Effects of nursing instruction on asthma knowledge and quality of life in schoolchildren with asthma

The issue of whether nursing instruction efforts could improve asthma knowledge and quality of life among schoolchildren was investigated using a quasi-experimental design. The key instruments were the Asthmatic Knowledge Questionnaire and the Childhood Asthma Questionnaire-Form B. Asthmatic knowledge increased among children who received instruction from nurses (Meanpre/post=22.20/31.87, p<.05). These children also experienced significant improvements in their active quality of life (Meanpre/post=27.53/30.20, p<.05), and decreased distress (Meanpre/post=24.04/10.86, p<.05) and asthma severity (Meanpre/post=13.27/8.3, p<.05). This study finds nursing instruction helpful in improving asthma knowledge. However, in terms of quality of life, elevated knowledge has a marked (negative) correlation only with levels of distress and severity. It shows no detectable relationship with active or passive life quality. Therefore, though nursing instruction can improve schoolchildren's knowledge about asthma, the improvement in knowledge only relates to reducing distress and severity and thus improving quality of life. This result can provide guidance for nursing personnel in developing nursing instruction to improve active quality of life in child patients.     

Symptom assessment and management in children with asthma

Asthma is the most prevalent and costly chronic childhood disease worldwide, unexpected flare-ups and exacerbation of which threaten the safety and quality of life of children and their families. As the capacity for self-management among children is limited by their developmental level, much of the weight of asthma management falls on the shoulders of caregivers. This article outlines the impact of asthma, and guidelines for diagnosis and management of asthma, and symptom self-monitoring and management in children. It is aimed at facilitating self-monitoring to improve assessments of the severity of the condition in order to prevent deterioration and improve the quality of life of children and their families.     

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.     

Association between quality of life,severity of asthma,sleep disorders and exercise capacity in children with asthma: a cross-sectional study

Objective

To assess the association between quality of life, asthma severity, sleep disorders and exercise capacity in children with asthma.

Evidence for a causal relationship between respiratory syncytial virus infection and asthma

Respiratory syncytial virus (RSV) infects all children early in life, is the most common cause of infant lower respiratory tract infections, and causes disease exacerbations in children with asthma. Episodes of lower respiratory tract infection in early life are associated with asthma development. Whether RSV infection early in life directly causes asthma or simply identifies infants who are genetically predisposed to develop subsequent wheezing is debatable. Recent studies suggest that these two explanations are not mutually exclusive, and are likely both important in asthma development. An open-label study of RSV immunoprophylaxis administered to preterm infants reduced recurrent wheezing by 50%. Clinical trials of infant RSV prevention, delay or severity reduction on the outcome of childhood asthma would confirm the causal relationship between RSV infection and asthma, and offer a primary prevention strategy.     

Evidence for a causal relationship between respiratory syncytial virus infection and asthma

Respiratory syncytial virus (RSV) infects all children early in life, is the most common cause of infant lower respiratory tract infections, and causes disease exacerbations in children with asthma. Episodes of lower respiratory tract infection in early life are associated with asthma development. Whether RSV infection early in life directly causes asthma or simply identifies infants who are genetically predisposed to develop subsequent wheezing is debatable. Recent studies suggest that these two explanations are not mutually exclusive, and are likely both important in asthma development. An open-label study of RSV immunoprophylaxis administered to preterm infants reduced recurrent wheezing by 50%. Clinical trials of infant RSV prevention, delay or severity reduction on the outcome of childhood asthma would confirm the causal relationship between RSV infection and asthma, and offer a primary prevention strategy.     

以家庭为中心的护理对哮喘患儿疗效的影响

目的提高家长的家庭护理能力,减少哮喘复发的次数,改善哮喘患儿及家庭的生活质量。方法通过调查问卷评估哮喘患儿家长的家庭照护能力,通过多种途径对家长提供长期、连续、完整、个性化的培训和指导。结果干预措施前后患儿家长对哮喘知识掌握差异有统计学意义(P<0.01);干预前后患儿哮喘复发差异有统计学意义(P<0.01)。结论有效的家庭护理指导,能提高患儿及家庭的自我管理能力和遵医行为,并有效预防和控制病情的发展,改善患儿及家庭的整体生活质量。     

Educational and exercise programs for asthmatic children

We designed programs to teach appropriate exercises to asthmatic children and to educate their parents about their special needs. Each of 11 programs over a six-year period included a weekly two-hour session for four weeks. Lectures for parents dealt with the etiology and precipitating events of asthma, environmental control and drug therapy, family interaction with a psychiatrist, and hyposensitization therapy and food allergy. The 59 children, aged 4 to 13, played group games, learned breathing exercises, and were assisted by their parents in postural drainage. School absences decreased in 59%, emergency room visits decreased in 70%, medication usage decreased in 54%, and the number of attacks decreased in 70%. Greater understanding of asthma by both parents and children improved the quality of life and lessened the severity of the disease.     

延续性护理结合强化呼吸功能锻炼对支气管哮喘患儿肺功能及生活质量的影响

目的探讨延续性护理结合强化呼吸功能锻炼对支气管哮喘患儿肺功能及生活质量的影响。方法选取本院儿科收治的56例支气管哮喘患儿为研究对象,将其随机分为对照组(28例,常规护理)和观察组(28例,延续性护理+强化呼吸功能锻炼)。比较两组的哮喘控制效果、肺功能指标、生活质量及家属满意度。结果观察组的哮喘总控制率明显高于对照组(P<0.05)。护理后,两组的FEV1、PEF、FVC及PAQLQ各项评分均升高,且观察组高于对照组(P<0.05)。观察组的家属满意度明显高于对照组(P<0.05)。结论支气管哮喘患儿采用延续性护理结合强化呼吸功能锻炼可有效控制哮喘,改善肺功能,提高患儿生活质量及家属满意度。     

Quality of life in Jordanian children with asthma

The purpose of this study was to describe how Jordanian children with asthma experience their quality of life (QoL). Two hundred children with asthma (34% girls and 66% boys) participated in the study. The Paediatric Asthma Quality of Life Questionnaire was used to measure how children with asthma disease impaired their daily life during the previous week on three domains: ‘activity limitations’, ‘symptoms’ and ‘emotional function’. The main finding of this study was that children with asthma scored their QoL towards the negative end of the scale, but they scored more limitations in the domain of activities than in emotions and symptoms. Children reported that the most restricted activity was their ability to run. Younger children, being a girl and living in the rural areas, were associated with lower QoL. The children in the present study might not comply with their health regimen, and this might gave a darker view of the daily life of children with asthma. Further studies of Jordanian children and their QoL were suggested to identify and support the factors which influence QoL of children with asthma and other chronic diseases in Jordan.     

以家庭为中心的护理干预模式在哮喘患儿中的应用效果观察

目的 探讨以家庭为中心的护理干预模式在哮喘患儿中的运用效果,为患儿出院后能获得优质的延伸照顾,从而降低哮喘复发率、提高生活质量,提供一种全新的护理干预模式提供依据.方法 选取2015年1月~2016年6月该院呼吸内科收治并纳入标准的哮喘患儿76例作为研究对象,按照患儿的住院顺序随机分为实验组和对照组各38例.对照组采用呼吸内科哮喘疾病常规护理和传统的他人护理模式;实验组患儿在对照组的基础上,采用以家庭为中心的护理模式干预6个月,即协助建立家庭、患儿及医护人员三者间良好关系,使家庭成员主动参与到患儿的疾病管理中来,根据实际情况,制定出个性化管理方案,并进行动态的评估和评价,随时调整管理方案.比较两组患儿的哮喘复发率、生活质量和居家自我护理行为的变化情况,并对数据进行统计学分析.结果 经干预后实验组患儿生活质量和居家自我护理行为都有明显的提高,与对照组患儿比较,差异有统计学意义(P<0.05);在干预期间,实验组患儿的哮喘复发率为18.42%(7/38),明显低于对照组患儿复发率31.58%(12/38),差异有统计学意义(P<0.05).结论 以家庭为中心的护理干预模式在哮喘患儿中运用,能有效提高患儿的居家自我护理行为,降低哮喘的复发率,从而提高患儿的生活质量.     

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A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息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。     

Influenza vaccination for children with asthma

QUESTION Parents of children with asthma are encouraged by many health organizations to vaccinate their children against seasonal influenza viruses. Is the influenza vaccine efficient in preventing asthma exacerbation? Are current vaccinations safe to administer to children with asthma?ANSWER Infection with influenza viruses can cause substantial respiratory morbidity in children with underlying chronic disease such as asthma. Although vaccination against influenza does not reduce or shorten asthma exacerbations, the intramuscular trivalent vaccine is safe and has a beneficial effect on the quality of life of children with asthma.     

Impact of disease severity on quality of life in adults with asthma

Health-related quality of life is increasingly used as an outcome measure in asthma. The aim of this study was to define the relationship between asthma symptoms, lung function and health related quality of life in a community based sample of people with asthma ranging from no recent asthma to severe persistent asthma. We recruited subjects at the age of 42 years from a well-described community cohort, the Melbourne Epidemiological Study of Childhood Asthma, to define this association. 161 subjects completed a respiratory symptom survey, the Asthma Quality of Life Questionnaire and had lung function testing. According to the previous surveys and when applicable in agreement with GINA, subjects were classified into 4 groups: no recent asthma, sporadic asthma, intermittent asthma and persistent asthma, with the persistent asthma group further categorised by wheezing frequency and lung function. 55 had no recent asthma, 31 had sporadic asthma, 39 had intermittent asthma and 36 had persistent asthma. There was clear evidence of lower total scores with increased asthma severity, with median scores of 6.8 for the sporadic asthma group, 6.4 for the intermittent and 5.5 for the persistent asthma group compared to 6.9 in those with no recent asthma. All domain scores within the intermittent and persistent asthma groups were lower than scores for the no recent asthma group (p < 0.01). Those with persistent asthma and low FEV1% had the lowest quality of life scores (4.6). Analysis of this population cohort highlights that health related quality of life in patients with asthma strongly depends on symptom frequency and lung function and underlines the necessity of adequate treatment.     

Evaluation of a community-based outreach worker program for children with asthma

OBJECTIVE: An asthma outreach worker (AOW) can provide home-based education about asthma management and methods to minimize home environmental asthma triggers. A theory-based AOW program was implemented by a community partnership and its effectiveness was evaluated. DESIGN: Baseline and follow-up surveys were used to evaluate the effectiveness of the AOW. SAMPLE: The convenience sample consisted of 60 caregivers whose children received AOW services. MEASURES: Quality of life, use of asthma management plans, medication use, health care utilization, home environmental behavior changes to reduce triggers, and satisfaction with AOW services were self-reported by caregivers. RESULTS: Caregivers reported significantly higher quality of life at follow-up than at baseline. At follow-up, 93% of the children had asthma management plans as compared with 31% at baseline. Self-reported hospitalizations were significantly reduced. All of the families made changes to minimize household asthma triggers. Caregivers reported high satisfaction with the AOW and 90% of them felt that the home environmental assessment conducted by the AOW helped improve their child's asthma. CONCLUSION: Short-term community-based AOW services for children can be effective in enhancing self-management capabilities, improving the quality of life, increasing the use of asthma management plans, and helping families reduce asthma triggers in the home environment.     

影响社区哮喘患儿父母生活质量因素的调查分析

目的了解社区哮喘患儿父母生活质量水平并探讨其影响因素。方法采用儿童照护者生活质量问卷(paediatric asthma caregiver’s quality of life questionnaire,PACQLQ)对125名哮喘患儿父母进行调查。结果 125名社区哮喘患儿父母的PACQLQ总均分为(4.34±1.03)分,其中活动限制维度得分为(4.29±1.55)分,情感功能维度得分为(4.36±0.89)分。患儿父亲PACQLQ得分为(5.01±0.97)分,母亲得分为(4.02±0.90)分,两者比较,t=5.592,P<0.05,差异具有统计学意义。与患儿关系和患儿病程为影响患儿父母生活质量的主要因素。结论社区哮喘患儿父母生活质量处于中等水平。哮喘患儿母亲的生活质量水平较父亲低,且哮喘患儿在诊断哮喘初期,其父母的生活质量水平是最低的。在进行健康教育时应更关注患儿母亲的心理压力,而且健康教育的工作应当在患儿确诊为哮喘后尽快开展。     

Asthma patients with low perceived burden of illness: a challenge for guideline adherence

RATIONALE AND AIMS: The reason why many patients seem to tolerate suffering from sub-optimal treated asthma remains unclear. The aim was to evaluate the guideline adherence combined with quality of life of patients with moderate to severe asthma. METHODS: 256 asthma patients from 43 primary care practices in Saxony-Anhalt filled in a questionnaire including the Asthma Quality of Life Questionnaire (AQLQ), the Patient Health Questionnaire (PHQ-D) and questions evaluating the asthma severity, medication and self-management. RESULTS: 43.4% suffered from moderate to severe asthma. Drug treatment accorded with guidelines in 36.9%, drug dosage of inhaled steroids was too low in 34.3%, and 21.5% were not treated according to guidelines. A total of 7.3% of the patients received end-of-dose therapy. AQLQ declined and depression rose with asthma severity and guideline non-adherence (P < 0.001). Only 29.1% received asthma education. However, 64.5% of the patients without education did not want to receive education. They had a higher quality of life, lower depression (P < 0.001) and lower use of steroids (P = 0.016). Higher depression scores where related with hospital admission (OR 3.29; 95% CI 1.57-6.87 for each quartile of PHQ-D) and unscheduled home visits or ambulatory care (OR 1.58; 1.07-2.33). CONCLUSION: There is a large variation of asthma severity which can partly be explained by the guideline adherence of medication and deficits of patients' management. The perceived burden of illness plays a more important role for education and self-management than the real severity of disease. Therefore, target-oriented interventions are needed to identify and motivate patients at risk.     

个性化健康教育对哮喘患儿父母生活质量的影响

目的探讨社区个性化健康教育对哮喘患儿父母生活质量的影响。方法采用随机数字表法,将101名哮喘患儿及家长分为干预组52名和对照组49名。对照组采用传统授课和发放儿童哮喘知识宣教手册,干预组在此基础上实施个性化健康教育,即在传统授课的基础上加入家庭哮喘应对行动计划的书写及行动目标的拟定。采用儿童照护者生活质量问卷(paediatric asthma caregiver’s quality of life questionnaire,PACQLQ)测评干预前后两组患儿父母PACQLQ得分的差异。结果干预1个月后,干预组患儿父母PACQLQ总分、活动受限和情感功能维度得分均高于对照组和干预前,组间和组内比较,差异具有统计学意义(均P<0.001)。结论个性化健康教育提高了哮喘患儿父母的生活质量。     

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.