Integrative Review of Programs to Improve Outcomes for Children With Comorbid Asthma and Anxiety/Depressive Symptoms

Asthma is one of the most common pediatric chronic physical conditions. Youth with comorbid asthma and anxiety/depressive symptoms tend to have less controlled asthma and an increased use of health services in schools. The purpose of this integrative review was to examine the literature on educational and behavioral/ cognitive behavioral skills interventions for children with asthma and anxiety/depressive symptoms. Five electronic databases and forward/backward citations were searched. Eleven peer reviewed articles were retained for review. Main findings of the limited evidence suggest that educational and behavioral/cognitive behavioral skills programs may increase asthma knowledge and asthma-related self-efficacy while reducing anxiety/depressive symptoms. One study showed a decrease in use of quick relief inhalers and another had increased adherence to asthma controller medication. The literature indicates that educational and cognitive behavioral skills programs can have a positive impact on children with asthma and symptoms of anxiety/depression. School-based skills programs had better retention than outpatient programs.

Literature Review : Hubungan Tingkat Kontrol Asma Dengan Kualitas Hidup Penderita Asma

Knowledge is the result of knowing someone by sensing certain objects, sensing can occur through the five human sense, namely the senses of sight, hearing, smell, taste, and touch. Good knowledge can couse good preventive behaviors. Early prevention is the only thing that can be done to avoid the recurrebce of asthma. The prevention is done to minimize the risk of asthma attacks. This literature review aimed to determine the correlation between knowledge about asthma and the prevention of recurrence of asthma. This literature Review accessed PUBMED by combining the keywords “Knowledge” and “Prevention Asthma”. Participants in this study were patients with asthma who had a P-Value of 0,000. The Results showed that there was a correlation between knowledge about asthma and efforts to prevent the recurrence of asthma. This study is expected to be a reference for hospitals or health centers to increase educational activities and knowledge about asthma.Keyword: Asthma Knowledge, Asthma Prevention AbstrakTingkat kontrol asma merupakan suatu tingkatan pengamatan manifestasi asma pada penderita asma atau berkurangnya maupun menghilangnya penyakit asma melalui pengobatan. Tingkat kontrol asma terbagi atas terkontrol penuh, terkontrol sebagian, dan tidak terkontrol. Pengklasifikasian tersebut memudahkan dalam mengetahui derajat berat dan ringannya penyakit asma serta untuk mengetahui respon terapi. Penyakit asma memberikan dampak negatif terhadap kualitas hidup penderita asma. Dampak negatif yang ditimbulkan antara lain terganggunya aktivitas sehari-hari, tidak dapat mengikuti pelajaran sekolah, tidak kuat untuk melakukan kegiatan olahraga, dan hilangnya hari kerja bagi penderita asma yang bekerja di kantor. Kontrol asma berhubungan dengan kualitas hidup. Semakin buruk kontrol asma, maka kualitas hidup akan semakin menurun. Literature Riview ini bertujuan untuk Mengetahui hubungan tingkat kontrol asma dengan kualitas hidup pasien asma. Literature review dilakukan dengan menggunakan artikel yang bersumber dari database online yaitu PubMed, Garuda dan Google Scholar dengan kata kunci “Asthma AND Asthma control level”, “Quality of life”, “Tingkat kontrol asma”, dan “Kualitas hidup” dengan batasan 5 tahun terakhir. Hasil penelitian ini menunjukan bahwa ada hubungan tingkat kontrol asma dengan kualitas hidup penderita asma. Tingkat kontrol asma salah satu faktor yang mempengaruhi kualitas hidup pasien asma.Kata Kunci: Asma, Tingkat kontrol asma, Kualitas hidup.

Literature Review : Hubungan Pengetahuan Asma dengan Upaya Pencegahan Kekambuhan pada Penderita Asma

Knowledge is the result of knowing someone by sensing certain objects, sensing can occur through the five human sense, namely the senses of sight, hearing, smell, taste, and touch. Good knowledge can couse good preventive behaviors. Early prevention is the only thing that can be done to avoid the recurrebce of asthma. The prevention is done to minimize the risk of asthma attacks. This literature review aimed to determine the correlation between knowledge about asthma and the prevention of recurrence of asthma. This literature Review accessed PUBMED by combining the keywords “Knowledge” and “Prevention Asthma”. Participants in this study were patients with asthma who had a P-Value of 0,000. The Results showed that there was a correlation between knowledge about asthma and efforts to prevent the recurrence of asthma. This study is expected to be a reference for hospitals or health centers to increase educational activities and knowledge about asthma.Keyword: Asthma Knowledge, Asthma Prevention AbstrakPengetahuan merupakan hasil dari tahu seseorang dengan cara melakukan penginderaan terhadap obyek tertentu, penginderaan dapat terjadi melalui panca indra manusia yaitu dengan indra penglihatan, pendengaran, penciuman, rasa dan raba. Pengetahuan yang baik maka perilaku pencegahan juga akan baik. Pencegahan sejak dini merupakan satu-satunya hal yang bisa dilakukan untuk menghindari terjadinya penyakit asma, pencegahan dilakukan untuk memperkecil risiko terjadinya serangan asma. Literature Riview ini bertujuan untuk Mengetahui hubungan pengetahuan tentang asma dengan upaya pencegahan kekambuhan pada penderita asma. Literature Review ini mengakses database melalui PUBMED dengan mengkombinasikan kata kunci ‘’Knowledge’’ AND ‘’Prevention Asthma’’. Partisipan pada studi ini adalah pasien dengan penderita asma yang didapatkan P-Value 0,000, diperoleh dengan menggunakan metode melalui cross sectional. Hasil Literature Review ini menunjukkan bahwa adanya hubungan pengetahuan tentang penyakit asma dengan upaya pencegahan kekambuhan penderita asma.Studi ini diharapkan dapat menjadi referensi pihak Rumah Sakit atau Puskesmas untuk meningkatkan kegiatan terhadap pendidikan serta pengetahuan tentang penyakit asma.Kata Kunci: Pengetahuan Asma, Pencegahan Asma

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

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.

Child and caregiver experiences and perceptions of asthma self-management

Asthma 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.

Evaluation of a Community Pharmacist Managed Asthma Consultation Service

Background: Asthma is one of the most common chronic health conditions, affecting 900,000 Ontarians and 2.4 million Canadians. Research evidence indicates that pharmacists can play a critical role in the management of asthma yet there is a paucity of studies which focus on community-based pharmacist asthma interventions on adults in Ontario, Canada. Purpose: The aim of this study is to evaluate an asthma-specific pharmacist-led intervention over a 12-month period in relation to patient health outcomes and patient satisfaction. Methods: This prospective cluster randomized controlled study required trained intervention pharmacists to identify asthma patients, deliver medication reviews and educate patients in order to improve asthma measures. The validated measures selected for the study were adherence to medication, asthma knowledge and peak expiratory flow rate. 12 pharmacies in and around Toronto, Ontario were recruited. Results: A total of 81 patients were identified by pharmacists as potential participants over the course of the program. Of these, 19 consented to participate and 14 completed the program. The intervention group saw a statistically significant improvement of asthma knowledge scores (p=0.02). In both groups, all patients had improved medical adherence scores after completion of the program. Diurnal variation between control and intervention groups was found to be significantly different. Control patients had significantly more days of high variability than the intervention group. Conclusion: The implementation of a pharmacist-provided comprehensive education program in a community pharmacy setting had a positive impact on patients’ diurnal variation, asthma related knowledge and adherence to medication. While the target sample size was not achieved and results cannot be generalized, this study is an important step towards understanding the benefits of a pharmacist-delivered intervention in asthma management.

Evaluation of a Community Pharmacist Managed Asthma Consultation Service

Background: Asthma is one of the most common chronic health conditions, affecting 900,000 Ontarians and 2.4 million Canadians. Research evidence indicates that pharmacists can play a critical role in the management of asthma yet there is a paucity of studies which focus on community-based pharmacist asthma interventions on adults in Ontario, Canada. Purpose: The aim of this study is to evaluate an asthma-specific pharmacist-led intervention over a 12-month period in relation to patient health outcomes and patient satisfaction. Methods: This prospective cluster randomized controlled study required trained intervention pharmacists to identify asthma patients, deliver medication reviews and educate patients in order to improve asthma measures. The validated measures selected for the study were adherence to medication, asthma knowledge and peak expiratory flow rate. 12 pharmacies in and around Toronto, Ontario were recruited. Results: A total of 81 patients were identified by pharmacists as potential participants over the course of the program. Of these, 19 consented to participate and 14 completed the program. The intervention group saw a statistically significant improvement of asthma knowledge scores (p=0.02). In both groups, all patients had improved medical adherence scores after completion of the program. Diurnal variation between control and intervention groups was found to be significantly different. Control patients had significantly more days of high variability than the intervention group. Conclusion: The implementation of a pharmacist-provided comprehensive education program in a community pharmacy setting had a positive impact on patients’ diurnal variation, asthma related knowledge and adherence to medication. While the target sample size was not achieved and results cannot be generalized, this study is an important step towards understanding the benefits of a pharmacist-delivered intervention in asthma management.