Medical management of asthma and folk medicine in a Hispanic community.

OBJECTIVE: To describe beliefs about asthma and asthma treatment in a Hispanic (Dominican-American) community to determine how alternative belief systems affect compliance with medical regimens. METHOD: Twenty-five mothers of children with asthma were interviewed in their homes, in their primary language, Spanish. Mothers were questioned about their beliefs regarding asthma etiology, treatment, prevention of acute episodes, and use of prescribed medications. RESULTS: Most mothers (72%) said that they did not use prescribed medicines for the prevention of asthma; instead, they substituted folk remedies called "zumos." The home remedies were derived from their folk beliefs about health and illness. Most mothers (60%) thought that their child did not have asthma in the absence of an acute episode. Eighty-eight percent said that medications are overused in this country and that physicians hide therapeutic information from them. CONCLUSIONS: Mothers' reliance on home remedies for asthma prevention leads to a high rate of noncompliance with prescribed regimens. Yet they perceive themselves as compliant with an effective regimen that differs from standard medical practice. Further studies should explore ways of promoting physician/patient communication in order to find ways of coordinating medical and folk beliefs to enhance compliance with medically prescribed regimens.

Development and evaluation of an interactive CD-ROM for children with leukemia and their families.

To meet the need for an interactive software product to educate children with leukemia, ages 4-11 years, and their families about the disease and its treatment, we developed and evaluated an interactive, comprehensive, multimedia CD-ROM product, Kidz with Leukemia: A Space Adventure. The prototype was tested using a randomized controlled experimental design. Children with leukemia and their parents were randomized to receive either the newly developed CD-ROM or the book You and Leukemia by Lynn Baker. Health care providers (HCPs) and other content/technical experts evaluated only the CD-ROM. Data were collected on children's health locus of control, their understanding of leukemia, and the satisfaction of participants with their assigned intervention. Children in the CD-ROM group, compared with those in the book group, showed increased feelings of control over their health. Although there was a high level of satisfaction with the CD-ROM among all users, younger children and their parents were most satisfied. In conclusion, the CD-ROM, Kidz with Leukemia: A Space Adventure, was found to be a useful, engaging, and empowering tool for children with leukemia and can serve as a model for developing future health-related educational materials.

The impact of a computer network on pediatric pain and anxiety: a randomized controlled clinical trial.

This was the third randomized controlled clinical trial (RCCT) of Starbright World (SBW)--a private, interactive computer network for hospitalized children. The present randomized controlled clinical trial (RCCT) consisted of a series of 39 replicated single system designs (SSDs) that compared children's self-reports of pain intensity, pain aversiveness and anxiety in the SBW condition with those in a stan- dard clinical practice condition. Findings from the SSDs were aggregated using meta-analysis. Although children experienced slightly less pain intensity, pain aversiveness, and anxiety in the SBW condition, these results did not achieve statistical significance. The relationship of these findings to the two prior studies of the effectiveness of SBW is discussed.