Davis Deborah Winders, Gordon Melissa K, Burns Barbara M
Department of Pediatrics, University of Louisville, Louisville, KY, USA.
Pediatr Nurs. 2011 Jan-Feb;37(1):31-8.
Millions of children in the U.S. suffer from asthma. A disproportionately large number of those children are from low-income and racial minority families. With or without asthma, children from low-income families are at risk for delayed school readiness and less than optimal academic achievement trajectories. The aim of this article was to review the literature on educational interventions for young children with asthma and their families to determine if there was sufficient evidence to guide practice. In addition, a new theoretical model upon which to base new interventions is proposed. Literature was reviewed from Medline, CINAHL, PsycInfo, and the Cochrane Reviews databases. A limited number of randomized, controlled studies of educational interventions for children and their families was found, and only one study was specifically aimed at preschool-age children. Comparisons among studies are difficult because of varying methodologies, and findings are non-conclusive. In conclusion, comprehensive, multidisciplinary, multi-level interventions are needed to minimize the effects of childhood asthma, especially for children from low-income families. Large-scale, randomized, controlled studies are needed to provide empirical evidence for the efficacy of specific interventions for preschoolers prior to school entry to minimize the detrimental effects of uncontrolled asthma on school achievement.
美国有数百万儿童患有哮喘。其中，来自低收入和少数族裔家庭的儿童数量多得不成比例。无论是否患有哮喘，低收入家庭的儿童都面临入学准备延迟以及学业成绩不尽如人意的风险。本文的目的是回顾有关针对患有哮喘的幼儿及其家庭的教育干预措施的文献，以确定是否有足够的证据来指导实践。此外，还提出了一个可作为新干预措施基础的新理论模型。我们检索了医学文献数据库（Medline）、护理学与健康领域数据库（CINAHL）、心理学文摘数据库（PsycInfo）以及考科蓝系统评价数据库（Cochrane Reviews）中的文献。我们发现针对儿童及其家庭的教育干预措施的随机对照研究数量有限，且只有一项研究专门针对学龄前儿童。由于研究方法各异，研究之间难以进行比较，研究结果也尚无定论。总之，需要采取全面、多学科、多层次的干预措施，以尽量减少儿童哮喘的影响，尤其是对低收入家庭的儿童。需要开展大规模的随机对照研究，为入学前针对学龄前儿童的特定干预措施的有效性提供实证依据，以尽量减少未得到控制的哮喘对学业成绩的不利影响。
