The adaptation of written self-management plans for children with asthma

BACKGROUND: Self-management plans are an important element of asthma care. Although asthma is common in children, there is limited guidance for adaptation of self-management plans for children. AIMS:. A study was conducted in order to develop a set of criteria for adaptation of asthma self-management plans for school aged children; and to use these criteria to review self-management plans used in United Kingdom (UK) centres. METHODS: Self-management plans were obtained by telephone survey (response rate: 81%) of 47 selected UK paediatric, respiratory and community centres during the period between March and October 2001. The content of self-management plans was analysed according to criteria developed from a review of the literature, including objectives, opportunities for individualization, and the implied roles of parent and child in asthma management. Agreement was achieved between the authors and a third independent rater. RESULTS: The majority of centres (31 of 47) used or planned to use adapted self-management plans while the remainder used the standard National Asthma Campaign self-management plan. There were wide variations in self-management plans, including variation in the person to whom plans were addressed, criteria for treatment and the objectives stated for self-management. Few opportunities were provided for individualization of self-management. LIMITATIONS: The study was limited to the documents used in self-management in selected centres. CONCLUSION: The results suggest that many practitioners believe that self-management education requires adaptation for children. There is little consistency in the adaptation of self-management plans for children. Principles for devising adapted self-management plans are proposed.