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Challenges in Parental Management of Aerosol Therapy: A Single-Center Study of Children with Early-Onset Wheezing
Evrim Hepkaya1, Samed Cihad Çelik2, Senanur Şanlı Çelik2
1Department of Pediatric Pulmonology, Kocaeli City Hospital, Kocaeli, Türkiye.
Insights
Parental behaviors significantly impact aerosol therapy effectiveness in young children with recurrent wheezing. Improving parental knowledge on nebulizer use enhances treatment outcomes.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Child Health
Background:
- Parental management challenges in aerosol therapy can impair lung drug delivery.
- Early-onset recurrent wheezing affects young children, necessitating effective aerosolized medication administration.
Purpose of the Study:
- To examine parental behaviors in aerosol medication and nebulizer use.
- To assess the impact of clinical and demographic variables on aerosol therapy outcomes.
- To identify factors influencing treatment effectiveness in pediatric wheezing.
Main Methods:
- Evaluated 124 children (0-36 months) with early-onset recurrent wheezing undergoing daily aerosol treatment.
- Collected data on parental knowledge, attitudes, sociodemographics, and wheezing history.
- Assessed adherence, nebulizer application techniques, cleaning practices, and environmental exposures.
Main Results:
- Treatment adherence was 85%; 60.5% used mask tightly, 39% used blow-by.
- Aerosols administered during crying (33.9%) or sleep (53.2%).
- Poor mask cleaning linked to increased wheezing attacks (P=.01); home tobacco smoke exposure correlated with increased salbutamol use (OR=2.11).
Conclusions:
- Parental factors significantly influence aerosol therapy effectiveness in young children with recurrent wheezing.
- Enhanced knowledge for healthcare providers and parents on nebulizer techniques is crucial.
- Optimizing parental practices can improve clinical outcomes for pediatric respiratory conditions.
Objective:
This study examines parental behaviors related to aerosol medication and nebulizer use, considering the patients' clinical and demographic variables' impact on treatment outcomes. Parental challenges in managing aerosol therapy may reduce drug delivery efficiency to the lungs.
Materials And Methods:
A total of 124 children aged 0-36 months with early-onset recurrent wheezing who were receiving daily regular aerosol treatment were evaluated. Data regarding parental knowledge and attitudes regarding nebulizer use and sociodemographic variables such as age, smoking, educational levels, and employment status were recorded. Phenotypes and history of wheezing attacks in previous months were also evaluated.
Results:
Adherence to aerosol treatment was 85%. While 60.5% of parents applied the mask tightly, 39% used the blow-by method. Aerosols were given during crying in 33.9% and during sleep in 53.2% of cases. Only 44% cleaned the mask after each use; 13% never did, and 80.6% did not disinfect. Poor cleaning was linked to more wheezing attacks (P=.01). Among those exposed to tobacco smoke at home, 54.7% used nebulized salbutamol >48 hours in the past month (OR = 2.11, P = .054; 95% CI: 0.99-4.52). Device type, aerosol method, and phenotype showed no clinical impact.
Conclusion:
The findings of this study highlight the significant influence of parental perceptions, attitudes, and behaviors on the effectiveness of aerosol therapy in young children with early-onset recurrent wheezing. Improving the knowledge of both health care professionals and parents about nebulizer treatment steps can enhance the clinical outcomes of patients.
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