Jianli Chen1, Yongmin Chen2. 1. Department of Pediatrics, Huzhou Central Hospital, Affiliated Hospital of Huzhou Normal University Huzhou, Zhejiang Province, China. 2. Department of Internal Medicine, Huzhou Hospital of Traditional Chinese Medicine Affiliated Zhejiang University of Traditional Chinese Medicine Huzhou, Zhejiang Province, China.
Abstract
OBJECTIVE: To explore the effects of a nurse-led hierarchical management model for managing the out-of-hospital asthma control and quality of life in children with bronchial asthma. METHODS: A prospective randomized controlled study was designed. Children with bronchial asthma treated in our hospital were recruited as the study cohort and randomly divided into a test group (n=60) and a control group (n=60). After their discharge from the hospital, the children with bronchial asthma in both groups underwent out-of-hospital management led by nurses. In addition to this management, the test group underwent hierarchical management according to the results of their social living ability and temperament type evaluations. The levels of control of the asthma within 6 months after discharge were compared between the two groups. The changes in the asthma control test (ACT) scores, the daily variation rates in the peak expiratory flows (PEF), the pulmonary functions, the changes in the airway inflammation indicators, and the two groups' quality of life were compared. In addition, univariate and multivariate logistic regressions were used to analyze the factors influencing the acute asthma attacks in children. RESULTS: Compared with the control group, the number of acute asthma attacks, the emergency medical treatment and hospitalization rates in children with acute asthma attacks within 6 months were significantly decreased in the test group (P<;0.05). After 3 and 6 months of the nursing, the test group had better ACT scores, better daily PEF variation rates, better pulmonary function, better serum inflammatory factors, better Medication Adherence Report Scale for Asthma (MARS-A) scores, and better pediatric asthma quality of life questionnaire (PAQLQ) scores than the control group (all P<;0.05). A multivariate logistic regression analysis showed that acute asthma attacks in childhood asthma were associated with the age of the first attack ≤f years (OR=3.635), a family history of rhinitis/asthma (OR=1.425), poor medication adherence (OR=1.855), the baseline IgE level (OR=1.305), and the hierarchical nursing management (OR=0.593). CONCLUSIONS: A nurse-led hierarchical management model can effectively improve the level of out-of-hospital asthma control in children with bronchial asthma and can improve their pulmonary function and quality of life as well. AJTR
RCT Entities:
OBJECTIVE: To explore the effects of a nurse-led hierarchical management model for managing the out-of-hospital asthma control and quality of life in children with bronchial asthma. METHODS: A prospective randomized controlled study was designed. Children with bronchial asthma treated in our hospital were recruited as the study cohort and randomly divided into a test group (n=60) and a control group (n=60). After their discharge from the hospital, the children with bronchial asthma in both groups underwent out-of-hospital management led by nurses. In addition to this management, the test group underwent hierarchical management according to the results of their social living ability and temperament type evaluations. The levels of control of the asthma within 6 months after discharge were compared between the two groups. The changes in the asthma control test (ACT) scores, the daily variation rates in the peak expiratory flows (PEF), the pulmonary functions, the changes in the airway inflammation indicators, and the two groups' quality of life were compared. In addition, univariate and multivariate logistic regressions were used to analyze the factors influencing the acute asthma attacks in children. RESULTS: Compared with the control group, the number of acute asthma attacks, the emergency medical treatment and hospitalization rates in children with acute asthma attacks within 6 months were significantly decreased in the test group (P<;0.05). After 3 and 6 months of the nursing, the test group had better ACT scores, better daily PEF variation rates, better pulmonary function, better serum inflammatory factors, better Medication Adherence Report Scale for Asthma (MARS-A) scores, and better pediatric asthma quality of life questionnaire (PAQLQ) scores than the control group (all P<;0.05). A multivariate logistic regression analysis showed that acute asthma attacks in childhood asthma were associated with the age of the first attack ≤f years (OR=3.635), a family history of rhinitis/asthma (OR=1.425), poor medication adherence (OR=1.855), the baseline IgE level (OR=1.305), and the hierarchical nursing management (OR=0.593). CONCLUSIONS: A nurse-led hierarchical management model can effectively improve the level of out-of-hospital asthma control in children with bronchial asthma and can improve their pulmonary function and quality of life as well. AJTR
Authors: Daiane de Oliveira Santos; Maria Cleusa Martins; Sonia Lucena Cipriano; Regina Maria Carvalho Pinto; Alberto Cukier; Rafael Stelmach Journal: J Bras Pneumol Date: 2010 Jan-Feb Impact factor: 2.624
Authors: Amy Vaughan Van Hecke; Peter C Mundy; C Françoise Acra; Jessica J Block; Christine E F Delgado; Meaghan V Parlade; Jessica A Meyer; A Rebecca Neal; Yuly B Pomares Journal: Child Dev Date: 2007 Jan-Feb