; and (3) communication dissatisfaction. Participants expressed concern at schools' social and physical environments and a lack of confidence in the ability of schools to manage their child's asthma, especially when their child was ill. Most of the participants advocated for staff training and school community engagement to improve the management of asthma in Saudi primary schools. CONCLUSION This research clearly describes a need for school-based asthma support, including asthma-related policies, procedures and education on asthma and first aid in Saudi primary schools.
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Affiliation(s)
- Noha Abdullah Al Aloola
- a Faculty of Pharmacy, University of Sydney , Camperdown Campus, Sydney , NSW , Australia.,b Department of Clinical Pharmacy , Faculty of Pharmacy, King Saud University , Riyadh , Saudi Arabia
| | - Lisa Nissen
- c School of Clinical Sciences, Queensland University of Technology , Brisbane , Australia
| | | | - Nawaf Al Faryan
- d School of Allied Health, Department of Community and Clinical Allied Health , College of Science, Health and Engineering, La Trobe University , Bundoora , Australia
| | - Bandana Saini
- a Faculty of Pharmacy, University of Sydney , Camperdown Campus, Sydney , NSW , Australia
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Westergren T, Fegran L, Nilsen T, Haraldstad K, Kittang OB, Berntsen S. Active play exercise intervention in children with asthma: a PILOT STUDY. BMJ Open 2016; 6:e009721. [PMID: 26733570 PMCID: PMC4716232 DOI: 10.1136/bmjopen-2015-009721] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 12/08/2015] [Accepted: 12/14/2015] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Increased physical activity (PA) may be beneficial for children with asthma. Knowledge about how to intervene and encourage children with asthma to be physically active is required. In the present study, we aimed to pilot a 6-week exercise intervention designed as active play and examine attendance rate, exercise intensity and children's perceptions of participating. METHODS 6 children with asthma (4 boys, 2 girls) aged 10-12 years, participated in 60 min of active play exercise twice weekly. A mixed-methods design was applied. The data analysed included attendance rate, exercise intensity assessed by heart rate (HR) monitoring during exercise sessions, registration and description of the active play exercise programme, 3 semistructured focus groups, field observations of 5 exercise sessions, and preintervention and postintervention testing. FINDINGS The average attendance rate was 90%. Intensity ≥ 80% of maximal HR (HRmax) was recorded for a median (IQR) time of 22 (8) out of 60 min per session. Median (IQR) HR during the sessions was 146 (9; 74% of HRmax) bpm. Children reported increased health-related quality of life (HRQoL) post-test compared with baseline. Children enjoyed participating and reported no limitations by asthma or serious asthma attacks. Instead, they perceived that their asthma and fitness had improved after the programme. The instructors created an inclusive atmosphere that was characterised by easy-to-master games, fair competition, humour and mutual participation. CONCLUSIONS The exercise intervention pilot focusing on active play had a high attendance rate, relatively high exercise intensity, and satisfaction; the children perceived that their fitness and asthma had improved, and reported increased HRQoL. A randomised controlled trial of active play exercise including children with asthma should be conducted to evaluate effect on PA level, physical fitness, asthma control and HRQoL.
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Affiliation(s)
- Thomas Westergren
- Faculty of Health and Sports Science, University of Agder, Kristiansand, Norway
| | - Liv Fegran
- Faculty of Health and Sports Science, University of Agder, Kristiansand, Norway
- Department of Paediatrics, Sørlandet Hospital, Kristiansand, Norway
| | - Tonje Nilsen
- Faculty of Health and Sports Science, University of Agder, Kristiansand, Norway
- Department of Physical Therapy, Sørlandet Hospital, Kristiansand, Norway
| | - Kristin Haraldstad
- Faculty of Health and Sports Science, University of Agder, Kristiansand, Norway
| | | | - Sveinung Berntsen
- Faculty of Health and Sports Science, University of Agder, Kristiansand, Norway
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Elaro A, Shah S, Armour CL, Bosnic-Anticevich S. A snapshot of pharmacist attitudes and behaviors surrounding the management of pediatric asthma. J Asthma 2015; 52:957-68. [PMID: 26291141 DOI: 10.3109/02770903.2015.1020387] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The aim of this study is to identify the current status of pediatric asthma management in the Australian community pharmacy setting from the pharmacists' perspective. This research will allow us to identify training needs of community pharmacists. METHOD Pharmacists were recruited from the Sydney metropolitan region and asked to complete a self-reported questionnaire that elucidated information on four general domains relating to pediatric asthma management within community pharmacy. All data collected were analysed descriptively. Bivariate Pearson correlations were performed to determine whether interrelationships existed between specific domains. RESULTS All 77 pharmacists completed the questionnaire. Thirty-two percent had not completed any asthma related CPD in the past year and only 25% of pharmacists reported using the national asthma guidelines in practice. Just over half of the pharmacists (54%) reported that they provide device technique demonstrations for new inhaled medicines, and 35% of pharmacists reported that they check for written asthma self-management plan possession. Although 65% of pharmacists reported confidence in communication skills, most pharmacists were not confident in setting short-/long-term goals with the patient and carer for managing asthma at home. Pharmacists believed that they are just as effective as doctors in providing asthma counseling and education. Lack of time was identified as a significant barrier. CONCLUSION We have identified a gap between guideline recommended practices and the self-reported practices of community pharmacists. Pharmacists need more appropriate continuing education programs that can translate into improved pediatric asthma self-management practices and thus improved asthma outcomes in children. This may require an alternative approach.
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Affiliation(s)
- Amanda Elaro
- a Woolcock Institute of Medical Research, University of Sydney , NSW , Australia
| | - Smita Shah
- b Primary Health Care Education and Research Unit, Primary and Community Health Network, Sydney West Area Health Service , Sydney , NSW , Australia .,c Sydney Medical School, University of Sydney , Sydney , NSW , Australia , and
| | - Carol L Armour
- a Woolcock Institute of Medical Research, University of Sydney , NSW , Australia .,d Sydney Local Health District , Sydney , NSW , Australia
| | - Sinthia Bosnic-Anticevich
- a Woolcock Institute of Medical Research, University of Sydney , NSW , Australia .,d Sydney Local Health District , Sydney , NSW , Australia
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BinSaeed AA. Caregiver knowledge and its relationship to asthma control among children in Saudi Arabia. J Asthma 2014; 51:870-5. [PMID: 24654707 DOI: 10.3109/02770903.2014.906608] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The objective of this study was to examine caregiver responses to individual questions of the asthma knowledge questionnaire and to compare the prevalence of uncontrolled asthma among children according to caregiver responses (correct vs. incorrect). METHODS We conducted an analytical cross-sectional study among 158 children with asthma aged 4-11 who were attending the pediatric primary care clinic of the King Khalid University Hospital in Riyadh, Saudi Arabia. The asthma knowledge questionnaire for use with parents or guardians of children with asthma was used to measure the knowledge of caregivers. Asthma control in the children was measured using an Arabic version of the childhood asthma control test. Pearson's chi-square or Fisher's exact tests were used to compare the prevalence of uncontrolled asthma according to the caregivers' responses. RESULTS This study showed substantial gaps in knowledge among caregivers of children with asthma. The answer to only one of 17 questions was well known (86.1%); this question involved the harm of smoking near a child with asthma. Answers on 11 of 17 questions were significantly (p < 0.05) associated with asthma control in children. Among the key questions explored, the prevalence of uncontrolled asthma was 3.0 (1.8-4.9), 2.5 (95% confidence interval = 1.7-3.9) and 1.8 (1.3-2.5) times higher among children of caregivers who did not disagree with the statements that it is not good for children to use an inhaler for too long, that inhalers can affect or damage the heart, and that children with asthma should use asthma medications only when they have symptoms. CONCLUSIONS Although innovations are needed to help patients improve their adherence to treatment and to effectively utilize the benefits of contemporary asthma medications, we observe substantial knowledge-related problems in the asthma management of children in Saudi Arabia.
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Affiliation(s)
- Abdulaziz A BinSaeed
- Prince Sattam Bin Abdul Aziz Research Chair of Epidemiology and Public Health, College of Medicine, King Saud University , Riyadh , Saudi Arabia and
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