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Asthma education by community child health nurses
Insights
A community nurse program for childhood asthma increased medication use and hospital readmissions in European children. Polynesian children showed no significant differences in outcomes.
Area of Science:
- Pediatrics
- Community Health Nursing
- Respiratory Medicine
Background:
- Childhood asthma management requires effective family support and education.
- Community health nurses play a vital role in delivering interventions to pediatric patients with chronic conditions.
- Assessing the impact of educational programs on asthma outcomes is crucial for improving patient care.
Purpose of the Study:
- To evaluate the effectiveness of a community child health nurse-led educational program for children with asthma and their families.
- To determine the impact of the intervention on medication adherence, symptom control, and healthcare utilization.
- To compare outcomes between European and Polynesian children receiving the educational program.
Main Methods:
- A randomized controlled trial involving 368 children (aged 2-14) hospitalized for asthma.
- The intervention group received monthly nurse visits for six months.
- Outcomes were assessed via postal questionnaires six months post-intervention, with long-term follow-up on readmissions.
Main Results:
- European children in the intervention group used more asthma medications, including theophylline and inhaled steroids.
- Increased use of hospital services for severe asthma attacks and higher re-admission rates were observed in the European intervention group.
- No significant differences in improvement, missed schooling, or severe asthma attacks were reported between groups for European children.
- Polynesian children showed no significant differences in any outcome measures between the intervention and control groups.
Conclusions:
- The educational program led to increased medication use and healthcare utilization in European children with asthma.
- The program did not demonstrate improvements in symptom control or reduce missed schooling for European children.
- The intervention showed no discernible benefit for Polynesian children with asthma.
- Further research is needed to understand the differential effects of asthma educational programs across diverse ethnic groups.
Abstract:
A randomised controlled study of an educational programme for children with asthma and their families was carried out by community child health nurses. Three hundred and sixty eight children aged 2 to 14 years were enrolled in the study after admission to hospital for asthma. The intervention group was visited monthly by a nurse for six months. The subjects were assessed six months later by a postal, self administered questionnaire. European children in the intervention group were taking significantly more drugs for the treatment of asthma six months after the index admission to hospital than those in the control group (mean (SD) intake 2.7 (1.1) v 2.1 (1.0), respectively). In particular, they were using more theophylline (56.6% v 37.0%) and inhaled steroids (34.9% v 21.0%). There was no difference between the groups for parental reports of improvement, of missed schooling, and in severe attacks of asthma of not responding to the usual treatment at home. European children in the intervention group used the hospital services for severe attacks of asthma more than controls (34.2% v 10.5%). There were more re-admissions in the European intervention group in the subsequent six months after the index admission than in the control group (mean (SD) 0.51 (0.97) v 0.29 (0.65). Re-admission continued to be higher in the 12 months after the nurse had stopped visiting (0.81 (1.65) v 0.25 (0.65]. There was no difference in the duration of hospital stay between the intervention and control groups. For Polynesian children there was no difference between the groups for any outcome measures.