Rural elementary school teachers' intent to manage children with asthma symptoms

A study of 212 rural elementary school teachers sought to determine the relationships among the variables of their general knowledge about asthma, attitude toward asthma, self-efficacy in helping children with asthma manage their asthma, and social support for initial management of children's asthma with the teachers' intent to manage children who present with signs and symptoms of asthma in the classroom. The situational variables of number of years teaching experience, number of children with asthma that teachers have had in their classroom during their teaching profession, and whether or not the teacher had asthma or knew of someone with asthma also were explored in relation to intent to manage asthma. Results indicate that although teachers had a favorable attitude toward asthma and were tolerant of students with asthma, their knowledge about asthma was low. Because asthma can be life-threatening, it is essential to assist those involved in monitoring and managing children with asthma to provide timely, appropriate care. In this way, the goal of having a child with asthma live as normal a life as possible, including all school activities, can be realized.     

Schools' capacity to help low-income, minority children to manage asthma.

This article describes the challenges and strengths of asthma management in 14 low-income, predominantly African American urban elementary schools serving more than 5,000 students. Asthma prevalence was 24.5%. Teachers, school principals, parents, and children described how asthma was managed at school. Data from classmates of students with asthma showed that they had moderate to high levels of information about the disease. Data from teachers indicated the great need for practical instruction on how they might effectively support a child with asthma in the classroom and on the playground. Principals raised concerns about expectations for the functioning of school staff and implementation of school policies especially related to asthma emergencies. Parents reported a range of problems their children face at school. Data from children with asthma showed that 75% believed asthma affected their school work. Findings from this study should be useful to school personnel, health providers, and others who assist children and their families to manage asthma at school. Data suggest that making school nursing services available is warranted, given the impact of asthma on the school community.     

Getting back to school

Two nurses in Essex are tackling absenteeism among primary school pupils by educating children and their parents about how to manage minor illnesses. The school liaison nurses provide a telephone helpline and home visits, and support with the management of chronic conditions such as asthma.     

Parent and teacher perceptions of the impact of school nurse interventions on children's self-management of diabetes

Diabetes is a common chronic illness among school-age children. The school nurse collaborates with the student, parents, and teachers to help the child manage their diabetes effectively. Very little is known about the relationship between school nurse interventions and parent/teacher perceptions of the child's self-management. We examined this relationship in a sample of 69 school-age children who received case management from school nurses. Our findings suggest that teachers and parents do not always agree on how well a child manages their illness. When school nurses provide more education and counseling, parents are more likely to perceive an improvement in their child's self-management. Teachers are more likely to perceive an improvement when the nurse provides more classroom visits and includes the physical education teacher and guidance counselor. These findings suggest that the roles of educator, counselor, and collaborator are important for school nurses who provide care to school-age children with diabetes.     

School re-entry for the child with chronic illness: parent and school personnel perceptions

PURPOSE: The number of children returning to school with chronic illnesses has increased during the past decade. Studies have suggested that school personnel are not well informed about chronic illness, receive little or no training, and feel unprepared to deal with these children in the classroom. Few studies address the concerns of parents when their children return to school. The purpose of the study was to identify and describe specific concerns and educational needs of parents and school personnel. METHOD: Telephone interviews were conducted with 21 parents. Twenty-four questionnaires were completed by school personnel, social workers, principals, psychologists, teachers, and school nurses. Content analysis was used to explore the data for recurrent themes. FINDINGS: Five areas of concern were evident in the survey responses of parents and school personnel: (a) how parents informed the school about the child's illness (breaking the news), (b) the processes related to the child's actual re-entry into the school (making the transition), (c) the ongoing monitoring of the child's health status both parents and teachers felt necessary (watching the child), (d) the need to teach school personnel about unexpected health problems (teaching the teachers), and (e) school personnel's expectations for the child (working with the child). Specific examples of positive and negative experiences related to these themes are provided.     

School violence: an insider view

PURPOSE: To discover what teachers perceive to be contributing factors to violence in schools. STUDY DESIGN AND METHODS: Open-ended questions were asked of a convenience sample of teachers ( = 396) during an in-service education program on school violence. The teachers were in a semi-rural school district in a Mid-Atlantic state. Answers were analyzed using content analysis; all responses were reviewed and important themes were extracted. Identified themes were then placed into suitable categories and studied to determine relationships. RESULTS: Of the surveys analyzed ( = 239), 13 themes were identified. The three categories which then identified probable causes of school violence were (1) lack of knowledge, (2) lack of support, and (3) inadequate safety measures. CLINICAL IMPLICATIONS: Nurses can use the results of this study in multiple ways. One is to help parents understand their role in preventing school violence. Because violence in the home and violence in the media seem to foster violent acting-out behavior, nurses can teach parents about these correlations and seek solutions such as the elimination of family violence, and monitoring television viewing and video games. Nursing assessments of school-aged children and their families can include these elements. School nurses in particular can use these study results as an opportunity to develop interventions for students, teachers, and families that stress knowledge building about impulse control, anger management, appropriate parenting, and early intervention for at-risk children.     

Asthma and the school teacher: the status of teacher preparedness and training.

The increasing number of children with asthma in the nation's schools necessitates an examination of the preparedness of teachers in the care and management of children with asthma. This article reports the findings of a random sample of 291 public elementary school teachers regarding the knowledge and perception of the training they have received on asthma and its management. Data from this study suggest that teachers are not adequately prepared to assist children with the management of asthma in the classroom. Implications for school nurses on assisting teachers with asthma management are provided.     

Allergy-like conditions and health-care contacts among children with exclusion diets at school

AIM: To find out whether children with exclusion diet at school had allergy-like conditions that could explain their food avoidance, the objective of this study was to describe health-care contacts and diagnostic testing among schoolchildren with exclusion diet and compare the magnitude of allergy-like conditions between those children who had vs. had not consulted health-care professionals. Telephone interviews were conducted with the parents of 230 schoolchildren, aged 6-18 years, with certificates for exclusion diets at school. RESULTS: The majority of the schoolchildren (85%) had consulted health-care professionals for food-related problems, and 68% were doctor-diagnosed as having food hypersensitivity. Those who had consulted health-care professionals specifically for their food-related problems had more complex and severe problems compared with those who had not consulted health-care professionals. Breathing difficulties (27/196) and anaphylaxis (9/196) related to intake of food were reported only for those who had sought health-care professionals (n = 196). Regardless of whether the children had consulted the health-care professionals, their food-related problems were consistent with food hypersensitivity. Schoolchildren avoided food items known to be associated with food hypersensitivity such as tree nuts, fruit, egg, peanut, lactose and fish. Furthermore, 83% of the 230 children also had allergic diseases (i.e. asthma, eczema or hay fever) or were hypersensitive to other substances besides food, and 83% had at least one sibling or parent with hypersensitivity to foods or other substances. CONCLUSIONS AND IMPLICATIONS FOR THE SCHOOL NURSE: Schoolchildren with food certificates for exclusion diets, based on parents' statements, have food-related and allergy-like problems that may well motivate exclusion diets at school. The school nurses can rely on the parents' information as to what foods their children should avoid, even when doctor diagnoses have not been made or health-care consultations have not been carried out.     

School nurses' knowledge and beliefs about the management of children with ADD.

The purpose of this study was to examine school nurses' knowledge and beliefs about the management of children with attention deficit disorder (ADD). Seven hundred eighty-six school nurses responded to mailed surveys regarding their attitudes and knowledge about the management of children with attention deficit disorder. Surveys were mailed to school nurses randomly selected from the membership of the National Association of School Nurses. School nurses' knowledge of school management of ADD and their attitudes about physicians' participation as part of a team effort in this care were explored. School nurses responded that physicians should increase their efforts to educate children and parents about ADD. Recommendations for school nurses in the management of children with ADD are offered.     

School-age children with asthma and their parents: relationships with health care providers

Health care providers, including nurses, physicians, and other personnel, are key figures who design and implement plans of care to help families manage childhood asthma, yet families' perceptions of relationships with these professionals has received limited study. Child and parent perspectives about relationships with their health care providers emerged as themes in a study that explored responsibility sharing between school-age children with asthma and their parents (Buford, 2004). Fourteen school-age children with asthma and 14 of their parents from 11 families participated in the study. Parents and, to a lesser extent, children, described aspects of their relationships with their health care providers that were supports or barriers to asthma management. Implications for nurses and other health care providers stem from these data and include the importance for health care providers to educate themselves and their patients about state-of-the-art asthma care. Education should be directed to both parents and their children. In addition, parents need to receive education about how to coach their children because the children depend on them for information and direction. Finally, nurses and other health care providers need to listen to parents and value their input about their children's conditions.     

Parental attitudes toward death education for young children

An exploratory study was conducted to ascertain perceptions of parents toward the role of early childhood educators in teaching young children about aspects of death education. A secondary objective was to contrast perceptions of parents with those of teachers toward death education for young children utilizing data from a previous study. Although parents of young children generally agreed with statements depicting the need for early childhood educators' self-development, communication with children, interaction with children's parents, and curriculum planning, they expressed significantly less support than teachers for death education as a part of early childhood education. Moreover, although parents acknowledged the importance of children acquiring an ecumenical understanding of and respect for others' beliefs about death, they did not wish teachers to share their personal philosophical or religious beliefs about death with young children. Parents also exhibited a more protective attitude than teachers relative to children's questions and expressed concerns about death.     

Sudden cardiac death of school-age children

Approximately 60 to 80 cases of childhood sudden death occur under school supervision every year in Japan and about 71% of them are sudden cardiac death. The incidence of sudden death among school-age children increases with age. 0.3 per 100,000 for elementary schoolchildren, 0.8 per 100,000 for junior high school children and 0.9 per 100,000 for high school children, approximately. Boys are remarkably more prone to sudden death than girls. Cardiac sudden death is often related to physical exercise and 70% of cases occur during running exercise. Although it is usually difficult to prevent the actual occurrence of sudden cardiac death, efforts to decrease sudden cardiac death should be reinforced by the cardiac screening examination and by ensuring in cooperation with children themselves, their parents, school staffs, and medical professionals. In particular, it is recommended that all teachers at junior high schools and high schools should have more knowledge about diseases related to sudden death.     

Empowering students on medication for asthma to be active participants in their care: an exploratory study.

This article is part of a larger study of young students with asthma. It focuses on the observations of school nurses and comments from parents and students pertinent to school nursing practice. The study shed light on the educational needs of 9- to 11-year-old students with asthma and identified some areas where the school nurse could easily enhance the health management of these students. Responses from students and parents about asthma provided insight into the daily challenges faced by students with asthma. Students with asthma may or may not fully understand the seriousness of their chronic condition or how to recognize and treat symptoms. The purpose of this pilot study was to identify strategies school nurses might use to determine the knowledge level of students and to determine the effects of asthma education programs. School nurses who participated in the study were provided with a comprehensive package containing current asthma information and an education program to update knowledge and skills. These school nurses also received Open Airways for Schools, an American Lung Association education program for students in grades three to five. The study was a two-group exploratory, quasi-experimental design. Questionnaires were prepared for students, school nurses, and parents to collect information on knowledge and perceptions about asthma. Students who participated in the educational program were reported by their school nurses to have increased knowledge and management skills related to their disease.     

Sociocultural influences on disability status in Puerto Rican children.

BACKGROUND AND PURPOSE: This article describes culturally defined meanings of childhood function and disability in Puerto Rico to provide a context for the interpretation of test scores from the Spanish translation of the Pediatric Evaluation of Disability Inventory (PEDI). SUBJECTS AND METHODS: More than 600 Puerto Rican teachers, parents and caregivers of children with and without disabilities, and members of the general community participated in ethnographic interviews, which were designed to describe their beliefs, attitudes, and knowledge about childhood function and disability. RESULTS: Qualitative and quantitative data analysis confirmed that differences exist between Puerto Ricans and the norms established in the United States for the performance of functional skills by children, and the analysis also described Puerto Rican beliefs and attitudes toward disability. DISCUSSION AND CONCLUSION: Puerto Rican values of interdependence, a?o?ar (pampering or nurturing behaviors), and sobre protectiva (overprotectiveness) influence parental expectations for the capability of children with disabilities and should be considered when interpreting scores from the PEDI and establishing plans of care. Additional research is needed on the influence of contextual variables on child development and behavioral adaptations to disability.     

Parental satisfaction with an outpatient asthma-management program for children and adolescents – A pilot study

The objective of our asthma management program is to optimize the disease management and the quality of life of children and adolescents with asthma. An improvement in coping with asthma should be achieved by teaching theoretical aspects and practical skills. The training is performed in small groups of children and adolescents of similar age, going for 10 sessions each lasting 90 minutes. Additionally, in 1999 and 2000, the program was also offered as a two-week workshop in the summer holidays. The goal of this study was the assessment of parental satisfaction with the outpatient asthma management program for children and adolescents. We developed a short questionnaire and assessed the following aspects: general parental satisfaction with the training, judgement of the children's knowledge about asthma, coping skills and recommendation of the training. All parents (n = 138) whose children/adolescents attended the training between 1999 and 2002 were invited to take part in this study. 106 parents (76.8%) returned the questionnaire. The results showed that most parents (95%) were highly satisfied with this asthma management program. They equally positively rated their children's coping skills (87% classified them as "much better") and their knowledge (96% rated it as "very good" resp. "good") about asthma after the training. Almost all parents (97%) recommended our program. The results were very helpful for planning the recently started, prospective case-control study on outcome evaluation of this program.     

Asthma care of children in clinical practice: do parents report receiving appropriate education?

This paper describes asthma education received from the health care provider as reported by parents of children with asthma and evaluates differences in their report based on socio-demographic and disease characteristics. Methods: Parents of 228 children with asthma were recruited from diverse clinical practice sites and asked to report on the level of education received in key content areas the National Asthma Education and Prevention Program identified as critical. Results: The overall proportion of education content fully discussed was 66%. Areas that dealt with acute management (how to manage an asthma attack: 75%) and medication administration (how to use an MDI: 81%) were most likely to be discussed. Content dealing with ongoing chronic management and collaborative care planning (discussing goals of management: 44%; providing written guidelines for acute management: 44%) was significantly less likely to be discussed. Education reported differed significantly based on symptom severity and socio-demographic characteristics. Parents of children with moderate to severe persistent symptoms reported receiving more education than those of children with mild symptoms (p < .05). Minority and poor parents, parents with less education, and parents whose children received health care in a clinic practice setting reported more education received than did their counterparts (p < .05). Summary: Significant gaps exist in education received overall, and specifically in areas associated with developing a collaborative relationship between parent and health care provider. The initial observation of socio-demographic differences in education reported has implications for pediatric nurses involved in asthma education and warrants further investigation.