Caregivers Of Asthmatic Children Research Articles

Childhood Asthma-Management Practices in Rural Nigeria: Exploring the Knowledge, Attitude, and Practice of Caregivers in Oyo State.

Background: Caregivers of asthmatic children have a poor knowledge of proper asthma-management practices in Nigeria. This study examined the knowledge, attitudes, and practice behaviors of caregivers in the management of asthma in children under 5 years of age in Oyo State, Nigeria. Methods: While a mixed method was used in the original research, this brief describes the quantitative method used in this study to evaluate caregivers' asthma-management practices. A 55-item questionnaire on childhood asthma knowledge, attitude, and practice was administered during child welfare-clinic visits to 118 caregivers. Data were analyzed using the IBM SPSS Version 25.0. Statistical significance was set at p < 0.05 and 95% CI. Result: More than 70% of caregivers knew that asthma is associated with airway inflammation and about 90% knew that flu infections triggered asthma attacks in their children. Caregivers with a higher income (OR = 3.0; 95% CI = 1.558-5.778; p = 0.001) were 3.0 times more likely to practice proper asthma-care behavior than those with a lesser income. Conclusions: Childhood asthma remains underdiagnosed and undertreated in Nigeria. An optimal public health approach is needed to identify and target underserved communities that suffer poorer asthma outcomes and to improve caregivers' knowledge and practices of asthma management.

Influenza vaccination among caregivers and household contacts of children with asthma

Data on influenza vaccination status among household contacts of asthmatic children are lacking. Our aim was to assess the influenza vaccination status of parents and caregivers of asthmatic children in the 2018–2019 season as well as to identify reasons for undervaccination. We performed a questionnaire-based survey in parents, caregivers and household contacts of 178 asthmatic children. Only the 50.6% of children were vaccinated, while in 79.8% of cases both parents were unvaccinated. More than 40% of them reported that they were unaware about the necessity of vaccination; approximately 30% stated that they were not properly advised, and the rest were concerned about influenza vaccine side effects and effectiveness. Factor analysis identified three groups: (a) influenza vaccine “believers” who were unaware that vaccination was necessary; (b) “deniers” who were less educated and with older children; (c) older and more educated vaccine “deniers”. To improve influenza vaccine coverage among household contacts of asthmatic children, appropriate counseling and targeted interventions should be planned.

Relationship between pediatric asthma and psychosocial status of caregivers

ObjectiveTo determine the relationship between psychosocial caregiver disorders and childhood asthma. Study designWe performed a matched case–control study with asthmatic children (6-14 years of age) from two different clinics in Zaragoza, Spain, between 2010 - 2016. Clinical data were collected from medical records and psychosocial disorders were assessed by interviewing the caregiver using validated questionnaires (Goldberg, CES-D, SF-12, PSS and SPIN). General analysis of cases and controls was performed using McNemar, Chi2 and Wilcoxon nonparametric tests. A logistic regression model to predict more severe asthma, adjusted by caregiver psychosocial disorders was performed. Results208 children were evaluated (104 cases). Mean age was 9.7 ± 2.4 years, with a male predominance (62.5%). Anxiety, social phobia, depression, acute and chronic psychological disorders, and poor quality of life related to mental health were significantly more prevalent in caregivers of asthmatic children (p<0.05). On multivariate analysis, all of the above disorders significantly increased the risk of uncontrolled asthma, where anxiety, acute psychological disorders, and chronic psychological disorders were the most significant (OR 8.54, 95%CI 3.46-21.05, p<0.001; OR 6.05, 95%CI 2.39-15.28, p<0.001; and OR 4.86, 95%CI 1.97-12.02, p=0.001, respectively). ConclusionThe prevalence of psychosocial disorders in caregivers of asthmatic children is high, when compared to caregivers of healthy children. The presence of anxiety, social phobia, depression, and poor quality of life is associated with an increased risk of worse controlled asthma. Perhaps, early detection and treatment of these disorders could positively impact childhood asthma control.

Variations and Misconceptions of Asthma Terminology, Triggers and Therapy among the Caregivers of Asthmatic Children in Makkah, Saudi Arabia

Asthma is the most common chronic disease of childhood leading to an ongoing burden on the emergency departments all around the world. The present study was conducted with the aim to assess the awareness and misconceptions related to the terminology, triggers and management among the caregivers of asthmatic children in Makkah, Saudi Arabia. An observational cross-sectional study was conducted among the asthmatic children above 6 months of age at the Maternity and Children’s Hospital in Makkah, Saudi Arabia during the period between March 2018 and July 2018. Data were collected by a structured questionnaire that includes demographic data, knowledge and awareness of the terminology, severity, triggers, follow-up and management of the disease with a focus on Metered-Dose Inhalers (MDIs), nebulizer therapy and Inhaled Cortico-Steroids (ICS). A total 242 children were included in the study 64.5% were males, 35.5% were females. A majority (71.5%) of caregivers believed that nebulizers are more effective than MDIs to treat their children. Among the 242 children, 47.1% use spacer devices regularly and only 40.5% of them have used ICS. The main reason for not using steroid inhalers and spacer devices as stated by most caregivers (68% and 49.3% respectively). was “never recommended by physicians”. 73.1% of the children had no Asthma follow up outside the ED. 73.7% of caregivers who reported having a smoker in their homes did not know the harmful effects of smoking on their children. Many misconceptions about the terminologies, triggers, the nature of the ED medications and outpatient treatment were found among the caregivers of the children included in the study. Physicians poor adherence to current asthma treatment guidelines and the lack of well structured follow up and educational programs may be contributing to the caregivers inconsistencies with outpatient treatment and follow up.

Effectiveness of providing health education to caregivers of hospitalized children with asthma for the prevention of recurrent attacks: a quasi-randomized trial

Objective: To determine the effectiveness of health education intervention for caregivers of children with asthma, focused on preventing recurrent attacks and improving knowledge.Methods: A quasi-randomized trial of 177 caregivers of asthmatic children was conducted in government hospitals in a district of Sri Lanka. At the time of discharge from the hospital, a health education booklet was prepared and given to the caregivers in the intervention group, along with individual explanation and discussion. The caregivers’ knowledge of asthma and preventive practices was assessed. The primary outcome was the proportion of children with recurrent attacks of asthma who needed doctor visits during the three month post discharge period. The intention-to-treat principle was applied for data analysis.Results: In comparison to the control group, the intervention group had a 76% significant reduction in visits to the doctor for recurrent attacks (95% CI:45%-90%) and a 75% significant reduction in hospital admissions required for asthmatic children (95% CI:16%-93%) at the end of three months of intervention. The mean score of knowledge of asthma in the intervention group was 1.73 units higher at three months (p < 0.01) and 1.47 units higher at six months (p < 0.01) than the control group. The mean score of preventive practices for asthma in the intervention group was 1.25 units higher at three months (p = 0.02) and 1.15 units higher at six months (p < 0.01) versus the control group.Conclusion: Health education intervention significantly decreased doctor and hospital visits at three months. In addition, caregiver knowledge of asthma and preventive practices also improved.Trial Registration Number: SLCTR/2010/007

Assessment of caregivers' knowledge and behavior in the management of pediatric asthma in Jazan, Saudi Arabia

Objectives: The knowledge and behavior of caregivers are playing a significant role in preventing and managing the emergency conditions of disease or disorder suffered by their children. Pediatric asthma is one such severe health disorder, which cripples the child from regular activities and exerts enormous stress on parents if not appropriately managed with adequate knowledge and skills in the initial stage of onset. This research paper, thus, is aimed to appraise the caregivers' knowledge and behavior (n = 250) of asthmatic children admitted to general hospitals in Jazan province, Kingdom of Saudi Arabia, about the cause, prognosis, and therapy of asthma in preventing and handling emergency asthmatic attacks in their children. Materials and Methods: Caregivers were interviewed with the help of a questionnaire (35 items) about pediatric asthma. The questionnaire was adapted from the Chicago Community Asthma Survey. Results: The results revealed that information regarding complications of pediatric asthma, behavioral skills, and knowledge on its management that are required to practice during an emergency was very little among the caregivers of asthmatic children. Lack of proper education, insufficient knowledge of asthma, underprivileged socioeconomic class, and substandard living conditions came out as reasons for poor knowledge and behavior among them. Conclusion: The study recommends that there is an urgent and pressing need to educate caregivers and provide continuous training on the right practice during asthma attacks to take proper and efficient care of their children.

Understanding the Cognitive and Affective Mechanisms that Underlie Proxy Risk Perceptions among Caregivers of Asthmatic Children.

Medical decisions made on behalf of another person-particularly those made by adult caregivers for their minor children-are often informed by the decision maker's beliefs about the treatment's risks and benefits. However, we know little about the cognitive and affective mechanisms influencing such "proxy" risk perceptions and about how proxy risk perceptions are related to prominent judgment phenomena. Adult caregivers of minor children with asthma ( N = 132) completed an online, cross-sectional survey assessing 1) cognitions and affects that form the basis of the availability, representativeness, and affect heuristics; 2) endorsement of the absent-exempt and the better-than-average effect; and 3) proxy perceived risk and unrealistic comparative optimism of an asthma exacerbation. We used the Pediatric Asthma Control and Communication Instrument (PACCI) to assess asthma severity. Respondents with higher scores on availability, representativeness, and negative affect indicated higher proxy risk perceptions and (for representativeness only) lower unrealistic optimism, irrespective of asthma severity. Conversely, respondents who showed a stronger display of the better-than-average effect indicated lower proxy risk perceptions but did not differ in unrealistic optimism. The absent-exempt effect was unrelated to proxy risk perceptions and unrealistic optimism. Heuristic judgment processes appear to contribute to caregivers' proxy risk perceptions of their child's asthma exacerbation risk. Moreover, the display of other, possibly erroneous, judgment phenomena is associated with lower caregiver risk perceptions. Designing interventions that target these mechanisms may help caregivers work with their children to reduce exacerbation risk.

Family caregivers' reported nonadherence to the controller medication of asthma in children in Casablanca (Morocco): Extent and associated factors

ABSTRACTObjective: Recent statistics show a relatively high prevalence of asthma among Moroccan children and a weak control over their symptoms. To our knowledge, no research has been carried out to document adherence to the controller treatment in this population. This study aims 1) to assess the extent of children's nonadherence to the controller treatment of asthma in an urban region of Morocco as reported by a family caregiver, and 2) to identify the associated factors. Methods: We conducted a cross-sectional study among caregivers of asthmatic children (2–12 years old) in different health and education facilities of Casablanca-Settat. We administered face-to-face questionnaires incorporating validated instruments (Medication Adherence Rating Scale-Asthma (MARS-A), Beliefs about Medicines Questionnaire (BMQ), Asthma Knowledge Questionnaire). Univariate and multivariate log-binomial regressions evaluating the association between several factors and reported nonadherence were performed (prevalence ratios (PR) and 95% confidence intervals (CI)). Results: Through two public hospitals, three private medical clinics, and one private school, 103 caregivers were recruited. Low adherence to the controller treatment of asthma was reported by 48% of the caregivers (MARS-A <45). In the multivariate model, caregivers with the lowest level of knowledge about asthma were almost three times more likely to report low adherence compared to caregivers with the highest level (PR = 2.93; 95% CI: 1.14–7.52). Conclusions: This study highlights the finding that low adherence is widespread in this context and also the importance of targeting caregivers' knowledge of asthma for interventions.

Corticosteroid phobia among parents of asthmatic children.

Özçeker D, Uçkun U, İslamova D, Tamay Z, Güler N. Corticosteroid phobia among parents of asthmatic children. Turk J Pediatr 2018; 60: 142-146. Asthma is one of the most prevalent chronic diseases among children. Its prevalence and morbidity have been rising in recent decades. Pediatric asthma causes a significant burden on families; allergen-avoidance measures, uncontrolled disease, and disease severity which are the major cost predictors of childhood asthma in Turkey. Inhaled corticosteroids (ICS) are considered as cornerstone medications in asthma management which reduce asthma morbidity and mortality. Our aim was to address corticosteroid phobia in caregivers of asthmatic children and its impact on asthma management. Five hundred caregivers of asthmatic children were interviewed using structured questionnaire in this study. Over fifty percent of the caregivers (56.8%), most of whom (82.6%) are already aware of using corticosteroids in their anti-asthma drug regimen, mentioned that they are afraid of using them. Almost one fourth of caregivers (24.8%) made either some changes in their treatment regimen or stopped using the drugs due to corticophobia. Of the caregivers 55.2% had no idea about the side effects of corticosteroids and only 12.6% of them mentioned that they were informed by their physicians about the effects of corticosteroids. Any change in asthma treatment regimen due to corticophobia was found to be related with poor asthma control level (p: 0.004). The impact of parental information about the effects and importance of steroids given by the physicians on better asthma control was found to be highly significant (p < 0.001). That`s why physicians and health care providers should spend enough time explaining the importance of adherence to treatment in asthma management, which may help in overcoming the fear of using ICS.

ASTHMATIC CHILDREN

Objectives: To assess the knowledge, attitude and practices among caregiversof asthmatic children and to describe their clinical and biographic features. Material andmethods: A descriptive cross-sectional study was conducted in asthma clinic and medicalwards of children hospital P.I.M.S.100 diagnosed asthmatic children and their caregivers wereenrolled. Two questionnaire one comprising clinical aspects and other regarding knowledgeattitude and practices among caregivers were administered. Results: 100 asthmatic childrenand their caregivers participated. Among children, 77% were breastfed, 95% were immunized,only 13% were receiving controller medications and 62% were having &gt;5 acute exacerbationsper year. Diagnosis of asthma was accepted by 76% of caregivers, of which 67% recognizedcorrect etiology. Multiple food items were blamed for acute exacerbations, while respiratoryinfections were most commonly recognized triggering factor. 50% of study population wasignorant of aerosol therapy and only 26% prefer it. Cough suppressants are most popular homemedications. Conclusions: Asthma awareness is inadequate. Controller medications andaerosol therapy is underused and unnecessarily blamed. Asthmatic children are deprived ofnutritious food considering them as triggering factors. Awareness raising strategies are neededin community.

447 Asthma Knowledge among Parents and/or Caregivers of Asthmatic Children Attending a Practical Allergy Course

BackgroundAsthma is one of the most frequent chronic diseases, with worldwide prevalence of 1 to 18%. Patient and the patient's family education is considered by all International Guides fundamental to achieve this disease control. The aim of this study is to asses the asthma knowledge among parents and/or caregivers of pediatric asthmatic patients before and after attending to a Practical Allergy Course given at Hospital Infantil de Mexico Federico Gomez by the Pediatric Allergy Department.MethodsTransversal Study that included 115 persons attending to a Practical Allergy Course that answered the previously validated instrument to asses the asthma knowledge among parents or caregivers NAKQ (Newcastle Asthma Knowledge Questionnaire); its Spanish version consisting in 31 questions; before and after the practical course. A descriptive annalysis was made; usefullness of the course was determinated by x2. Stadistical packagge used was SPSS 17.ResultsA total of 115 questionnaires were applied, only 99 were properly answered and were included in the analysis; from these 35 were male and 64 female; 80% with high-school and middle school schooling; 92% were small families with 1 to 3 children; 90% of the families had only one child with asthma; 63% was receiving the practical course for the first time. Before attending the practical course the mean answered questions was 30 and after attending the mean answered questions was 31 (LR = 57.465; P < 0.000); for the first evaluation the mean correct answers was 19 and the latter 22 correct answers, finding statistical significant differences (LR = 30.253; P < 0.000).ConclusionsWe found improved asthma knowledge among parents and caregivers of asthmatic children after attending to a Practical Allergy Course.

Evaluation of quality of life among the caregivers of asthmatic children: The new IFABI-R questionnaire

Background The health-related quality of life (HRQoL) of asthmatic children and their caregivers is correlated to management of the disease and the presence of certain morbidity indicators. The integral assessment of paediatric asthma must include the evaluation of HRQoL among the caregivers, although existing questionnaires only partially assess the dimensions of this aspect. The present study describes a new questionnaire for evaluating HRQoL among the caregivers, comprising three dimensions (functional, emotional, and socio-occupational). Material and methods The study involves two phases. A total of 81 patients between 3 and 9 years of age and their caregivers participated in the first phase, involving a qualitative and psychometric study of the preliminary version of the questionnaire (IFABI). A total of 137 patients between 2 and 17 years of age and their caregivers participated in the second phase, in which the revised version of the questionnaire (IFABI-R) was developed and subjected to psychometric evaluation. Results First phase: The IFABI showed important reliability and internal consistency (Cronbach alpha=0.93), concurrent validity requiring improvement, and a scantly clear internal structure. Second phase: The IFABI-R showed important reliability and internal consistency (Cronbach alpha=0.90), adequate concurrent validity, and a three-dimensional structure whose three factors correspond to the three dimensions of the questionnaire. Conclusions The good psychometric results obtained with the IFABI-R justify its use in paediatric asthmatic patients. The questionnaire is currently being scaled, and its sensitivity to change is being assessed.

Depressive symptoms amongst asthmatic children’s caregivers

We wanted to find out, whether the number of depressive symptoms is higher amongst asthmatic children's caregivers, compared to international data, to the Hungarian population average, and to parents of children with chronic renal disease. Are these depressive symptoms connected to the children's psychological status, asthma severity or current asthma symptoms? One-hundred and eight, 7- to 17-yr-old asthmatic children were enrolled, who have been treated at the Semmelweis University, First Department of Pediatrics. Children were suffering from asthma for at least 1 yr, with a median of 8 yr (1-16 yr), they started to develop asthmatic symptoms between the age of 0.5-14 yr (median: 3 yr). We also identified 27 children with chronic renal diseases and their caregivers, who functioned as a control group. Children were asked to complete the Hungarian-validated versions of the Child Depression Inventory, the Spielberger State Anxiety Inventory for Children and the Juniper Pediatric Asthma Quality of Life Questionnaire. Asthma severity and current symptoms were also documented, 56% had no symptoms on the preceding week. Caregivers were asked to complete the Hungarian versions of the Beck Depression Inventory (BDI) short form, the Spielberger Anxiety Inventory and the Juniper Pediatric Asthma Caregivers' Quality of Life Questionnaire. Caregivers of asthmatic children had significantly more depressive symptoms (7.73 +/- 6.69 s.d.) than the age-specific normal population (p < 0.01). Caregivers of renal patients also experience more depressive symptoms (9.61 +/- 7.43 s.d.) than their healthy peers, but difference between the two chronic diseases' group did not prove to be significant. Asthmatic children's caregivers who scored more points on the BDI than the population average suffer from more anxiety symptoms, but their quality of life is not worse than the caregivers' with less depressive points. Depressive symptoms were neither connected to the children's psychological and asthmatic symptoms nor quality of life. Amongst caregivers of asthmatic children, at least mild depressive symptoms were represented amongst 39% of men and 33% of women. Gender difference was not significant, despite observations in the normal Hungarian population. Amongst caregivers of renal patients, depressive symptoms were represented in 14% of men and 50% of women. Gender difference was significant. (p = 0.05). Significant difference was observed between male asthmatic and renal caregivers, albeit difference was not significant between the female groups. No difference was found in depressive symptoms according to caregivers' level of education. Caregivers of children with asthma have more depressive symptoms than the average Hungarian population, but their results do not differ from caregivers taking care of children with chronic renal diseases. Caregivers of asthmatic children having at least mild depressive symptoms tend to have higher anxiety symptoms as well. Up to date, childhood chronic disease management and long-term care should also focus on parental psychology, mainly on depression and anxiety, as prevalence is higher than in the average population.

Assessment of quality of life in caregivers of asthmatic children

Assessment of quality of life in caregivers of asthmatic children

Asthma-related health status determinants of environmental control practices for inner-city preschool children

Asthma guidelines recommend environmental control practices (ECPs) to improve asthma health. In the inner city, where asthma morbidity is high, it is not known whether children's health status affects the use of ECPs. To investigate health status determinants of ECPs in the homes of children with asthma. Caregivers of children aged 2 to 6 years with (n = 150) and without (n = 150) asthma completed a survey about ECPs. Atopic status was determined by means of skin prick testing. Most ECPs were similarly practiced, regardless of whether the child had asthma. Only pet avoidance was more common in children with asthma (30% vs 19%). Asthma severity and recent acute health care visits for asthma were not associated with ECP use. Most ECPs were not linked to allergen sensitization (eg, mite and mouse), although cockroach-sensitized children were more likely to have cockroach control than nonsensitized individuals (65% vs 45%). Caregivers of asthmatic children with rhinitis were more likely than those without rhinitis to report ECPs, including pet avoidance (44% vs 15%), smoking avoidance (78% vs 53%), cockroach control (65% vs 42%), mouse control (78% vs 42%), air-conditioning (45% vs 24%), and allergyproof covers (7% vs 0%). The presence of asthma, asthma severity, and allergen sensitization seem to have little relationship to ECP use in the homes of inner-city children. Rhinitis was consistently linked to ECPs, which suggests that caregivers may make changes in the home environment for upper airway but not lower airway symptoms.

Learning Preferences of Caregivers of Asthmatic Children

Purpose of the Study. To determine the learning styles of the caregivers of asthmatic children seen in a pediatric allergy and immunology clinic. Study Population. Parents of asthmatic children seen in a tertiary care pediatric allergy and immunology clinic. Methods. Caregivers completed the Visual-Aural-Read/Write-Kinesthetic (VARK) questionnaire anonymously, and the responses were evaluated on the basis of previously validated scoring instructions. Results. Analysis of 98 respondents showed that 42% had a single learning-modality preference, and the remaining 58% were multimodal learners. Of those who reported a single mode of learning, 61% preferred kinesthetic, 27% preferred reading/writing, and &amp;lt;1% each preferred aural or visual stimuli. Of all 98 caregivers, 82% included kinesthetic as a learning preference, 59% included reading/writing, 50% included aural stimuli, and 41% included visual stimuli. Conclusions. The majority of caregivers preferred the kinesthetic learning method, whether as a single learning preference or in combination with other approaches. Incorporating kinesthetic methods of learning, such as role playing and problem-solving case scenarios, into standardized asthma education curricula may be beneficial to patients and families in terms of understanding and using their regimen. Reviewer Comments. This is a novel study that attempted to improve asthma care by identifying the learning preferences of the caretakers of asthmatic children. Asthma regimens can be complex, and simplification and understanding of these regimens can improve overall adherence. Individual caretakers demonstrate multiple modes of learning preference, and the current educational modules should focus on role playing and other visual modalities to enhance the understanding of the caretakers’ asthma knowledge. Streamlining and improving these educational methods could result in significant improvement in medication adherence, symptom recognition, and appropriate utilization of medical care.

Learning Preferences of Caregivers of Asthmatic Children

Background. People learn in different ways: visually, aurally, by reading/writing, and kinesthetically. In our clinic, we use color-coded Asthma Action Cards to educate our patients and their caregivers on asthma management. Our teaching is largely aural based, with the cards providing reading and visual stimulation and hands-on practice with devices offering kinesthetic stimulation. Objective. We sought to determine the learning styles of the caregivers of our asthmatic children. Methods. Caregivers in our Asthma/Allergy Clinic completed the Visual-Aural-Read/Write-Kinesthetic (VARK) questionnaire anonymously, and the responses were evaluated on the basis of previously validated scoring instructions. Results. Analysis of 98 respondents showed that 42% had a single learning modality preference, and the remaining 58% were multimodal learners. Of those who reported a single mode of learning, 61% preferred kinesthetic, 27% preferred reading/writing, and less than 1% each preferred aural or visual stimuli. Of all 98 caregivers, 82% included kinesthetic as a learning preference, 59% included read/write, 50% included aural, and 41% included visual. Conclusion. The majority of caregivers preferred the kinesthetic learning method, whether as a single learning preference or in combination with other approaches. Incorporating kinesthetic methods of learning, such as role plays and problem-solving case scenarios, into standardized asthma education curricula may be beneficial to patients and families in terms of understanding and using their regimen.

Association between asthma control in children and loss of workdays by caregivers

Although the economic burden of pediatric asthma is a significant public health issue, the loss of workdays by caregivers because of their children's asthma remains scarcely investigated. To evaluate asthma-related loss of workdays incurred by caregivers of asthmatic children and its association with the level of asthma control. A retrospective observational study was conducted based on a French computerized general practitioners' database and a survey questionnaire. Children aged 6 to 16 years with persistent asthma (Global Initiative for Asthma grade > or = 2) were included in the study. Level of children's asthma control was evaluated from recent asthma symptoms. Caregivers reported the number of workdays lost because of their child's asthma during the 12-month study. Nearly 30% of caregivers lost workdays during the study because of their children's asthma. More than 13% of caregivers lost more than 5 days. Caregiver absenteeism significantly correlated with all components of asthma control (use of relievers, nocturnal symptoms, impairment of activities, and asthma crises). A significant 8-fold risk of losing more than 5 workdays by caregivers was observed when the child's asthma was poorly controlled (odds ratio, 8.6; 95% confidence interval, 2.4-30.5); caregivers' absenteeism also increased significantly with the number of episodes of oral corticosteroid use during the study. Caregivers' loss of workdays owing to their children's asthma is substantial and is highly correlated with the level of asthma control. These findings highlight the necessity of educational programs for children with poor asthma control and their caregivers to prevent severe asthma attacks that lead to caregiver absenteeism.

The impact of a large-scale population-based asthma management program on pediatric asthma patients and their caregivers

The consequences of pediatric asthma include missed school attendance, limitations in physical activity, and increased health care utilization and costs. Caregivers of asthmatic children are affected through missed work days and decreased job productivity. In response to these issues, a disease management program encompassing asthmatic children and their caregivers was developed as part of the core services offered to members of a large, national health care plan. To determine the impact of the asthma management program on pediatric asthma patients and their caregivers over a 12-month period. In this longitudinal study, 401 randomly selected member households with asthmatic children from 17 regional markets completed surveys before and after 12 months of participation in the asthma management program. Program interventions, which were tailored according to risk and need status, included various staggered educational mailings, reminder aids, videos, a peak expiratory flow rate meter, and telephonic case management. The Asthma Quality Assessment System survey, a battery of self-reported quality indicators, was used to solicit information from parents or caregivers of asthmatic children on issues pertaining to quality of life, asthma management skills and knowledge, and lost work/school days related to asthma. Statistically significant postprogram outcomes were observed in various domains, including a reduction in adverse utilization, symptomatology, and restricted activity days for children and lost work days for adult caretakers. These findings demonstrate that a large-scale population-based intervention program can produce measurable clinical and economic benefits, thereby lessening the burden of asthma on the family unit.

Characteristics of African American women caregivers of children with asthma.

To describe the attributes and characteristics of African American women who were the primary caregivers of children with asthma. Descriptive qualitative ethnography. Data collection consisted of formal interviews, participant observation, and fieldnotes. Each study participant was formally and informally interviewed (audiotaped) during a 1-year period. The researchers also observed and participated in family activities in various naturalistic settings. Six themes emerged that depict the characteristics of these women: (1) Knowledge about the child's asthma; (2) Gatekeepers to the child's care; (3) Being religious; (4) Support; (5) Roles as teacher, counselor, and advisor to the child; and (6) Self-sufficiency and industriousness. Nurses should use the information in this study to examine the ways in which they interact with caregivers of asthmatic children. The caregivers personal beliefs, need for information, and previous experiences with asthma and family illness should be assessed. These mothers and grandmothers should be respected as the gatekeeper to the family's healthcare. Nurses should be nonjudgmental and supportive of caregivers when they express their religious beliefs and practices. Nurses who understand how mothers cope can reinforce these coping skills and provide better nursing care.