The Interventional Study On Self-Care Behavior And Self-Concept Of School-age Children With Asthma

Background Self-concept is one of the important components of children personelity development.School-age period is an important and sensitive phase which is easily influenced by various negative events such as illness and hospitalization.As the most common chronic illness,asthma will affect physical and psychological development of school-age children.At present,it is well accepted that self-care behaviors play an important role on controlling chronic illness.Therefore the first purpose of this study is to describe self-care behaivor and self-concept of school-age children with asthma as well as factors influencing them.Another purposes is to evaluate the impact of psychological behavioral intervention on self-care behavior and self-concept of school-age children with asthma.Objectives There are two stages for this study.The purpose of the first stage is to describe self-care behaivor and self-concept of school-age children with asthma and to examine factors influencing them.At the second stage,the purpose is to evaluate the impact of psychological behavioral intervention on self-care behavior and self-concept of school-age children with asthma.Methods A convenient sample of 100 school-age children with asthma were recruited from out-patient clinic of a Children's Hospital and then divided into intervention group and control group.There were no statistical differences in gender, age,frequency of attack,course of diseases,number of previous hospitalization, education of their major care-givers(p＞0.05).Self-care behavior questionnaire and Piers-Harris Children's Self-Concept Scale(PHCSS) was administered to collect data. After the baseline investigation,those in the intervention group attended a 6-month psychological behavioral intervention in addition to routine follow-up visit,while the control group received the routine follow-up visit only.The self-care behaviors and self-concept of the sample were measured repeatly at 3 months and 6 months. Repeated-measure of ANOVA and MANOVA was applied to analyse data.Results During baseline phase:①Score of self-concept of school-age children with asthma was below the national norm.②Score on subscale of self-care behavior meeting health deviation self-care requisites was the lowest among three subscales of self-care behavior questionnaire(p＜0.01).③Self-care behavior score was related to self-concept score positively(r=0.47,p＜0.01).④Significant differences for self-care behavior score were evidenced by age,frequency of attach,duration of hospitalization, and education background.of their major care-givers;⑤Self-care behavior score, attack frequency and age are the significant predictors of self-concept of school-age children with asthma,which account for 39%of the variance of self-concept.During the intervention phase:①It was evident that the scores of gernal self-care behavior and self-care behavior meeting health deviation self-care requisites of intervention group were higher than those of control group at intervention 3 months and 6 months(P＜0.001),the score of self-care behavior meeting development self-care requisites of intervention group was higer than that of control group at intervention 3 months and 6 months(P＜0.01).The result also indicated that there was no statistical difference in the scores of self-care behavior meeting universal self-care requisites at intervention 3 months between two groups(p＞0.05),but there was statistical differences in the score of self-care behavior meeting universal self-care requisites at intervention 6 months(P＜0.01).②It is evident that the number of attack and days of school-absent for intervention group were less than those of control group(p＜0.01),but there was no statistical difference in days of hospitalization between two groups(p＞0.05).③It is evident that there was no statistical difference in the score of overall self-concept between two groups at intervention 3 months (p＞0.05),but the score was higer than that of control group at 6 months(P＜0.001). It is evident that there were no statistical differences in the scores of physical appearance and attribute and popularity between two groups at intervention 3 months (p＞0.05),but these scores were higer than those of control group at 6 months (P＜0.05).It is also evident that the score of intelligence and academic competence of intervention group is higher than that of control group at 3 months(P＜0.05) and 6 months(P＜0.01).In addition,the score of anxiety of intervention group was higher than that of control group at 3 months(P＜0.05) and 6 months respectively(P＜0.05). The results also indicated that there were no statistical differences in the scores of social behavior and satisfaction and happiness between two groups at 3 months and 6 months(p＞0.05).Conclusion Score of self-concept of school-age children with asthma was lower than national norm.Score on subscale of self behavior meeting health deviation self-care requisites were the lowest among three subscales of self-care behavior questionnaire.There was positive relationship between self-care behavior and self concpt of school-age children with asthma.Psychological behavioral intervention was effective in improving self-care behavior and self-concept of school-age children with asthma.