Establishment and evaluation of a preschool asthma programme: a pilot study.

In New Zealand asthma has been recognised as a major health issue for preschool children and their families (Public Health Commission, 1995). While nurses have been involved with Asthma Self management programmes which have improved the outcomes for older children and adults (Garret, Kolbe, Richards, Whitlock & Rea, 1995: Mitchell, Ferguson & Norwood, 1986) self management programmes have rarely been used for preschool children. The aims of the study were to establish a Preschool Asthma Programme and evaluate whether it would enable parents and their children to increase their knowledge, confidence and skills in asthma management, while improving asthma control. Fifteen families with children aged between three and a half and five years with moderate and severe asthma participated; five families in each of the three programmes offered. The programmes were evaluated using both formative and outcome evaluation. Results indicated that the programme increased knowledge and changes in asthma management by parents and children and increased the confidence of parents in both their own ability, and that of their child, to manage asthma. Seven parents and seven children on the programme achieved positive change in all the self management criteria considered and six parents and two children made changes in most of them. Participation in the programme was associated with improved lung function, asthma control and preschool attendance. The programme was more successful if the child was over four years old and had suboptimal asthma control. It is concluded that, contrary to what has previously been thought, preschool children can be taught self management skills. There is evidence that a Preschool Asthma Programme is a useful addition to the conventional management and can result in improvements in asthma management.