scholarly journals Impact of a Household Environmental Intervention Delivered by Lay Health Workers on Asthma Symptom Control in Urban, Disadvantaged Children With Asthma

2009 ◽  
Vol 99 (S3) ◽  
pp. S657-S665 ◽  
Author(s):  
Tyra Bryant-Stephens ◽  
Cizely Kurian ◽  
Rong Guo ◽  
Hauqing Zhao
2019 ◽  
pp. 160-165
Author(s):  
A. K. Zastrozhina ◽  
I. N. Zakharova ◽  
D. A. Sychev

The search for factors affecting the efficacy of bronchial asthma (BA) therapy in children is an actual problem. subject of many modern scientific studies. Authors note that adherence to therapy in patients with asthma ranges from 30 to 70%. Often this index does not exceed 50%. Analysis of adherence to medical recommendations in children with asthma and the search for compliance reduction factors is one of the ways for optimizing therapy and improving the quality of life for children with asthma.Purpose. In order to optimize bronchial asthma therapy in pediatric practice, we analysed adherence to medical recommendations and its effect on the controllability of the disease in children with asthma.Materials and methods. The study included 94 children aged 6 to 17 years with an established diagnosis of bronchial asthma. All patients had previously been recommended basic therapy in the form of inhaled glucocorticosteroids (ICS) or their fixed combinations with long-acting beta2-adrenomimetikami (LABA). An assessment of BA control symptoms was carried out, and factors affecting adherence to medical recommendations were analyzed. The effect of decreased patient compliance on the control of asthma symptoms was evaluated.Results. 61.7% of children with asthma have insufficient disease control. In 42.55% of patients, a survey revealed insufficient adherence to medical recommendations. 88.3% of children and their parents reported the presence of factors capable of influencing the decrease in compliance. The most frequently occurring factor in reducing adherence to therapy turned out to be insufficient patient awareness of the disease itself, the mechanisms of therapy action, and the prospect of treatment. Statistical data processing showed a statistically significant decrease in adherence to medical recommendations in the group of patients with insufficient asthma symptom control (p = 0.038).Conclusion. Only 38.3% of children had complete asthma symptom control. The statistically significant reduction in adherence to medical recommendations in the group of children with insufficient symptom control suggests the need for educational activities for children with BA and their parents in order to increase adherence to medical recommendations, optimize the effectiveness of therapy and improve the quality of patients’ life.


1995 ◽  
Vol 40 (5) ◽  
pp. 141-143 ◽  
Author(s):  
P.J. Madge ◽  
L. Nisbet ◽  
J.H. McColl ◽  
A. Vallance ◽  
J.Y. Paton ◽  
...  

Objective: To audit the use of home nebulisers in children with asthma. Design: Postal questionnaire. Setting: Two Health Board Areas in Central Scotland-one large industrialised city, one mixed urban and rural. Subjects: 297 children with asthma. Measures evaluated: Initial supply and technical support for the compressor. Education: Pattern of drug usage. Symptom control: Monitoring and treatment of acute attacks. Results: The full burden of the home nebulised therapy is not being met by the NHS. Supply and servicing arrangements for home nebuliser therapy were poorly organised. Chronic asthma symptoms did not appear to be optimally controlled on present medication, with 61% reporting sleep disturbance in the previous three months. About 20% of parents admitted that they would give nebulised bronchodilator therapy more frequently than the recommended 3 to 4 hourly. Conclusion: Re-organisation of resources and arrangements could improve the service and bring it in line with recognised standards of care.


Author(s):  
Richard A. Taylor ◽  
J. Nicholas Dionne-Odom ◽  
Erin R. Currie ◽  
Macy Stockdill ◽  
Marie A. Bakitas

Access to palliative care remains challenging to those living in rural areas across the globe. This disparity of care leaves many without critically important palliative care services across their illness trajectory, especially in its final stages. Creative strategies to meet the palliative care needs of rural patients such as telehealth, videoconferencing specialists’ consultation, and web-based resources exist. Using these strategies where available can address some palliative care disparities and access to care in rural areas that were previously absent. Developing clinical capacity of rural clinicians through enhanced education in primary palliative care in training programs, expanding services with the use of nurse practitioners, and using palliative care–trained community lay health workers are also strategies to improve access. Additionally, by developing rural hospital providers’ knowledge and skills to provide primary palliative care in tasks such as establishing care goals, communication, and basic symptom control may prevent many transfers to academic centers miles away. Through ongoing education and primary palliative care training and innovations in bringing specialty care to rural areas, “palliative care everywhere” will soon be a reality.


2019 ◽  
Vol Volume 14 ◽  
pp. 631-643 ◽  
Author(s):  
Patrick White ◽  
Gill Gilworth ◽  
Simon Lewin ◽  
Lauren Hogg ◽  
Rachel Tuffnell ◽  
...  

Author(s):  
Manali I. Patel ◽  
Sana Khateeb ◽  
Tumaini Coker

Introduction: Advance care planning and symptom screening among patients with cancer require team-based approaches to ensure that these services are equitably and appropriately delivered. In several organizations across the United States, we trained and employed lay health workers (LHWs) to assist with delivering these services for patients with cancer. The aim of this study was to understand LHWs’ views on delivering these services. Methods: We conducted semi-structured interviews with 22 LHWs in 6 US-based clinical cancer care settings in 4 large cities. We recorded, transcribed, and analyzed interviews using the constant comparative method of qualitative analysis. Results: Participants noted the importance of their role in assisting with the delivery of advance care planning (ACP) and symptom screening services. Participants noted the importance of developing relationships with patients to engage openly in ACP and symptom screening discussions. Participants reported that ongoing training provided skills and empowered them to discuss sensitive issues with patients and their caregivers. Participants described challenges in their roles including communication with oncology providers and their own emotional well-being. Participants identified solutions to these challenges including formal opportunities for introduction with oncology clinicians and staff and grievance sessions with LHWs and other team members. Discussion: LHWs from several organizations endorsed the importance of their roles in ensuring the delivery of ACP and proactive symptom screening. LHWs noted challenges and specific solutions to improve their effectiveness in delivering these important services to patients after their diagnosis of cancer.


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