家庭管理水平对儿童哮喘控制水平的影响

目的 :调查哮喘儿童家庭管理水平与哮喘控制水平现状,并分析两者之间的关系。方法 :采用儿童哮喘家庭管理方式测评量表和儿童哮喘控制测试问卷(Children Asthma Control Test,C-ACT)对197例4~11岁的哮喘患儿及其父母进行测评,分析患儿哮喘控制水平的影响因素。结果 :父母夫妻关系、家长对患儿及疾病的认同程度影响患儿哮喘控制水平;完全控制组哮喘患儿家庭管理方式多为适应型,部分控制和未控制组的家庭管理方式多为忍耐型。结论 :家庭管理水平对儿童哮喘的控制水平有一定影响。     

健康教育对儿童哮喘家庭治疗依从性的效果观察

[目的]探讨健康教育对儿童哮喘家庭治疗依从性的效果。[方法]针对120例临床上已明确诊断为哮喘的儿童及其家长根据其文化程度、对疾病的重视程度及家庭经济情况等原因进行针对性及系统性的相关哮喘知识讲座和哮喘控制测试等多种形式的健康教育。对健康教育前后患儿及其家长进行儿童哮喘疾病的认知度、用药治疗依从性、哮喘控制情况等比较。哮喘控制情况采用中文版的儿童哮喘控制测试问卷(CH-CACT)症状评分进行评价。[结果]哮喘患儿健康教育后疾病认知、用药依从性、用药规范、定期复查情况以及CH-CACT评价情况优于健康教育前(P0.05)。[结论]健康教育可提高儿童哮喘家庭治疗依从性。     

哮喘患儿的健康教育及家庭护理指导

目的探讨哮喘患儿的健康教育方法及家庭护理对策。方法对专科门诊的哮喘患儿建立哮喘病历档案,发放哮喘知识手册,并定期开展哮喘之家活动,对患儿及家长进行系统的哮喘相关知识教育及家庭护理指导。结果通过健康教育及家庭护理指导,提高了患儿及家长对哮喘的认识水平和家庭护理能力,患儿得到长期、合理、充分、有效的治疗。结论健康教育及家庭护理指导有助于促进哮喘患儿的健康,提高其生活质量。     

哮喘患儿的健康教育及家庭护理指导

目的探讨哮喘患儿的健康教育方法及家庭护理对策.方法对专科门诊的哮喘患儿建立哮喘病历档案,发放哮喘知识手册,并定期开展哮喘之家活动,对患儿及家长进行系统的哮喘相关知识教育及家庭护理指导.结果通过健康教育及家庭护理指导,提高了患儿及家长对哮喘的认识水平和家庭护理能力,患儿得到长期、合理、充分、有效的治疗.结论健康教育及家庭护理指导有助于促进哮喘患儿的健康,提高其生活质量.     

微信平台在儿童支气管哮喘管理中的应用研究

目的探讨微信平台在儿童支气管哮喘管理中的应用效果。方法选取在哮喘门诊就诊的支气管哮喘患儿75例,分为实验组39例和对照组36例。对照组接受常规门诊指导,实验组在对照组基础上运用微信平台对患儿进行管理,包括组建微信群、微信健康教育、在线咨询答疑、随访提醒和个案管理。比较两组患儿家长的疾病认知水平及患儿用药依从性和肺功能。结果运用微信平台对哮喘患儿进行管理后,实验组患儿家长的疾病认知水平提高,患儿用药依从性提高,患儿肺功能改善(P0.01)。结论微信平台能有效促进医患互动,提高工作效率,提高患儿及家长对儿童哮喘的认知水平,提升儿童哮喘管理水平,促进哮喘患儿疾病康复。     

儿童哮喘照顾者健康信念及家庭功能对哮喘控制的影响

目的调查儿童哮喘照顾者健康信念、家庭功能与哮喘控制情况,并分析两者及哮喘控制的关系。方法采用问卷调查法,以中文版儿童哮喘控制测试(Children Asthma Control Test,C-ACT)评估儿童哮喘控制情况,Champion健康信念模型量表评估患儿照顾者的健康信念,家庭功能量表(Family Assessment Device,FAD)评估家庭功能,并使用SPSS 16.0软件包进行统计分析。结果儿童哮喘总体控制率为55.07%。不同哮喘控制情况的患儿照顾者的健康信念及家庭功能差异有统计学意义(P0.05)。除易感性、严重性认知因子外,哮喘患儿照顾者健康信念及家庭功能与哮喘控制情况呈显著相关性(P0.05或P0.01)。结论哮喘患儿照顾者的健康信念及家庭功能与其哮喘管理水平具有密切关系,医护人员在对哮喘患儿及其主要照顾者进行相关治疗管理时,应帮助指导患儿及其主要照顾者提高健康信念和改善家庭功能。     

建立社区儿童哮喘家庭医学管理模式之探索

目的探索一套适合我国国情的集医疗、预防、保健、康复为一体的儿童哮喘防治模式一社区家庭医学管理模式。方法在街道建立哮喘管理与技术指导小组，选择四个居委试点，开展儿童哮喘病流行病学调查，检出哮喘息儿建立电脑档案，通过医院诊疗指导、社区咨询、宣教、父母学校、电话或家访联系与指导。防治工作由医生、街道干部、病儿与家长共同参与，并对开展本模式工作前后有关资料予以对照。结果四居委应检儿童1110名，实检1107名(99．73％)，检出哮喘儿童99名(8．94％)，随访中迁出13名，获长期指导、随访的86名。多数病家获得哮喘防治知识，每个患儿至少进行2次以上具体指导，掌握吸入技术。3年内无典型发作人数由原来的11例(12．8％)上升到44例(51．2％)，X^2=29．1，P＜0．01。复发次数与发作程度也均较开展本模式工作前明显减少与减轻，年人均治疗费用明显减少。结论社区以家庭医学管理模式防治儿童哮喘效果好，可行。符合我国国情，值得推广。     

过敏原检测对指导哮喘儿童家庭管理效果的研究

目的 调查哮喘儿童过敏原,进行家庭管理指导,提高哮喘儿童生活质量.方法 皮肤点刺检测哮喘儿童过敏原.对过敏原阳性的患儿设计家庭管理指导方案并监督实施,并对接受家庭管理及不接受家庭管理指导的2组患儿进行为期1年的对比研究.结果 104例哮喘儿童共有78例过敏原点刺呈阳性反应,阳性率为75.0%.其中粉尘螨58例占55.7%,屋尘螨49例占47.1%,为主要过敏原.过敏原呈阳性的哮喘儿童1年随访对比研究结果,接受家庭管理的52例哮喘儿童急诊14例,住院6例,因病缺课12例,经济损失平均每人每年1840.5元.不接受家庭管理的26例哮喘儿童急诊15例,住院10例,因病缺课14例,经济损失平均每人每年3267.3元.2组比较差异显著.结论 过敏原阳性的哮喘儿童,接受针对性的家庭管理指导,可使哮喘儿童儿生活质量明显改善.     

支气管哮喘患儿家庭管理方式现状及影响因素分析

目的调查分析支气管哮喘儿童家庭管理方式现状及影响因素,为支气管哮喘儿童制定个体化的家庭管理模式和提高支气管哮喘控制水平提供参考依据。方法选取2021年2月—2022年2月广西百色市某三级甲等医院住院的153例支气管哮喘儿童及其家长作为调查对象。应用家庭管理方式测评量表对支气管哮喘儿童及其家长进行调查。结果单因素结果显示,患儿性别、过敏性鼻炎史、医疗付费方式、母亲受教育程度、家庭结构、父母夫妻关系、家庭居住地均为影响支气管哮喘儿童家庭管理方式的因素(P<0.05);多元线性回归分析显示影响支气管哮喘儿童家庭管理方式的主要因素为患儿的家庭结构、父母夫妻关系、家庭居住地及过敏性鼻炎史(P<0.05)。结论影响支气管哮喘儿童家庭管理方式相关因素较多,应重点关注支气管哮喘患儿的过敏性鼻炎史、家庭结构、父母的夫妻关系、居住地等因素,采取个体化的家庭管理方式来提高支气管哮喘控制水平。     

过敏原检测对指导哮喘儿童家庭管理效果的研究

目的 调查哮喘儿童过敏原,进行家庭管理指导,提高哮喘儿童生活质量。方法 皮肤点刺检测哮喘儿童过敏原。对过敏原阳性的患儿设计家庭管理指导方案并监督实施,并对接受家庭管理及不接受家庭管理指导的2组患儿进行为期1年的对比研究。结果 104例哮喘儿童共有78例过敏原点刺呈阳性反应,阳性率为75．0％。其中粉尘螨58例占55．7％,屋尘螨49例占47．1％,为主要过敏原。过敏原呈阳性的哮喘儿童1年随访对比研究结果,接受家庭管理的52例哮喘儿童急诊14例,住院6例,因病缺课12例,经济损失平均每人每年1840．5元。不接受家庭管理的26例哮喘儿童急诊15例,住院10例,因病缺课14例,经济损失平均每人每年3267．3元。2组比较差异显著。结论 过敏原阳性的哮喘儿童,接受针对性的家庭管理指导,可使哮喘儿童儿生活质量明显改善。     

毛细支气管炎继发哮喘的高危因素分析及对策

目的探讨毛细支气管炎患儿继发哮喘的高危因素。方法对102例住院治疗的毛细支气管炎患儿进行继发哮喘的高危因素调查，对所获数据进行Logistic回归分析。结果102例中继发哮喘47例，占46．08％。多变量Logistic回归分析显示，居住环境、被动吸烟、患儿特异性体质、家族过敏和（或）哮喘病史与继发哮喘显著相关。结论毛细支气管炎患儿的生活环境、被动吸烟、特异性体质及家族过敏和（或）哮喘病史等是继发哮喘的重要因素，在这些方面要加强护理干预。     

Children's Exposure to Community Violence

Purpose: To analyze the effects of exposure to chronic community violence on children and adolescents.
Design: An integrative review of the literature was conducted on reports of studies about children's exposure to community violence.
Sources: Studies for analysis were identified through a literature search of relevant topics in Medline, CINAHL, and PsycINFO.
Conclusions: Exposure to community violence is related to significant stress and depression in children. Evidence on how exposure to violence affects children's growth patterns, intellectual growth, school performance, decision-making ability, or their hope for a future is needed.     

Accuracy of Children's Self-Reported Adherence to Treatment

Purpose: To examine the relationship between self-reported and electronically monitored adherence to a recommended asthma treatment and to assess the accuracy of the diary data reported by school-age children.
Design: A randomized, controlled clinical trial of the effectiveness of an asthma self-management program. The relationship between self-reported and electronically recorded daily peak expiratory flow rate (PEFR) adherence was assessed in a sample of 42 children, ages 7 through 11 years with moderate to severe asthma in one community in West Virginia, USA. Cognitive social learning theory served as the framework for the intervention.
Methods: At-home adherence to PEFR monitoring during the 5-week study was evaluated using the self-report Asthma Diary and an electronic PEFR meter. Recommended twice daily (morning and evening) PEFR monitoring was measured.
Results: Self-reported and electronically recorded PEFR adherence were modestly correlated. Self-reported adherence was significantly higher than electronically monitored adherence during Week 5. Accuracy of the self-reported PEFR declined over time, and over half of the children fabricated at least one PEFR value during the final week of the study.
Conclusions: Clinicians often evaluate the efficacy of prescribed treatment for children with chronic conditions based on the children's self-reported diary data. The findings indicate that these children's self-reported adherence behaviors contained errors. Parent education regarding supervision of children's adherence, including validating the accuracy of diary data, is critical for successful self-management in children with chronic conditions.     

哮喘儿童生存质量自我评价与代理者评价的一致性研究

目的 探索哮喘儿童生存质量自我评价与代理者评价的一致性,为哮喘儿童的临床治疗护理提供理论依据.方法 运用PedsQLTM量表体系的普适性核心量表及哮喘模块中文版对哮喘患儿及其代理者进行问卷调查,采用配对设计资料的Wilcoxon秩和检验以及计算组内相关系数(ICC)来评估结果的一致性.结果 哮喘儿童自评报告和代理者报告(主要是父母)总分及各维度得分(除生理维度外)无显著差异,组内相关系数(ICC值)除生理维度外,其余均≥0.7.而通过对年龄进行分层分析后,部分维度得分有差异.结论 基于PedsQLTM问卷调查的结果显示儿童自评报告与代理者报告的一致性良好.     

Parents' perspectives of asthma crisis hospital management in infants and toddlers: an interpretive view through the lens of attachment theory

Interpretive phenomenology and attachment theory were used to discover the underlying concerns of parents and children during children's hospitalization for asthma. Home interviews were conducted with families of low income and with Latino and African-American infants and toddlers with severe persistent asthma. Narratives revealed that asthma crises were fearsome situations for parents and children. Hospital procedures escalated fear in children. Parents, agonized by their children's suffering, were embarrassed by feelings of helplessness. Results imply that effective, efficient care depends on addressing parents' fears, being aware of their sensitivity to the suffering of their children, and supporting their desire to alleviate it.     

Relationship among asthma knowledge, behavior management and social adaptation in school-age children with asthma in Taiwan

This study examined the relationships between asthma knowledge, behavior management, and social adaptation among school-age children with asthma. A total of 210 school-age asthmatic children and their parents were recruited from a medical hospital in Taiwan. The children completed asthma knowledge and behavior management questionnaires, and their parents completed the Child and Adolescent Adjustment Profile. There was a statistically significant positive correlation between behavior management and social adaptation among asthmatic children. Asthma knowledge and behavior management were positively associated but did not correlate with children's social adaptation. The behavior management of the children acted as a predictor of their social adaptation. These findings suggest that efforts to raise children's asthma knowledge will benefit these individuals in terms of behavior management. The introduction of asthma behavior management plans could facilitate the social adaptation of asthmatic children and, in particular, increase their independence and reduce their withdrawal as well as enhance their self-confidence and self-esteem.     

Is Rural School-Aged Children's Quality of Life Affected by Their Responses to Asthma?

The unpredictable nature of asthma makes it stressful for children and can affect their quality of life (QOL). An exploratory analysis of 183 rural school-aged children's data was conducted to determine relationships among demographic factors, children's responses to asthma (coping and asthma self-management), and their QOL. Coping frequency, asthma severity, and race/ethnicity significantly predicted children's asthma-related QOL. Children reported more frequent coping as asthma-related QOL worsened (higher scores). Children with more asthma severity had worse asthma-related QOL. Post hoc analyses showed that racial/ethnic minorities reported worse asthma-related QOL scores than did non-Hispanic Whites.     

未变性乳清蛋白对支气管哮喘儿童红细胞GSH和GSH-PX的影响

目的:观察未变性乳清蛋白对支气管哮喘儿童GSH和GSH-PX的影响。方法:采集30例健康儿童血标本。收集56例哮喘患儿资料。所有病例随机分两组,治疗组30例采用未变性乳清蛋白加普米克(布地奈德气雾剂);对照组28例单用普米克治疗。分别测定健康儿童和支气管哮喘儿童对照组及治疗组红细胞浆内总谷胱甘肽(GSH)含量及谷胱甘肽过氧化物酶(GSH-PX)活性。结果:支气管哮喘儿童红细胞总GSH含量较健康儿童减少,GSH-PX活性降低;服用未变性乳清蛋白的治疗组较对照组红细胞GSH含量及GSH-PX活性有明显的提高。结论:未变性乳清蛋白能有效提高支气管哮喘患儿红细胞浆中GSH水平,增加GSH-PX活性。     

Asthma self-care: just another piece of school work

In the transition from childhood to adolescence, middle school children, aged 11 to 14 years, are becoming increasingly independent. For children who have asthma or other chronic illness, self-care for the condition becomes increasingly important. Cognitive social learning theory framed the questions asked and interpretations made of focus group data collected from 25 middle school children with asthma about their self-care behaviors. Data suggests that managing and preventing asthma episodes takes place in contexts defined by "powerful others" who can either facilitate or hinder self-care. Successful management of asthma reinforces middle school children's autonomy and growing independence. Although participants wanted and needed support during asthma attacks, they did not want to lose their autonomy. This study highlights the kinds of challenges children with asthma face.