A preliminary study to evaluate a patient-centred asthma education programme on parental control of home environment and asthma signs and symptoms in children with moderate-to-severe asthma.

AIMS AND OBJECTIVES: To evaluate the effectiveness of a nurse-led patient-centred asthma education programme on home environmental control behaviours of parents of children with moderate or severe asthma. BACKGROUND: Reducing allergic triggers is important self-management behaviour for preventing asthma attacks and patient-centred asthma education has been shown to effectively manage chronic disease. DESIGN: A preliminary quasi-experimental, non-equivalent control group design was used. METHOD: Dyads (n = 75) of parents and their children with moderate or severe asthma (ages 6-14 years) were purposively recruited from the asthma clinics of two hospitals in central Taiwan. The experimental group of 38 children/parents from one hospital received patient-centred asthma education. The comparison group of 37 children/parents from the other hospital received routine individual education. At pretest and at the end of the three-month patient-centred asthma education programme, we measured parents' control of home environmental triggers, children's asthma signs/symptoms and children's pulmonary function. Data were analysed by the general linear model for repeat measures. RESULTS: The level of improvement in dust and cleaning methods was significantly greater among parents in the experimental group than among those in the comparison group (p < 0.05). Children with moderate or severe asthma in the experimental group had fewer signs/symptoms of asthma and better lung function than children in the comparison group. CONCLUSIONS: Our patient-centred asthma education programme improved parents' home environmental control and children's asthma sign/symptoms and lung function. RELEVANCE TO CLINICAL PRACTICE: Nurses can play primary roles as patient educators in asthma clinics. Well-trained patient educators can continuously monitor self-management behaviours to improve patients' compliance with home environmental control, thus leading to better physical outcomes in children with asthma than routine individual asthma education alone.

[Developing a hospital-based asthma case management program].

The case management model, on the basis of current trends, is likely to be the main model for caring for chronic disease in the future. Since 2001, asthma care has been covered under chronic disease-management by Taiwan's Health Insurance Bureau. But there is no report describing a hospital-based asthma case management program. The purposes of this essay were to develop a hospital-based asthma case management model and introduce the procedures for this model: recruitment, monitoring, implementation, evaluation and follow-up. This model can be used as the standard case management model for caring for children with chronic asthma.