Effect of intervention on the use of Metered Dose Inhaler amongst the children suffering with asthma and their caregivers

Abstract

Background: Asthma is one of the most common worldwide chronic conditions and is considered a major health problem in children. Limited knowledge and poor management skills regarding use of MDI identified as the major reasons for the high morbidity and mortality. Objective: To develop skill in use of MDI among the children suffering with asthma and their caregivers. Design: Operational study Setting: Asthma clinic, Advanced Pediatrics Centre, PGIMER, Chandigarh. Participants/ Patients: By using Purposive sampling technique 100 diagnosed children with bronchial asthma between age group of 3-14 yrs were enrolled in the study. The tools used for data collection were semistructured interview schedule to gather the information regarding socio-demographic profile of the subjects, knowledge, performance and practice of using the MDI. A protocol regarding right technique of using inhaler was developed in Hindi and English. An observation checklist was used to observe the steps/ technique of using MDI by the subjects. Material and Methods: Each subject was interviewed personally. After assessing the baseline performance scores, the right technique of using MDI was demonstrated. The demonstrations were repeated until the children and caregivers developed proficiency. Power point presentation was also prepared and showed to all subjects. Booklet was given to each subject. All the subjects were asked to come for the follow up after fifteen days interval. Skill of using MDI was assessed in three subsequently follow up visits by using follow up data sheet. Maximum attainable score was 14 for using inhaler without spacer & 15 score for using inhaler with spacer. Result: Mean age of the subjects was 7.6± 0.6 yrs with the range of 3-14 yrs. 56% subjects were in the age group of 6-10 yrs. Out of total subjects, 86% were using inhaler. Out of them, 3.4% achieved very low scores, 65.3% were at low scores and 31.3% were attained average scores. Whereas 14 subjects were using inhaler without spacer. Out of them, 92.9% were at low and 7.1% subjects attained average score. None of the subject in both the groups was at the good or excellent score. Baseline mean performance score of all the subjects was 6.81±1.1 which increased to 11.39±1.03, 12.60±1.14 and 13.98±.09 subsequently in first, second and third follow up respectively. Conclusion: Repeated demonstrations regarding use of MDI are required to make the person skillful and proficient.