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A qualitative study of case management of children with asthma
Yvonne M Sterling1, Lisa J Linville
1Yvonne M. Sterling, PhD, RN, AE-C, is Professor of Nursing at the LSUHSC School of Nursing. She is also Adjunct Professor at the Tulane University School of Public Health, Department of Environmental Sciences, New Orleans, LA. She earned a Bachelor of Science in Nursing degree from Dillard University, New Orleans, LA and the Master of Science in Nursing and PhD in Nursing from the Catholic University of America in Washington, DC. She is a certified asthma educator. She was a coinvestigator of the Head of Environmental Asthma in Louisiana study. She is a board member of the American Lung Association of the Southeast, Inc. Lisa J. Linville, DNS, JD, MN, RN, is an Assistant Professor at the Loyola, New Orleans, School of Nursing, where she teaches in the Bachelor of Science and Master's Nursing programs. Dr. Linville has a health care career spanning 25 years with practice in administrative roles, case management, pediatrics and as a utilization review consultant. In addition, Dr. Linville is a licensed attorney in Louisiana and practiced law in New Orleans, specializing in health care regulatory, corporate compliance, privacy, and medical malpractice cases. Dr. Linville holds a Juris Doctor degree from Loyola University and Doctor of Nursing Science degree from Louisiana State University Health Sciences Center in New Orleans, LA.
Purpose:
The purpose of this study was to describe the process of case management delivered to Head-off Environmental Asthma in Louisiana (HEAL) study participants.
Primary Practice Setting:
Participants' homes; community facilities (clinic and library meeting rooms, schools) in a post-Katrina environment.
Methodology And Sample:
A qualitative descriptive study consisted of analysis of existing data that describe the case management provided by HEAL asthma counselors to 151 children, aged 4-12 years, with moderate-severe asthma, and their families. The HEAL study (2006-09) was conducted in the New Orleans area after Hurricane Katrina.
Findings/Conclusions:
Case management was intensive and comprehensive and consisted of asthma education, symptom management, addressing caretaker/participant/family issues, consistent follow-up, referrals, and goal-setting. Several factors impacted the case management process, including caretaker beliefs, accessibility, and posthurricane issues.
Implications For Case Management Practice:
Health care providers must recognize the complexity of case management in a postdisaster environment, consider the influence of social determinants and one's health literacy on asthma treatment adherence and outcomes, and develop models of case management to effectively manage children with asthma and their families.
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