scholarly journals Parent Experiences with Electronic Medication Monitoring in Pediatric Asthma: A Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Kristin Kan ◽  
Sara Shaunfield ◽  
Madeleine Kanaley ◽  
Avneet Chadha ◽  
Kathy Boon ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Healthcare Delivery ◽  
Asthma Management ◽  
Qualitative Inquiry ◽  
Comparative Approach ◽  
Digital Tool ◽  
Medication Monitoring ◽  
Children With Asthma ◽  
Electronic Medication Monitoring ◽  
The Impact

BACKGROUND Electronic medication monitoring (EMM) is a digital tool that can be used for tracking daily medication use. Previous studies of EMM in asthma have examined experiences of adults or have studied pediatric interventions that use EMM for less than a year. To understand acceptance of an EMM-enhanced intervention, we explore the experiences of parents of children with asthma, recruited from outpatient practices for a 12-month intervention trial. OBJECTIVE Through qualitative inquiry, we studied: (1) How did using the intervention change parents/caregivers’ experiences of managing their child’s asthma, and (2) What do parents recommend for improving the intervention in the future? METHODS Parents were recruited from the intervention arm of a multi-component, health intervention enhanced by Bluetooth-enabled sensors placed on inhaler medications. Semi-structured interviews were conducted with 20 parents of children with asthma (4-12 years old). Interviews were audio-recorded, transcribed, and inductively analyzed using a constant comparative approach. RESULTS Interview participants reflected an even mix of publicly and privately insured children and a diverse racial-ethnic demographic. Parents discussed six key themes related to their experience with the EMM-enhanced intervention: compatibility with their lifestyle, the impact on asthma management, impact on their child’s health, emotional impact of the intervention, children’s engagement in asthma management with the intervention, and recommendations for future intervention design. CONCLUSIONS Our qualitative study of parents found that the intervention with EMM over 12 months was overall compatible with their daily lives, positively influenced their preventive and acute asthma management, and promoted child engagement. Parents in our study found the intervention acceptable and generally favorable. While use of technology-enhanced tools are increasingly popular in healthcare delivery and consumer health care, our study highlighted that careful attention must also be paid to the unique needs of parents of children with asthma and understanding how a digital tool can be adopted into their daily disease management.

scholarly journals Impact of the COVID-19 pandemic on asthma control among children: a qualitative study from caregivers’ perspectives and experiences

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e046525
Author(s):  
Yuanmin Jia ◽  
Jingxian Bao ◽  
Mo Yi ◽  
Zeyi Zhang ◽  
Jingjing Wang ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Asthma Control ◽  
Asthma Management ◽  
Face To Face ◽  
Semistructured Interviews ◽  
Children With Asthma ◽  
Tertiary Hospitals ◽  
Fear And Anxiety ◽  
Health Promotion Interventions ◽  
The Impact

ObjectivesTo understand the impact of the COVID-19 epidemic on asthma control in children based on caregivers’ perspectives and experiences.DesignThis was a qualitative study deploying face-to-face, semistructured interviews. Thematic analysis was carried out to analyse the data.SettingPaediatric respiratory clinics in three tertiary hospitals.Participants16 caregivers providing unpaid asthma-related care and assistance to children under 14 years who had been diagnosed with asthma for more than 1 year and were not only treated with short-acting β2-agonists.ResultsSix main themes were identified: (1) improved asthma control; (2) decreased willingness to seek medical care driven by fear; (3) increased adherence due to enhanced awareness of asthma control; (4) coping strategies for changes caused by COVID-19; (5) a new opportunity and (6) managing new challenges in asthma control.ConclusionsThe COVID-19 outbreak and the measures in response to it have had significant impacts on asthma control among children. Children with asthma are advised to continue good asthma management, take their prescribed asthma medications as normal, wash their hands regularly and wear face masks. Regularly supported self-management and remote consultations should be provided during the COVID-19 pandemic. In addition, supporting people financially, providing continued medical support and alleviating any fear and anxiety should be considered. We anticipate that our findings will inform health promotion interventions.

Feasibility study of a communication and education asthma intervention for general practitioners in Australia

2010 ◽  
Vol 16 (1) ◽  
pp. 75 ◽  
Author(s):  
Smita Shah ◽  
Brett G. Toelle ◽  
Susan M. Sawyer ◽  
Jessica K. Roydhouse ◽  
Peter Edwards ◽  
...  
Keyword(s):  
General Practitioners ◽  
Controlled Trial ◽  
Communication Strategies ◽  
Asthma Management ◽  
Doctor Patient Communication ◽  
Children With Asthma ◽  
The Usa ◽  
Randomised Controlled ◽  
Communication Behaviours ◽  
The Impact

The Physician Asthma Care Education (PACE) program significantly improved asthma prescribing and communication behaviours of primary care paediatricians in the USA. We tested the feasibility and acceptability of a modified PACE program with Australian general practitioners (GP) and measured its impact on self-reported consulting behaviours in a pilot study. Recruitment took place through a local GP division. Twenty-five GP completed two PACE Australia workshops, which incorporated paediatric asthma management consistent with Australian asthma guidelines and focussed on effective communication strategies. Program feasibility, usefulness and perceived benefit were measured by questionnaires before the workshop and 1 month later, and an evaluation questionnaire after each workshop. GP were universally enthusiastic and supportive of the workshops. The most useful elements they reported were communication skills, case studies, device demonstrations and the toolkit provided. GP self reports of the perceived helpfulness of the key communication strategies and their confidence in their application and reported frequency of use increased significantly after the workshops. The PACE program shows promise in improving the way in which Australian GP manage asthma consultations, particularly with regard to doctor–patient communication. The impact of the modified PACE Australia program on the processes and outcomes of GP care of children with asthma is now being measured in a randomised controlled trial.

scholarly journals Cockroach exposure and childhood asthma:  Is the effect an artifact of confounding by stress?

2020 ◽  
Author(s):  
Felicia Rabito ◽  
Derek Werthmann ◽  
Hua He ◽  
Aubrey S. Madkour ◽  
Whitney D. Arroyave ◽  
...  
Keyword(s):  
Strong Association ◽  
High Stress ◽  
Asthma Management ◽  
Stress Path ◽  
Mediation Effect ◽  
Asthma Morbidity ◽  
Modifiable Factors ◽  
Children With Asthma ◽  
Ed Visits ◽  
The Impact

Abstract Background Nonpharmacologic interventions for asthma management rely on identification and mitigation of important asthma triggers. Cockroach exposure is strongly associated with asthma morbidity. It is also associated with stress, another risk factor for asthma. Despite high prevalence of both in vulnerable populations, the impact of joint exposure has not been examined. Methods Participants included 173 children with asthma in New Orleans, Louisiana. Cockroach exposure was based on visual inspection using standard protocols. Caregiver stress was measured using Cohen’s 4-item Perceived Stress Scale. Outcomes included unscheduled clinic or emergency department (ED) visits, hospitalization, and pulmonary function. Multivariable logistic regression was performed to assess independent effects of the exposure on the outcome and effect modification was examined in stratified analysis based on stress. Path analysis to explore the mediation effect by stress was performed using a probit link with parameters based on Bayes’ method with non-informative priors. Results Adjusting for stress and other covariates, cockroach exposure was associated with unscheduled clinic/ED visits (aOR = 6.2; 95% CI 1.8, 21.7). Positive associations were also found for hospitalization and FEV1 < 80%. High stress modified the relationship with unscheduled clinic/ED visits (high aOR = 7.7 95% CI 1.0, 60.2, versus normal aOR = 4.1 95% CI 0.8, 21.9). Path models identified direct and indirect effects (p = 0.05) indicating that a majority of the total effect on unscheduled clinic/ED visits is attributed directly to cockroach exposure. Conclusion The strong association between cockroach exposure and asthma morbidity is not due to uncontrolled confounding by stress. The combination of cockroach exposure and high stress, common in urban homes, are modifiable factors associated with poor asthma outcomes.

scholarly journals Lessons from the COVID-19 pandemic for improving outpatient neuropalliative care: A qualitative study of patient and caregiver perspectives

2021 ◽  
pp. 026921632110173
Author(s):  
Zachary A Macchi ◽  
Roman Ayele ◽  
Megan Dini ◽  
Jensine Lamira ◽  
Maya Katz ◽  
...  
Keyword(s):  
Palliative Care ◽  
Qualitative Study ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Psychosocial Needs ◽  
Structured Interviews ◽  
Supportive Services ◽  
Care Needs ◽  
Survey Responses ◽  
The Impact

Background: COVID-19 has impacted persons with serious illness, including those with chronic, neurodegenerative conditions. While there are several reports on COVID-19’s impact on inpatient palliative care, literature is limited about the impact on outpatient care which may be more relevant for these patients. Aim: To generate a person-centered description of the impact of COVID-19 from the perspectives of patients living with neurodegenerative disease and caregivers to improve outpatient palliative care delivery. Design: This qualitative study used rapid analysis via matrix design to identify emergent themes related to participant perspectives on the challenges of COVID-19. Data sources included semi-structured interviews, open-ended survey responses, medical record documentation and participant-researcher communications. Setting/Participants: Data was collected from 108 patients with Parkinson’s disease, Alzheimer’s disease or related disorders and 90 caregivers enrolled in a multicenter, clinical trial of community-based, outpatient palliative care between March 20, 2020 and August 8, 2020 (NCT03076671). Results: Four main themes emerged: (1) disruptions to delivery of healthcare and other supportive services; (2) increased symptomatic and psychosocial needs; (3) increased caregiver burden; (4) limitations of telecommunications when compared to in-person contact. We observed that these themes interacted and intersected. Conclusions: Patients and caregivers have unmet care needs because of the pandemic, exacerbated by social isolation. While telemedicine has helped improve access to healthcare, patients and caregivers perceive clear limitations compared to in-person services. Changes in society and healthcare delivery in response to COVID-19 highlight ongoing and novel gaps that must be addressed to optimize future outpatient palliative care for neurologic illness.

scholarly journals A Single-Institution Experience in the Use of Chest Radiographs for Hospitalized Children Labelled as Asthma Exacerbation

2021 ◽  
Author(s):  
Ela Beyyumi ◽  
Mohamed Tawil ◽  
Huda AlDhanhani ◽  
Sara Jameel ◽  
Manal Mouhssine ◽  
...  
Keyword(s):  
Asthma Exacerbation ◽  
Asthma Management ◽  
Antibiotic Use ◽  
Chest Radiographs ◽  
Eligibility Criteria ◽  
Tertiary Center ◽  
Lower Oxygen ◽  
Children With Asthma ◽  
Model Coefficient ◽  
The Impact

Background: Risks of cancer have become more notable lately, especially for young children with a chronic condition such as atopy. This study reports on cumulative radiation from chest radiographs in children with asthma. Its main aims were to consider our current practice, and suggest minimizing chest radiograph use in this vulnerable people. Methods: The study was retrospective and conducted at tertiary center. Eligibility criteria included children 2-15 y who were admitted between January-2017 and December-2018 for asthma management. Results: Of 643 children who were admitted as ‘asthma exacerbation’, 243 (40% females; age [mean±SD] 5.4±3.3 y) met the study criteria for inclusion. Ninety-two (38%) children had temperature 38.8±0.7oC on the day of admission. Antibiotics were prescribed for 148 (61%) children, mainly for presumed pneumonia. Chest radiographs were requested for 214 (88%) children, mainly on the day of admission. Only 38 (18%) chest radiographs showed focal/multifocal pneumonia justifying antibiotic use. Significant predictors for requesting chest radiographs were antibiotic use for presumed pneumonia, lower oxygen saturation at presentation, and requesting blood culture. Rate of chest radiographs per year was negatively related to child’s age; the younger the child the higher the rate (model coefficient -0.259, P<0.001). For children <5 y, rate of chest radiographs was 1.39±1.21/y and radiation dose 0.028±0.025 mSV/y. The corresponding rates for children ≥5 y were 0.78±0.72/y and 0.008±0.007 mSV/y, respectively (P<0.001). Conclusion: Chest radiographs were commonly requested for children with asthma, especially the young ones. Prospective studies are necessary to measure the impact of this practice on their health.

scholarly journals Impact of a Diagnostic Therapeutic Educational Pathway (DTEP) Self-Management Program for Asthma Management in Preschool Children

2020 ◽  
Author(s):  
Sebastiano Guarnaccia ◽  
Cristina Quecchia ◽  
Andrea Festa ◽  
Michele Magoni ◽  
Giuseppe Zenoni ◽  
...  
Keyword(s):  
Preschool Children ◽  
Asthma Management ◽  
Population Based ◽  
Incidence Rates ◽  
Management Program ◽  
Emergency Department Visits ◽  
Outpatient Services ◽  
Older Children ◽  
Children With Asthma ◽  
The Impact

Abstract BACKGROUND: Preschool children with clinically-diagnosed asthma have a higher rate of emergency department visits and consume more resources for management than older children. However, no clinical trials have been performed measuring the impact of a combined diagnostic, therapeutic and educational pathway regimen for evaluation of wheezing control in children aged less than 6 years so far. The purpose of the present study was to assess the impact of a pediatric program developed in Italy, the Diagnostic Therapeutic Educational Pathway (DTEP), for asthma management in children less than 6 years old attending an asthma referral center.METHODS: This is a retrospective population-based cohort study performed in children with asthma aged 0-5 years, attending at “Io e l’Asma center”, Brescia, Italy between September 2007 and December 2014. The incidence rates (IRs) of hospitalization, emergency room visits, use of outpatient services and drug usage for dyspnea, wheezing, or respiratory symptoms were evaluated for time periods prior to and after DTEP intervention.RESULTS: A total of 741 patients, aged 0-5 years completed the DTEP, including 391 and 350 children aged 0-2 and 3-5 years, respectively. The percentage of children aged 0-2 and 3-5 years showing improved control of wheezing symptoms during the 1st to 3rd visit interval as a result of the DTEP intervention increased from 39.5% to 60.9% and from 25.5% to 75.5%, respectively. During these periods, the IRs showed a significant decrease for all outcomes, from-8.6% to -80.4%. Although specific IRs for drug prescriptions declined, particularly for LABA plus corticosteroids, antibiotics, and systemic corticosteroids, they increased for SABA, inhaled corticosteroid and leukotriene receptor antagonist usage.CONCLUSIONS: The results suggest that, an integrated DTEP program for preschool children not only can provide a real-world assessment for improved wheezing control, but also a measure for reduction of adverse therapeutic related outcomes.

Acceptability of Serious Games in Pediatric Asthma Education and Self-Management: Qualitative study with a consensual qualitative design (Preprint)

2021 ◽  
Author(s):  
Nicole Silva-Lavigne ◽  
Alena Valderrama ◽  
Sandra Pelaez ◽  
Myriam Bransi ◽  
Fabio Balli ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Support System ◽  
Serious Games ◽  
Self Management ◽  
Asthma Education ◽  
Asthma Knowledge ◽  
Children With Asthma ◽  
The Impact

BACKGROUND Asthma is the most common chronic pediatric disease. Despite existing tools to manage asthma, 40-55% of children with asthma suffer from uncontrolled asthma. Serious games (SGs) represent a novel approach in promoting asthma education and self-management for children. OBJECTIVE In this qualitative study with an embedded quantitative design, we used focus groups and questionnaires to describe the perceived role of SGs in different aspects of asthma self-management by children and their parents. These aspects include asthma perception and knowledge, the impact of asthma and barriers to asthma self-management, and the support system for asthma self-management. METHODS Five children with asthma and their parents were invited to participate during an organized gaming session. Children and their parents filled out a pre-gaming questionnaire on their medical history and asthma knowledge. They were then invited to test four original SGs prototypes, after which the children answered a post-gaming questionnaire on their asthma knowledge and perception of the SGs. Children and their parents subsequently participated in parallel focus groups which were video- and/or audio-recorded, transcribed verbatim, and analyzed by reaching consensus among members of the research team. RESULTS The mean age of the children was 10.3 year, with 20% being male. Qualitative data from the transcripts were coded into three separate domains: 1) asthma self-management perception and knowledge, 2) impact of asthma and barriers to asthma self-management, and 3) support system for asthma self-management. We specifically explored the perceived roles of SGs within each of these domains. A key takeaway message was identified for each of these three domains: 1) Heterogeneity of asthma knowledge and the ability of SGs to encourage knowledge transfer through games, 2) Consequences and limitations of asthma and the ability of SGs to allow for identification and management of real-life situations through games, and 3) Insufficient support system and the ability of SGs to encourage playing with others for support and shared knowledge. CONCLUSIONS Our study explored the role of SGs in the self-management of asthma as perceived by children and their parents. Our findings support the acceptability of SGs in asthma education and self-management in pediatrics and the necessity for future development in this field.

Schools’ Capacity to Help Low-Income, Minority Children to Manage Asthma

2005 ◽  
Vol 21 (4) ◽  
pp. 236-242 ◽  
Author(s):  
Elizabeth W. Anderson ◽  
Melissa Valerio ◽  
Manlan Liu ◽  
Dana Jones Benet ◽  
Christine Joseph ◽  
...  
Keyword(s):  
Low Income ◽  
Asthma Management ◽  
School Personnel ◽  
Asthma Prevalence ◽  
Health Providers ◽  
Minority Children ◽  
Parents And Children ◽  
Nursing Services ◽  
Children With Asthma ◽  
The Impact

This article describes the challenges and strengths of asthma management in 14 low-income, predominantly African American urban elementary schools serving more than 5,000 students. Asthma prevalence was 24.5%. Teachers, school principals, parents, and children described how asthma was managed at school. Data from classmates of students with asthma showed that they had moderate to high levels of information about the disease. Data from teachers indicated the great need for practical instruction on how they might effectively support a child with asthma in the classroom and on the playground. Principals raised concerns about expectations for the functioning of school staff and implementation of school policies especially related to asthma emergencies. Parents reported a range of problems their children face at school. Data from children with asthma showed that 75% believed asthma affected their schoolwork. Findings from this study should be useful to school personnel, health providers, and others who assist children and their families to manage asthma at school. Data suggest that making school nursing services available is warranted, given the impact of asthma on the school community.

scholarly journals Child and caregiver experiences and perceptions of asthma self-management

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Lauren Kelada ◽  
Charlotte J. Molloy ◽  
Peter Hibbert ◽  
Louise K. Wiles ◽  
Claire Gardner ◽  
...  
Keyword(s):  
Focus Groups ◽  
Asthma Management ◽  
Self Management ◽  
Emotional Wellbeing ◽  
Social And Emotional ◽  
Asthma Knowledge ◽  
School Aged Children ◽  
Management Interventions ◽  
Children With Asthma ◽  
The Impact

AbstractAsthma is the most common chronic condition of childhood. Self-management is integral to good asthma control. This qualitative paper explores how children with asthma and their parents perceive asthma, their experience with asthma, and how they manage symptoms, preventions and medications within and outside the home. We undertook 15 focus groups with 41 school-aged (6–11 years) children with asthma and 38 parents. Parents and their children attended the same focus groups. We used thematic analysis to analyse the transcripts. Our findings show the impact asthma can have on children’s social and emotional wellbeing and highlight how reliant school-aged children are on their parents to effectively manage their asthma. Parents reported being unsure when their child’s symptoms warranted visiting their doctor or hospital. Schools were identified as a source of difficulty regarding asthma management; families reported that children may be self-conscious about their asthma and using their inhaler at school. School policies and teachers’ lack of asthma knowledge were reported to exacerbate children’s reluctance to use their inhaler at school. Our results have implications for the design and implementation of children’s self-management interventions for their asthma, particularly when they are at school and away from their parents.

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