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教育项目对儿童慢性化脓性中耳炎管理的影响

Impact of Educational Program on the Management of Chronic Suppurative Otitis Media among Children.

作者信息

Elsayed Yousef Yousseria, Abo El-Magd Essam A, El-Asheer Osama M, Kotb Safaa

机构信息

Department of Pediatric Nursing, Faculty of Nursing, Sohag University, Egypt.

ENT, Faculty of Medicine, Aswan University, Egypt.

出版信息

Int J Otolaryngol. 2015;2015:624317. doi: 10.1155/2015/624317. Epub 2015 Feb 22.

Abstract

Background. Chronic suppurative otitis media (CSOM) remains one of the most common childhood chronic infectious diseases worldwide, affecting diverse racial and cultural groups in both developing and industrialized countries. Aim of the Study. This study aimed to assess the impact of educational program on the management of children with CSOM. Subjects and Methods. An experimental study design was used. This study included 100 children of both sexes of 2 years and less of age with CSOM. Those children were divided into 3 groups: group I: it involved 50 children with CSOM (naive) who received the designed educational program; control group: it involved 50 children who were under the traditional treatment and failed to respond; group II: those children in the control group were given the educational program and followed up in the same way as group I and considered as group II. Tools of the Study. Tool I is a structured questionnaire interview sheet for mothers. It consists of four parts: (1) personal and sociodemographic characteristics of child and (2) data about risk factors of otitis media (3) assessment of maternal practice about care of children with suppurative otitis medi (4) diagnostic criteria for suppurative otitis media. Tool II is the educational program: an educational program was developed by the researchers based on the knowledge and practices needs. This study was carried out through a period of 9 months starting from September 2013 to May 2014. The educational program was implemented for mothers of children with CSOM in the form of 5 scheduled sessions at the time of diagnosis, after one week, 1, 3, and 6 months. Results. There were significant differences between children who received the educational program and control group regarding the response to treatment after one and 3 months. The percentages of complete cure increased progressively 32%, 60%, and 84% after 1, 3, and 6 months in group I while they were 24%, 44%, and 64% in group II, respectively. Cure (dry perforation) was 64%, 36%, and 12% among children of group I after 1, 3, and 6 months while it was 64%, 44%, and 24% in group II, respectively. The percentages of compliance to the educational program improved with time in both groups: 44%, 64%, and 80% in group I and 32%, 48%, and 56% in group II after 1, 3, and 6 months, respectively. The percentages of cure were statistically significantly higher among children with complete compliance with the educational program in both groups in comparison to those with incomplete compliance (P = 0.000 for both). Conclusions. From this study we can conclude that the majority of children with CSOM had one or more risk factors for occurrence of the disease; the educational program is effective for management of CSOM (whether cure or complete cure); the higher the compliance of mothers with the program the higher the response rate; regular followup and explanation of the importance of the program played an important role in the compliance with the program.

摘要

背景。慢性化脓性中耳炎(CSOM)仍是全球最常见的儿童慢性传染病之一,影响着发展中国家和工业化国家的不同种族和文化群体。研究目的。本研究旨在评估教育项目对CSOM患儿管理的影响。研究对象与方法。采用实验性研究设计。本研究纳入100名2岁及以下患有CSOM的儿童,男女不限。这些儿童被分为3组:第一组:包括50名患有CSOM的儿童(初治患儿),他们接受了设计好的教育项目;对照组:包括50名接受传统治疗但无反应的儿童;第二组:对照组中的儿童接受教育项目,并与第一组以相同方式进行随访,被视为第二组。研究工具。工具一为针对母亲的结构化问卷调查表。它由四个部分组成:(1)儿童的个人及社会人口学特征;(2)中耳炎危险因素的数据;(3)对母亲护理化脓性中耳炎患儿做法的评估;(4)化脓性中耳炎的诊断标准。工具二为教育项目:研究人员根据知识和实践需求制定了一个教育项目。本研究从2013年9月至2014年5月历时9个月进行。教育项目以5次预定课程的形式在诊断时、一周后、1个月、3个月和6个月时对CSOM患儿的母亲实施。结果。在治疗1个月和3个月后,接受教育项目的儿童与对照组在治疗反应方面存在显著差异。第一组在1个月、3个月和6个月后的完全治愈百分比分别逐渐增加至32%、60%和84%,而第二组分别为24%、44%和64%。第一组儿童在1个月、3个月和6个月后的治愈(干耳穿孔)率分别为64%、36%和12%,而第二组分别为64%、44%和24%。两组对教育项目的依从率均随时间提高:第一组在1个月、3个月和6个月后分别为44%、64%和80%,第二组分别为32%、48%和56%。两组中完全依从教育项目的儿童的治愈率在统计学上显著高于不完全依从的儿童(两组P值均为0.000)。结论。从本研究我们可以得出结论:大多数CSOM患儿有一个或多个该疾病发生的危险因素;教育项目对CSOM的管理有效(无论是治愈还是完全治愈);母亲对该项目的依从性越高,反应率越高;定期随访以及对项目重要性的解释在项目依从性方面发挥了重要作用。

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