| Objective To construction a self-management intervention program for school-age children with asthma based on the theory of knowledge,attitude,and practice,and to investigate the effects of the program on self-management ability,medication adherence,asthma control,pulmonary function,the rates of asthma attacks,with the aim of providing a reference for improving the health education program for school-aged children with asthma in outpatient clinics and emergency departments.Method Literature review was used to analyze the status of self-management intervention in school-age children with asthma,formed the preliminary draft of the intervention program for self-management of school-age children with asthma based on the theory of knowledge,attitude,and practice.Through expert group meetings and pre-experiment revised the intervention program,and the final version of the intervention program based on the theory of self-management of school-age children with asthma was formed.One hundred and four cases with mild or moderate bronchial asthma who visited the pediatric outpatient clinic and emergency department of a first-class tertiary hospital in Qingdao from May 2019 to May 2021 were collected for the study,the subjects were been paired and then been randomly divided into control groups and observation groups.According to the inclusion and exclusion criteria,104 cases were enrolled in this study,a total of 4 cases were lost(3.85%),50 cases in the control group and 50 cases in the observation group were included at the end.The control group received conventional health education,whereas the observation group applied the self-management intervention program based on the theory of knowledge,attitude,and practice.The period of the intervention was 24 weeks,Self-management ability,medication adherence,and asthma control status were assessed by scales at the beginning,12 weeks and 24 weeks after intervention in all cases;pulmonary function(including FVC%,FEV1%,PEF%,FEF25%,FEF50%,FEF75%)was monitored simultaneously.The number of asthma attacks in the two groups within 12 weeks and 24 weeks after the intervention was counted;observation and comparison of the intervention effects between the two groups were performed.SPSS 26.0 was used for statistical analysis.Result 1.Through expert group meetings and pre-trials,the self-management intervention program for school-age children with asthma based on the theory of knowledge,attitude,and practice was finalized2.Self-management ability of children with asthma: the results of repeated measures analysis of variance confirmed that the interaction F = 66.419 and the significance between the two groups was different significantly(P < 0.001).Simple effects analysis showed no statistically difference(P > 0.05)in the self-management scale and the three subscales(psychosocial management,medical management of the disease,and management of daily living)between the two groups of sample cases before the intervention.At the end of the 12-week intervention,scores on the self-management scale and the three subscales(psychosocial management,medical management of the disease,and management of daily living)differed significantly between the two groups of sample cases within the range of(123.40±6.18,108.64±4.15,P < 0.05),(31.38±3.43,29.00±2.13,P < 0.05),(66.46±4.12,61.22±6.38,P < 0.05),(25.56±2.49,22.62±2.07,P < 0.05),respectively;at the end of the 24-week intervention,the scores of the self-management scale and the three subscales(psychosocial management,medical management of the disease,and management of daily living)differed significantly between the two groups of sample cases in the range of(141.32±5.94,122.10±8.36,P < 0.05),(37.30±2.18,31.58±4.93,P < 0.05),(74.36±3.92,65.78±5.06,P < 0.05),(29.66±1.73,24.74±1.77,P < 0.05),respectively.3.Medication adherence in children with asthma: the results of the generalized estimating equations showed that adherence in the observation group was 4.414 times higher than in the control group(exp = 1.485);adherence with 12 weeks after the intervention was 2.159 times higher than before the intervention(exp = 0.77);and adherence with 24 weeks after the intervention was 8.672 times higher than before the intervention(exp = 2.160).4.Asthma control in children with asthma: before the intervention,there was no statistically difference between the groups when comparing the C-ACT scores of the sample cases(18.52±1.98,18.86±1.88,P > 0.05);after 12 weeks,asthma control improved significantly in the observation group(22.56±2.17,21.04±2.34,P < 0.05);after 24 weeks,asthma control further improved significantly in the observation group(24.32±2.01,22.32±2.42,P < 0.05).5.Pulmonary function in children with asthma: before the intervention,there was no statistically difference in pulmonary function between the 2 groups(P > 0.05);at the end of the twelfth week,large airway function(FVC%,FEV1%,PEF%)was improved significantly in the observation group than the control group,in order of(85.96±3.46,82.72±3.42,P < 0.05),(88.24±3.45,84.70±3.99,P < 0.05),(84.78±3.41,81.10±3.49,P < 0.05),respectively;at the end of the 24-week,the pulmonary function(FVC%,FEV1%,PEF%,FEF25%,FEF50%,FEF75%)in the observation group was significantly better than that of the control group,in order of(88.90±2.82,85.20±3.43,P < 0.05),(90.38±3.57,86.02±3.51,P < 0.05),(89.92±2.86,86.46±2.96,P < 0.05),(84.46±3.35,82.16±3.32,P <0.05),(82.46±2.73,80.60±2.84,P < 0.05),(81.28 ± 3.42,79.86 ± 2.88,P < 0.05),respectively.6.Asthma attacks in children: at the end of the 12-week intervention,there were 25(50%)and 21(42%)cases in children in the control and observation groups,respectively,with no statistically difference(P > 0.05);at the end of the 24-week intervention,there were 39(78%)and 25(50%)cases in children in the control and observation groups,respectively,with statistically difference(P < 0.05).Conclusion The self-management intervention program for school-age children with asthma on the theory of knowledge,attitude and practice theory constructed in this study,improved self-management ability and medication adherence in the sample cases by improving selfmanagement behaviors in school-aged children with asthma and increasing asthma control and pulmonary function,which in turn decreased the rate of asthma attacks. |
PDF Full Text Request