Study On The Evaluation Of The Effect Of Self-management In Children And Adolescents With Asthma

Objective: To investigate the current status of asthma control and self-management in children and adolescents,to assess the impact of different self-management methods on asthma control,and to explore the factors associated with the level of asthma control in children and adolescents,to provide a theoretical basis for improving the health management of asthma in children and adolescents.Methods: A cross-sectional design was used in this study.Questionnaires were distributed to children with asthma and their parents nationwide through the Asthma Management App platform,outpatient clinics,and We Chat groups of parents from October to December2022,and children with asthma who met the inclusion and exclusion criteria were used as the study population to retrospectively collect asthma management of children within the past year.Data were processed using SAS 9.4 software,and frequencies,percentages,mean±SD,and medians(interquartile range)were used to describe the children’s asthma exacerbations and medical visits,asthma control,parents’ knowledge,attitude and practice level,and the impact of asthma exacerbations on the family in the past year;the χ~2 test or Fisher’s exact test was used to compare the asthma of children and adolescents with different characteristics;multi-factor logistic regression model was used to analyze the effects of different asthma self-management methods on children’s asthma control level,compliance with follow-up visits and family medical expenses,and to explore the factors associated with the management effects.Results: A total of 2203 questionnaires that met the criteria were included in this survey. Among them,1470(66.72%)were male and 733(33.27%)were female.The average age was(7.50±3.00)years,with 1686 people(76.53%)aged 4-9 years,21.52%(474)aged 10-14 years,and 1.95%(43)aged 15-19 years.The asthma control test(ACT)score ranged from 8-25 with a median score of 24;the childhood asthma control test(C-ACT)score ranged from 2-24 with a median score of 20,with 29.19%(643)of patients with complete asthma control;36.27%(799)of patients with partial control;and 34.54%(761) of patients with no control.The range of the parents’ KAP questionnaire score was 2-26,with a median score of 20.The percentage of parents with a good level of KAP was 44.76%(986);the percentage of parents with a passing level of KAP was 44.62%(983);and the percentage of parents with a failing level of KAP was 10.62%(234).Children who did not have an asthma attack in the past 1 year were 52.47%(1156)and 85.93%(1893)of children who followed the doctor’s orders for regular visits.During the past 1 year,33.45%(737)of the children with asthma missed school due to asthma attacks and 29.78%(656)of the parents missed work due to asthma attacks in their children.The number of children with online management was 36(1.36%);1055(47.89%)with offline management;480(21.79%)with both online and offline management;and 632(28.69%)without any management.Offline management and online and offline co-management(both P<0.05)were associated with improved asthma control and follow-up adherence compared with no management,while the effect on direct medical costs due to asthma exacerbations was not significant(both P>0.05).There was a positive effect of online and offline co-management on the improvement of asthma control,follow-up adherence,and the reduction of direct medical costs due to asthma exacerbations compared with offline management only(all P<0.05).Age,geographic region,monthly per capita household income,family history of asthma,food allergens,tobacco smoke exposure,and parents’ KAP were factors influencing the level of asthma control in children(all P<0.05).Conclusion: The children in this study had good control of asthma overall.The use of an asthma management app to assist in the management of Children’s asthma action plan was beneficial in improving asthma control levels and compliance with follow-up visits as well as reducing direct medical costs due to asthma attacks.Many factors influenced the level of asthma control,such as age,geographic area,monthly per capita household income,allergens,and family history of asthma.Self-management plays an important role in the management of asthma.Therefore,it is important to pay attention to asthma health education,enhance the awareness and ability of children and parents on self-management,and also pay timely attention to the risk factors affecting asthma control in the management of children with asthma,to improve the level of asthma control in children and adolescents.