1. A Caregiver’s Perception of Asthma Control in Children
Latonda S. Paymon, MSN, FNP-BC, DNP
Troy University, Troy, Alabama (USA)
BACKGROUND
MATERIALS AND METHODS
RESULTS
Diminished lung function and recurrent symptoms predispose the asthma patient to a lifetime of limited activities and restricted quality of life.
Uncontrolled asthma accounts for 35% to 50% of medical cost in children.
One out of every ten children attending school has asthma.
In the United States more than seven million children are affected by asthma.
In the United States, asthma affects 8.2% of the population.
Asthma has also been linked to14 million school absences each year, and 80% to 90% of children encounter symptoms by the age of four.
Asthma is a chronic disease of the airway. Inflammation of the airways causes coughing, wheezing, and/or shortness of breath to reoccur and the airway to become obstructed .
The implementation of allows caregivers and their children to gain new knowledge regarding symptoms and triggers, which could positively affect the perception of control.
The implementation of an AAP and peak flow meter equips the caregivers, health care providers, and children with the necessary tools to effectively manage asthma.
Significant clinical improvement was achieved from pre- and post- intervention demonstrating the effectiveness of the AAPs and PF meters among asthma patients.
Utilization of AAPs and PF meters
Data revealed that 100% of participants thought AAPs and PF meters were helpful.
After the initiation caregivers expressed an improve perception of asthma control.
Intervention
The interventions identified in the project consisted of the implementation of asthma action plans (AAPs) and use of peak flow meters.
The AAP consists of a colored coded two-page document that includes information about the patient’s asthma medication, triggers, and steps to be taken if symptoms increase. The green zone identifies what steps to take if the asthma is well-controlled, and with the patient not experiencing any symptoms. The yellow code indicates that the asthma is getting worse and at that time the patient would experience a cough, wheeze, chest tightness, shortness of breath, or nighttime wakening. The red zone indicates that the patient is experiencing shortness of breath and the quick relief medicine does not relieve the symptoms.
The colors also correspond to colors on the peak flow meter. The second page of the AAP provides additional information on allergens and irritants to help avoid triggers.
Pre-Intervention
30 caregivers of children aged five to 11with asthma, diagnosed with asthma for a minimum of one year who were able to read, comprehend, and write English were recruited.
Caregivers were contacted and scheduled for initial and 3- month follow appointment.
At initial visit, informed consent completed by caregiver, code number assigned, assessment completed, and verbal assent read to child, demographic tool, pre- intervention cACT, education session (peak flow education, AAPs, spacers, and asthma medication), pre-peak flow meter reading completed.
Post- Intervention
At follow-up appointment 3 months later, post-intervention assessment, demographic tool updated, cACT completed, and post peak flow meter reading recorded.
Post project survey was completed by the caregiver.
Data was analyzed and disseminated.
PURPOSE
The purpose of the project was to examine the effects of Asthma Action Plans (AAPs) and use of peak flow meters on the caregiver’s perception of symptom control among children with asthma.
The goals of the projects were to implement AAPs and peak flow (PF) meters with caregivers and patients diagnosed with asthma for at least one year and to improve caregiver’s perception of asthma control among children five to 11 diagnosed with asthma.
Pre and Post Intervention Asthma Control .
CONCLUSIONS
Asthma Action Plan
Peak Flow Meter.
Asthma is a chronic disease that has the ability to affect the caregiver and patients. However, as a result of this project, the DNP student concluded that the implementation of AAPs and peak flow meters better prepares caregiver when caring for the child with asthma.
The utilization of such evidence-based interventions improves the confidence needed to enhance care and improve outcomes. Although asthma may stress the family unit, data have shown that adequately educating the caregivers and patient tend to improve the perception of asthma control in the child.
The Childhood Asthma Control Test (cACT)
The Childhood Asthma Control Test was the tool utilized in the project. The cACT was developed to assess control among pediatric asthma patients between the ages of four years and 11 years. The cACT addresses a four-week period prior to testing and is comprised of seven questions, of which the child answers the first four and the caregiver answers the remaining three questions. Questions on the tool pertain to symptoms exhibited and activity limitations. The combined overall score can range from 0 to 27, with 27 defining complete control.