CARIBBEAN LATINX ADULTS WITH MODERATE-SEVERE ASTHMA BEAR GREATER ASTHMA MORBIDITY COMPARED TO OTHER LATINX SUBGROUPS

Objective. Childhood asthma morbidity and mortality are increasing despite improvements in asthma therapy. We hypothesized that a substantial number of children with moderate to severe asthma are not taking the maintenance medications recommended by national guidelines. The objective of this study was to describe medication use among US children with asthma and determine risk factors for inadequate therapy. Methods. The National Health and Nutrition Examination Survey (NHANES) III 1988–1994 provided cross-sectional, parent-reported data for children 2 months to 16 years of age. Analysis focused on children with moderate to severe asthma (defined as having any hospitalization for wheezing, ≥2 acute visits for wheezing, or ≥3 episodes of wheezing over the past year). We defined these children as adequately treated if they had taken a maintenance medication (inhaled corticosteroid, cromolyn, or theophylline) during the past month. Demographic variables were analyzed for independent associations with inadequacy of therapy. The statistical analysis used SUDAAN software to account for the complex sampling design. Results. A total of 1025 children (9.4%) had physician-diagnosed asthma. Of those with moderate to severe asthma (n = 524), only 26% had taken a maintenance medication during the past month. Even among children with 2 or more hospitalizations over the previous year, only 32% had taken maintenance medications. In a logistic regression analysis, factors significantly associated with inadequate therapy included: age ≤5 years, Medicaid insurance, and Spanish language. Children surveyed after 1991, when national guidelines for asthma management became available, were no more likely to have taken maintenance medications than children surveyed before 1991. Conclusion. Most children with moderate to severe asthma in this nationally representative sample, including those with multiple hospitalizations, did not receive adequate asthma therapy. These children may incur avoidable morbidity. Young children, poor children, and children from Spanish-speaking families appear to be at particularly high risk for inadequate therapy.

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Vivência materna no cuidado da criança com asma [Mothers’ experience in caring for children with asthma] [Experiencia materna en el cuidado de niños con asma]

Revista Enfermagem UERJ ◽

10.12957/reuerj.2018.16983 ◽

2018 ◽

Vol 26 ◽

pp. e16983

Author(s):

Rosana Dos santos Costa ◽

Maria De Lurdes Zanolli ◽

Lidya Tolstenko Nogueira

Keyword(s):

Health Service ◽

Qualitative Study ◽

Research Ethics ◽

Severe Asthma ◽

Family Health ◽

Ethics Committee ◽

Asthma Morbidity ◽

Health Strategy ◽

Children With Asthma ◽

Family Health Strategy

Objetivo: compreender o comportamento materno no cuidado à criança com asma. Método: estudo qualitativo, orientado pelo referencial do método etnográfico, realizado no período de julho de 2013 a janeiro de 2014. Participaram 12 mães de crianças com asma grave, de 6 a 7 anos de idade, selecionadas por equipes da estratégia saúde da família do município de Teresina-PI. O projeto de pesquisa foi aprovado por Comitê de Ética em Pesquisa. Resultados: as categorias extraídas dos discursos foram: a mãe diante do diagnóstico de asma infantil; a mãe e a crise de asma infantil; a mãe e o serviço de saúde do bairro. Conclusão: identificou-se que as mães apresentaram reduzido conhecimento sobre manejo adequado da doença e demonstraram insatisfação em relação ao serviço de saúde do bairro. Evidenciou-se a necessidade do desenvolvimento de atividades educativas para a redução da morbidade da asma na população estudada.ABSTRACTObjective: to understand mothers’ behavior in caring for children with asthma. Method: this qualitative study, guided by the ethnographic method, was conducted from July 2013 to January 2014. Participants were 12 mothers of 6 to 7 year olds with severe asthma selected by family health strategy teams in the municipality of Teresina, Piauí. The research project was approved by the research ethics committee. Results: the categories extracted from the accounts were: the mother and the child’s diagnosis of asthma; the mother and the child’s asthma crisis; the mother and the neighborhood health service. Conclusion: mothers were found to know little about proper management of the disease and displayed dissatisfaction with the neighborhood health service. There emerged a need for educational activities to reduce asthma morbidity in the study population.RESUMEN: Objetivo: comprender el comportamiento materno en el cuidado del niño con asma. Método: estudio cualitativo, orientado por el referencial del método etnográfico, realizado en el período de julio de 2013 a enero de 2014. Participaron 12 madres de niños con asma grave, de 6 a 7 años de edad, seleccionadas por equipos de la estrategia salud de la familia del municipio de Teresina-PI. El proyecto de investigación fue aprobado por Comité de Ética en Investigación. Resultados: las categorías extraídas de los discursos fueron: la madre ante el diagnóstico de asma del niño; la madre y la crisis de asma del niño; la madre y el servicio de salud del barrio. Conclusión: se identificó que las madres tenían poco conocimiento sobre el cuidado adecuado de la enfermedad y demostraron insatisfacción en cuanto al servicio de salud del barrio. Quedó evidente la necesidad del desarrollo de actividades educativas para la reducción de la morbilidad del asma en la población estudiada.

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