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PELICAN: Content evaluation of patient-centered care for children with asthma based on an online tool
Stephanie van Bragt1, Lisette van den Bemt2, Riet Cretier1
1Department of Primary and Community Care, Radboudumc, Route 106, Geert Grooteplein 21, Nijmegen, 6525 EZ, Netherlands.
Insights
This study evaluated a pediatric asthma management program focusing on individual child goals. While children and parents found the program engaging, only 25% of goals met SMART criteria, indicating a need for better goal-setting in pediatric asthma care.
Area of Science:
- Pediatric Pulmonology
- Asthma Management
- Patient-Centered Care
Background:
- Assessed an intervention integrating individual goals into outpatient asthma management for children aged 6-12.
- Intervention based on self-management principles.
Purpose of the Study:
- To evaluate the content and implementation of a patient-centered asthma management intervention for children.
- To assess the feasibility and effectiveness of integrating individual goals using the Pelican instrument.
Main Methods:
- Content evaluation study within a randomized controlled multicenter trial.
- Follow-up period of 9 months across five Dutch asthma clinics.
- Collected data on children's problems (Pelican instrument), management goals, and action plans.
- Assessed satisfaction of parents, children, and nurses via questionnaires.
Main Results:
- Commonly reported problems included cough, cigarette smoke exposure, and shortness of breath.
- Children actively participated in over 76% of formulated actions, with key recommendations like "using rescue medication prior to activities/triggers."
- Identified barriers: only 25% of goals were SMART, and traditional management aspects overshadowed individual child problems.
Conclusions:
- Recommended implementation of patient-centered care using the Pelican instrument in specialized pediatric asthma care.
- Suggested enhanced nurse training in patient-centered care (PCC) to improve intervention execution.
Background:
We assessed the content of an intervention which integrates individual goals in outpatient clinic asthma management (based on self management principles) of children 6-12 years of age.
Methods:
This is a content evaluation study and was part of a randomized controlled multicenter trial with 9 months follow-up in five Dutch outpatient asthma clinics among children with asthma aged 6-12 years. Information on children's individual problems and their level of impairment (as indicated by the Pelican instrument), asthma management goals, and actions (as indicated by written action plans) was collected. Satisfaction of parents, children, and nurses were assessed with questionnaires and analyzed with descriptive statistics.
Results:
Most frequently identified problems by children (n = 42) were "cough," "cigarette smoke," and "shortness of breath." Eighty-two percent of items that were selected by children showed room for improvement. About 2-7 actions were formulated and children had an active role in more than 76% of the actions. "Using rescue medication prior to activities/triggers," and "talk to others about your asthma" were most frequently recommended. Children thought the Pelican instrument was easy (95%) and fun (65%) and both parents and nurses were positive about the incorporation of the program in asthma management. Following barriers were found: (1) only 25% of goals was formulated according to SMART principles; (2) traditional management aspects (such as medication use) are often treated instead of individual problems of children.
Conclusion:
Implementation of patient-centered care based on the Pelican instrument is recommended in specialized care, although more extensive training of nurses in PCC will improve the successful execution of the evaluated treatment. Pediatr Pulmonol. 2016;51:993-1003. © 2016 Wiley Periodicals, Inc.
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