Evaluating the effectiveness of a family empowerment program on family function and pulmonary function of children with asthma: A randomized control trial |
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| Affiliation: | 1. School of Nursing, Min-Hwei College of Health Care Management, Tainan, Taiwan, ROC;2. School of Nursing, China Medical University & Nursing Department, China Medical University Hospital, Taichung, Taiwan, ROC;3. Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chang Gung Children''s Hospital and Chang Gung University, Taoyuan, Taiwan, ROC;4. Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Taichung Hospital Department of Health, Taichung, Taiwan, ROC;5. School of Nursing, National Defense Medical Center & China Medical University, Taipei & Taichung, Taiwan, ROC;1. Institut Universitari d’Investigació en Atenció Primària (IDIAP) Jordi Gol, Gran Via Corts Catalanes, 587 àtic, 08007 Barcelona, Spain;2. Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain;3. Department of Nursing, Universitat de Girona, c/ Emili Grahit 77, 17071 Girona, Spain;4. Primary Health Care Centre Cornellà 2 (Sant Ildefons), Direcció d’Atenció Primària Costa de Ponent, Institut Català de la Salut, Av. República Argentina s/n (cantonada Av. de Sant Ildefons), 08940 Cornellà de Llobregat, Spain;5. Primary Health Care Centre Carles I, Àmbit d’Atenció Primària Barcelona-Ciutat, Institut Català de la Salut, c. de la Marina, 168, 08018 Barcelona, Spain;6. Emergency Primary Care Centre El Castell, Consorci Castelldefels Agents de Salut (CASAP), c. Guillermo Marconi, 9 bxs, 08860 Castelldefels, Spain;7. Primary Health Care Centre La Mina, Àmbit d’Atenció Primària Barcelona-Ciutat, Institut Català de la Salut, c. del Mar, s/n, 08930 Sant Adrià de Besòs, Spain;1. Northwestern University Feinberg School of Medicine, Chicago, Illinois;2. University of Michigan College of Literature, Science, and the Arts, Ann Arbor, Michigan;3. Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;1. University of Wisconsin School of Medicine and Public Health, Madison, Wis;2. Washington University School of Medicine and St Louis Children''s Hospital, St Louis, Mo;3. Division of Pulmonology Medicine, Cincinnati Children''s Hospital & Medical Center, Cincinnati, Ohio;1. Center for Health-Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran;2. School of Nursing & Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran;3. Department of Epidemiology and Biostatistics, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran;4. School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran |
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| Abstract: | BackgroundEmpowerment can be an effective strategy for changing an individual's health behaviours. However, how to empower whole families to manage their children's asthma is a challenge that requires innovative nursing intervention based on family-centred care.AimsTo evaluate the effectiveness of a family empowerment program on family function and pulmonary function of children with asthma compared to those receiving traditional self-management only.DesignA randomized control trial.MethodsSixty-five families were recruited from one asthma clinic in a medical centre in Taiwan. After random assignment, 34 families in the experimental group received the family empowerment program consisting of four counselling dialogues with the child and its family. We empowered the family caregiver's ability to manage their child's asthma problems through finding the problems in the family, discovery and discussion about the way to solve problems, and enabling the family's cooperation and asthma management. The other 31 families received the traditional care in asthma clinics. The Parental Stress Index and Family Environment Scale of family caregivers, and pulmonary function, and asthma signs of children with asthma were collected at pre-test, 3-month post-test, and one-year follow-up. We utilized the linear mixed model in SPSS (18.0) to analyze the effects between groups, across time, and the interaction between group and time.ResultsThe family empowerment program decreased parental stress (F = 13.993, p < .0001) and increased family function (cohesion, expression, conflict solving, and independence) (F = 19.848, p < .0001). Children in the experimental group had better pulmonary expiratory flow (PEF) (F = 26.483, p < .0001) and forced expiratory volume in first second (FEV1) (F = 7.381, p = .001) than children in the comparison group; however, no significant change in forced expiratory volume in first second (FEV1)/forced vital capacity (FVC) was found between the two groups. Sleep problems did not show significant changes but cough, wheezing, and dyspnoea were significantly reduced by family caregiver's observations.ConclusionWe empowered families by listening, dialogues, reflection, and taking action based on Freire's empowerment theory. Nurses could initiate the families’ life changes and assist children to solve the problems by themselves, which could yield positive health outcomes. |
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| Keywords: | Asthma Caregivers Children Empowerment Family Family-centred nursing |
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