الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 214 |  |  |
| | | from | 214 | | |
Abstract
Asthma is a common, costly, and chronic disease that has a significant impact on children, their families, and the health care system. It is one of the most common causes of emergency department visits and hospitalization of children worldwide. Asthma exacerbations can range from mild to severe and can have an unfavorable impact on the quality of life (QoL) of children and their caregivers.
Several asthma-educational programs have been used for children and/or caregivers; including individual or group interventions provided by physicians, nurses, or teachers, and applied at specialized clinics, general clinics, or schools. group education interventions take the advantage of paired interaction to facilitate the transfer of knowledge, skills, and attitudes.
The aim of the present study was to study the effectiveness of an educational intervention program for mothers of children with asthma attending Alexandria University Specialized Children’s Hospital. Specific objectives included: assessing asthma-related knowledge and management skills among mothers of children with asthma; assessing mothers’ quality of life of asthmatic children; determining child’s asthma morbidities in terms of the frequency of asthma attacks and the number of hospital admissions; and finally constructing, implementing, and evaluating the effect of a parent-centered educational intervention program on mothers asthma-related knowledge and management skills, their quality of life as well as on their children’s asthma morbidities.
The present study targeted mothers of children with asthma attending the respiratory outpatient clinic, Alexandria University Specialized Children’s Hospital – (Smouha). The study sample mothers included those whose children had the following criteria: diagnosed by a pediatrician with typical active asthma i.e. symptoms of asthma or receiving medical treatment for asthma in the past 12 months prior to the study and under seven years of age. Mothers who attended parents’ education program on asthma in the past year prior to the study and children who had any other chronic disabling conditions like congenital heart, respiratory renal, and/or neurological diseases were excluded.
A quasi-experimental design was used to assess the efficacy of the intervention program. The researcher attended the outpatient respiratory clinic in Alexandria University Specialized Children’s Hospital (Smouha) two days a week. Mothers with asthmatic children fulfilling study eligibility criteria were consecutively recruited and alternatively allocated into two groups (intervention and control groups) until reaching the required sample size, 40 patients for each group.
The following techniques and tools were used to collect data:
A predesigned interviewing questionnaire was used to collect; demographic, socio-economic data, child asthma morbidity data (including; the number of asthma attacks, frequency of Quick Relief Medications (QRM) given to the child, the number of emergency department visits, and/or hospital admissions in the previous 6 months) and family history of asthma and atopy, the Arabic version of Pediatric Asthma Caregiver Quality of Life Questionnaire (PACQLQ), and asthma-related knowledge questionnaire.
An Arabic, brief, culturally sensitive educational intervention program was translated and adapted from the Wee Breather program. The program was conducted in groups (total of 4 groups); each group consisted of 8-12 participant mothers, and was organized into 4 sessions, each session was 60-90 minutes duration in the same study setting. Objectives of the program were namely: raising awareness and improving asthma-related knowledge of mothers; improvement of asthma management skills of mothers; improving QoL of mothers and decreasing asthma morbidity of children.
Evaluation of the program was carried out twice; immediately after the program completion and six months later using the study tools.
The study revealed the following important results:
The mean age of mothers of asthmatic children in the sampled intervention group was 32.25±6.18 years compared to 32.35±5.81 of the non-intervention group, and most of the sampled mothers were married (95% in both groups). The mean age of asthmatic children of the sampled intervention group was 4.99±1.55 years compared to 4.97±1.37 years of the non-intervention group; most of the children were boys (62.5%) in the intervention group compared to 67.5 % of the non-intervention group.
Concerning education, about one-third (32.5%) of the intervention sampled mothers were secondary \diploma compared to 30 % of the non-intervention group.
Regarding the occupation of the sampled mothers, housewives accounted for 77.5% of the intervention group compared to 67.5% of the non-intervention group.
In respect to the socioeconomic score, low socioeconomic status rated a lower percentage (55%) in the intervention compared to their counterparts of the non-intervention group (62.5%). No statistically significant difference was detected between the two groups.
The majority of both intervention and non-intervention groups (95% versus 97.5% respectively) had a positive family history of atopy, with no statistically significant difference between the two groups.
At baseline asthma-related knowledge score of the intervention group recorded a higher total mean score than the non-intervention group (10.18 ± 3.551, versus = 8.28± 2.978, respectively) which was statistically significant.
Concerning asthma-related knowledge of mothers, findings indicated statistically significant improvement in mean scores of intervention mothers’ knowledge at post1 and post 2 in results compared to baseline (X2f=75.718, P= 0.00). There was a mild decrement in knowledge mean scores from post 1 (19.85± 0.427) to post 2 (18.55± 1.197) in the intervention group. In addition, the significant differences between the intervention and control group on asthma-related knowledge of mothers were in favor of the intervention group at post-1and 2. (Z = -8.054, P= 0.00), (Z = -7.727, P= 0.00) respectively.
Regarding child’s asthma morbidity indicators (number of asthma attacks, frequency of QRM and number of emergency department visits and or/ hospital admissions), there were no statistically significant differences detected at baseline between the two groups, while there were significant differences in favor of the intervention group at post 2. (Z = -2.977, P= 0.003), (Z = -3.058, P= 0.002) and (Z = -2.487, P= 0.013) respectively.
There was a significant DROP in the mean number of child’s asthma morbidity indicators (number of asthma attacks, frequency of QRM, and number of emergency department visits and or/ hospital admissions) of the intervention group over time, the recorded mean values showed a significant DROP at post 2 compared to baseline (X2f= 55.386, P=0.00, X2f=44.623, P=0.00, X2f= 43.013, P= 0.00) respectively.
Concerning Pediatric Asthma Caregiver’s Quality of Life Questionnaire (PACQLQ): total score, activity and emotional domains, there were no statistically significant difference was detected at baseline between the two groups. Furthermore, there were significant differences in favor of the intervention group at post 1, 2 regarding total score: post1 (Z = -4.265, P= 0.000), post 2 (Z = -6.919, P= 0.000), and emotional domain: post1 (Z = -5.529, P= 0.000), post 2 (Z = -7.185, P= 0.000) respectively. While activity domain mean scores significantly deferred at post 2 (Z = -5.346, P= 0.000).
The current study revealed evidence for the effectiveness of the group educational intervention program in improving mean scores of Pediatric Asthma Caregiver’s Quality of Life Questionnaire (PACQLQ) total score and emotional domain of the intervention group at post1 and post 2 compared to baseline, while activity domain significantly improved at post 2 in the same group. (X2f= 67.072, P= 0.00), (X2f= 36.463, P= 0.00), and (X2f= 69.247, P= 0.00) respectively.