Giese Jeannie K
a Belmont University School of Nursing , Nashville , Tennessee , United States.
J Asthma. 2019 Jun;56(6):662-673. doi: 10.1080/02770903.2018.1472279. Epub 2018 May 29.
Asthma disproportionately impacts and has poorer outcomes in low-income, minority, and inner-city children. The home environment has a profound impact on a child's asthma. Home-based asthma visits have the potential to positively impact a child's asthma, especially in targeted populations. The purpose of this integrative review is 1.) to explore the effectiveness of home-based education and environmental measures and 2.) to explore specific indicators and tools to measure pediatric asthma control and program effectiveness.
Medline, CINHAL, and Ovid databases were searched from 2010 to 2017 utilizing the keywords healthy homes AND asthma and home based interventions AND asthma.
A total of 71 articles were retrieved of which 27 articles met the inclusion criteria of English language, human subjects, and the inclusion of pediatric populations. Three additional articles were hand-searched from previous references. In total, 30 articles were reviewed. A quality appraisal was conducted utilizing standardized appraisal tools.
Home-based asthma education and environmental interventions have proven to be effective. The programs reviewed varied in types of interventions, intensity and duration, the type of provider, length of follow-up, and outcome measures. Successful programs were patient-centered, included a home assessment and individualized education and interventions, and were collaborative. Multiple outcome indicators such as health care utilization, asthma control, missed days of school or productivity, asthma symptoms, and verification of environmental remediation have been utilized.
Home-based asthma programs can be beneficial to children with poorly controlled asthma and have the potential to be cost-effective.
哮喘对低收入、少数族裔及市中心儿童的影响尤为严重，且这些儿童的哮喘预后较差。家庭环境对儿童哮喘有深远影响。基于家庭的哮喘访视有可能对儿童哮喘产生积极影响，尤其是在目标人群中。本系统综述的目的是：1）探讨基于家庭的教育和环境措施的有效性；2）探索衡量儿童哮喘控制情况及项目有效性的具体指标和工具。
利用关键词“健康家庭与哮喘”以及“基于家庭的干预措施与哮喘”，检索2010年至2017年期间的Medline、CINHAL和Ovid数据库。
共检索到71篇文章，其中27篇文章符合英文、人体研究对象以及纳入儿科人群的纳入标准。另外从之前的参考文献中手工检索到3篇文章。总共对30篇文章进行了综述。使用标准化评估工具进行质量评估。
事实证明，基于家庭的哮喘教育和环境干预措施是有效的。所综述的项目在干预类型、强度和持续时间、提供者类型、随访时间长度以及结局指标方面各不相同。成功的项目以患者为中心，包括家庭评估、个性化教育和干预措施，并且具有协作性。已使用了多个结局指标，如医疗保健利用率、哮喘控制情况、缺课天数或生产力损失、哮喘症状以及环境整治的核实情况。
基于家庭的哮喘项目可能对哮喘控制不佳的儿童有益，并且有可能具有成本效益。
