Epidemiology of Asthma

Introduction

Asthma is a severe condition that affects many people, both children, and adults in the US. The commonly used treatment plan involves medication; however, it is essential for patients to be aware of the importance of adherence to medication, inhaler use techniques, and other aspects that can help mitigate severe outcomes. The disease impairs the quality of life for individuals; therefore, a proper approach to management should be developed to help patients with asthma. This paper aims to describe an implementation plan and project for asthma management intervention designed for children.

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The Spirit of Inquiry Ignited

The aspect worth noting is that this chronic condition often affects children; thus, presenting a need for specific care strategies. According to Loftus and Wise (2016), 8% of citizens in the US are affected by the disease. Additionally, the authors emphasize that ten percent of children in the country have asthma. Individuals that are at risk of developing the condition are the socially vulnerable populations because they may have limited access to healthcare services. This provides a need for interventions that are designed to specifically affect children because they require additional assistance when managing asthma.

During asthma attacks, patients cannot breathe properly, which may lead to severe consequences and complications. Most notably the illness affects the quality of life for people that have it. It is due to the fact that asthma attacks can be abrupt and occur uncontrollably. Kids can experience psychological issues connected to the condition, as well as impairment of learning capabilities. Additionally, the ability to be engaged in psychical activities is compromised due to the nature of asthma.

As it is a chronic condition, it requires long-term treatment interventions, which typically consist of medication in varying doses. Nurse education can be a vital aspect that affects the exacerbation of the condition. It is for this reason that the effect of asthma on a patient’s life can be mitigated through proper management strategies. Therefore, if an advanced practice nurse is capable of developing and implementing a plan that would help patients control their asthma their quality of life would not be compromised.

The PICOT Question Formulated

In children with asthma between the ages of 5 and 19 (P), does a combination program consisting of 5 weeks of education sessions, once per week including children and their families in the primary care setting and a daily controller medication (I) compared to using controller medication and one education section (C) reduce asthma exacerbations (O) over a one-year period (T)?

Search Strategy Conducted

CINAHL database was searched to locate evidence-based interventions that can help design an educational strategy for this project. The keywords included asthma intervention in children, educational intervention for asthma, asthma management program. A study by Garvey et al. (2014) was found through the search, which included over twelve thousand subjects. PubMed was searched using keywords asthma management in children and several studies related to the topic. Cochrane Library and National Guidelines Clearinghouse were applied using the same keywords. From these sources, Level II evidence was found within the research studies.

Critical Appraisal of the Evidence Performed

An evaluation table was used to examine the researches of educational interventions for children with asthma. In addition, the method of rapid critical appraisal was used in this project to evaluate the studies. An article by Garvey et al. (2014) described a cohort study conducted by the authors. The study includes an examination of patient outcomes over three uses by analyzing twelve thousand cases. The primary objective was to determine whether providers that have educational programs can enhance health outcomes for their patients. Garvey et al. (2014) concluded that providing patients with access to a full-time asthma education center reduces the number of exacerbations.

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An educational strategy that consists of forty-five-minute sessions for children, several follow-up visits, and communication through messaging apps is an appropriate design for asthma management programs. The intervention was developed by Liu and Qureshi (2016) designed and carried out by the caregiver. The approach was found to enhance the quality of life and management skills of children. The study used a control group to compare the primary aspects of asthma management; therefore, it can be concluded that educational sessions improve outcomes for patients and reduce possible adverse consequences.

The study by Kavitha and Devi (2018) indicated that fifty-minute study sessions carried out by a nurse practitioner help children understand the aspects of managing their condition. The outcomes were compared using the same groups of kids before and after the implementation of educational sessions. The results support a claim that nurses can enhance children’s quality of life and mitigate adverse outcomes for kids with asthma by providing them with the assistance and knowledge that is necessary for managing the disease.

Staying Healthy-Asthma Responsible and Prepared (SHARP) is another approach to asthma management. The evidence presented by Kintner et al. (2015), indicates that the SHARP approach is more effective when compared to other programs. Studies by Kinter et al. (2015), Kavitha and Devi (2018), and Liu and Qureshi (2016) provide an understanding that forty-five to fifty-minute sessions for children are sufficient as a management intervention. In all the presented studies caregivers were involved in the intervention plan, indicating that nurses can improve the outcomes of these sessions for children. Boulet et al. (2015) provided evidence that an introductory visit to a healthcare provider with several follow-up lessons can help children manage their symptoms.

No Level I evidence was located, which would serve as a guide for the implementation plan. However, all articles examined for the project provide similar results by presenting an improved understanding of asthma and better management skills in children who receive educational intervention from their healthcare provider.

For this project, five educational sessions were selected as an intervention because the specified amount of lessons should provide sufficient knowledge to patients, based on the examined evidence. Therefore, the purpose of this project is to educate children aged five to nineteen on how to manage their symptoms and take medication. The plan should be implemented by a nurse practitioner in the primary care establishment.

Evidence Integrated with Clinical Expertise and Patient Preferences to Inform a Decision and Practice Change Implemented

The plan for this project is to establish fifty-minute educational sessions carried out by a nurse practitioner in a primary healthcare setting over five weeks. The strategy will help evaluate the feasibility of the approach by assessing outcomes for children from five to eighteen years old who were diagnosed with asthma. Typically, kids are treated using medication prescribed by their healthcare provider. Additionally, some knowledge in regards to using an inhaler and visiting an emergency department is provided to patients. However, in most cases, the information is not sufficient and leads to poor management of the condition, frequent hospital visits, and improper intake of prescribed pharmacological substances, which results in exacerbation.

Patients prefer to use medication prescribed by a healthcare provider. However, not all individuals adhere to recommendations described by healthcare providers, which according to Stirratt et al. (2015) leads to adverse health outcomes. Thus, it is critical for patients with asthma to take their daily medication in the appropriate doses, which is part of the educational training presented in the interventions. Due to the nature of the disease care providers can either increase or decrease the dose of medication, which can impair an individual’s perception of the importance to adhere to recommendations. This intervention indicates that proper education can mitigate the risk.

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Advance practice nurses who work with children with asthma can use examples from their practice to illustrate particular aspects of disease management. The primary goal is to mitigate adverse outcomes of asthma, which are displayed through the quality of life that an individual can lead. Individuals who participate in the intervention should take daily controller medication. Additionally, they attended weekly educational sessions designed to help children understand their condition and manage it properly.

The knowledge that patients possess before intervention should be measured to understand their state before intervention and compare it to the outcomes. Additionally, the perception that a caregiver has in regards to health and adverse events should be considered as well. The instruments that were used to evaluate these factors are questioners. Patients should self-report their health state, adherence to medication, and current knowledge regarding the disease.

The responses were measured using a scale from one to five. Cronbach’s standardized alpha correlation should be applied to assess the results. The data were collected twice, once before the intervention and once after the implementation. The sessions were carried out in the office of a primary care provider and were obtained from medical records and questionnaire answers. The PICOT question indicates that the study should be monitored for one year to evaluate the efficiency of the chosen intervention.

Outcome Evaluated

The evidence-based researches examined in this project indicated that educational sessions lasting for five weeks could mitigate asthma exacerbation in children. The findings were evaluated by comparing the results from interventions and evaluating some hospital visits associated with asthma over one year. Through this approach, it is possible to understand whether children who participated in the research were able to enhance their knowledge regarding the condition and existing management skills.

It can be concluded that 45 to 50-minute educational sessions carried out by healthcare providers together with controller medication are more effective than one introductory session and controller medication. With this intervention, advanced practice nurses can provide patients with required information that will help them manage their asthma more efficiently.

Project Dissemination

The project details are presented in this paper, including the relevant aspects and data required for intervention implementation. Advanced practice nurses can use its findings to design their educational lessons for children. Primary care establishments can integrate five-week training sessions in their practice to improve the understanding of asthma. Additionally, the data that was gathered indicates that kids should be taught aspects of asthma because the approach can help improve quality of life, which is the primary objective of asthma management.

Conclusion

Overall, the project highlighted the importance of addressing asthma because ten percent of children in the US have the condition. Proper management approach and adherence to medication can enhance the quality of life. Due to this fact, the project examined studies that were aimed at identifying whether educational sessions over five weeks can help children manage their chronic disease more adequately. It can be concluded that such courses carried out by a healthcare provider have positive effects on the health state of individuals.

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References

Boulet, L. P., Boulay, M. E., Gauthier, G., Battisti, L., Chabot, V., Beauchesne, M. F., … Côté, P. (2015). Benefits of an asthma education program provided at primary care sites on asthma outcomes. Respiratory Medicine, 109(8), 991-1000.

Garvey, N. J., Stukel, T. A., Guan, J., Lu, Y., Bwititi, P. T., Guttmann, A. (2014). The association of asthma education centre characteristics on hospitalizations and emergency department visits in Ontario: A population-based study. BMC Health Services Research, 14, 561.

Kavitha, K., & Devi, T. K. (2018). Effectiveness of structured teaching program on knowledge of asthmatic school children towards control of bronchial asthma. Indian Journal of Nursing Sciences, 3(1), 1-5.

Kintner, E. K., Cook, G., Marti, C. N., Allen, A., Stoddard, D., Harmon, P.,… Van Egeren, L. A. (2015). Effectiveness of a school‐and community‐based academic asthma health education program on use of effective asthma self‐care behaviors in older school‐age students. Journal for Specialists in Pediatric Nursing, 20(1), 62-75.

Liu, Z., & Qureshi, K. (2016). Efficacy of an asthma self-management education intervention for children (9-13 years) with asthma and their caregiver in Wuhan, China. Journal of US-China Medical Science, 13, 117-128.

Loftus, P. A., & Wise, S. K. (2016). Epidemiology of asthma. Current Opinion in Otolaryngology & Head and Neck Surgery, 24(3), 245-249.

Stirratt, M. J., Dunbar-Jacob, J., Crane, H. M., Simoni, J. M., Czajkowski, S., Hilliard, M. E., … Nilsen, W. J. (2015). Self-report measures of medication adherence behavior: Recommendations on optimal use. Translational Behavioral Medicine, 5(4), 470-82.

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