McPherson Amy C, Glazebrook Cristine, Forster Debra, James Claire, Smyth Alan
School of Nursing, University of Nottingham, Nottingham, United Kingdom.
Pediatrics. 2006 Apr;117(4):1046-54. doi: 10.1542/peds.2005-0666.
The purpose of this study was to evaluate the impact and acceptability of an educational multimedia program designed to promote self-management skills in children with asthma.
We conducted a randomized, controlled trial with measures at baseline and 1- and 6-month follow-up. The trial was conducted in pediatric outpatient respiratory clinics in 3 United Kingdom hospitals. Participants included 101 children aged 7 to 14 years under the care of hospital-based asthma services. The children were randomly assigned to receive an asthma information booklet alone or the booklet plus The Asthma Files, an interactive CD-ROM for children with asthma. Asthma knowledge was the primary outcome measure. Other measures included asthma locus of control, lung function, use of oral steroids, and school absence.
At the 1-month follow-up (n = 99), children in the computer group had improved knowledge compared with the control group and a more internal locus of control. There were no differences in objective lung-function measures, hospitalizations, or oral steroid use. The study participants were positive in their evaluation of the intervention. At the 6-month follow-up (n = 90), significantly fewer children in the intervention group had required oral steroids and had had time off school for asthma in the previous 6 months. The difference did not reach statistical significance in the intention-to-treat analysis for both steroid use and school absence.
The Asthma Files was found to be an effective and popular health education tool for promoting asthma self-management skills within pediatric care.
本研究旨在评估一个旨在提高哮喘儿童自我管理技能的教育多媒体项目的影响和可接受性。
我们进行了一项随机对照试验,在基线以及1个月和6个月随访时进行测量。该试验在英国3家医院的儿科门诊呼吸诊所进行。参与者包括101名年龄在7至14岁、接受医院哮喘服务护理的儿童。这些儿童被随机分配,分别单独接受一本哮喘信息手册,或接受该手册加《哮喘档案》(一张面向哮喘儿童的交互式光盘)。哮喘知识是主要的结果指标。其他指标包括哮喘控制源、肺功能、口服类固醇的使用情况以及缺课情况。
在1个月随访时(n = 99),与对照组相比,计算机组儿童的知识有所提高,且控制源更偏向内控。在客观肺功能指标、住院情况或口服类固醇使用方面没有差异。研究参与者对干预措施的评价是积极的。在6个月随访时(n = 90),干预组中在前6个月需要口服类固醇以及因哮喘缺课的儿童明显减少。在类固醇使用和缺课的意向性分析中,差异未达到统计学显著性。
发现《哮喘档案》是一种在儿科护理中促进哮喘自我管理技能的有效且受欢迎的健康教育工具。