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Macêdo LA, Silva FVN, Dosea AS, Araujo-Neto FDC, Alcântara TDS, Cavalcante-Santos LM, Simões SDM, Lyra DPD. Perceptions of Children and Caregivers Regarding Asthma and Its Pharmacotherapy: A Qualitative Study. Clin Pediatr (Phila) 2024:99228241275033. [PMID: 39219180 DOI: 10.1177/00099228241275033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Asthma, when untreated, may lead to serious implications, especially in the pediatric population. Understanding the perceptions and needs of children and their caregivers may optimize asthma management. This study was aimed to analyze the perceptions of children and their caregivers regarding asthma and its pharmacotherapy. This is a qualitative study using 2 focus groups. We use the Bardin's content analysis. Three researchers made data cross-validation. As for results, the first focus group comprised 7 children who had uncontrolled asthma. The second group comprised 7 caregivers who were the children's mothers. Four categories emerged: living with asthma, impact of asthma, medications, and health care. Asthma and its pharmacotherapy significantly affect the daily activities of children and mothers. Thus, understand feelings and experiences of patients and caregivers, in addition to educational and welcoming interventions for families in asthma management may be carried out by health care professionals to minimize the damage caused by this disease.
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Affiliation(s)
- Luana Andrade Macêdo
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Brazil
- Graduate Program in Pharmaceutical Sciences, Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Brazil
| | - Fernanda Vilanova Nascimento Silva
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Brazil
| | - Aline Santana Dosea
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Brazil
- Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Brazil
| | - Fernando de Castro Araujo-Neto
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Brazil
- Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Brazil
| | - Thaciana Dos Santos Alcântara
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Brazil
| | - Lincoln Marques Cavalcante-Santos
- Department of Pharmaceutical Sciences, Pharmaceutical Care and Clinical Pharmacy Research Center, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Divaldo Pereira de Lyra
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Brazil
- Graduate Program in Pharmaceutical Sciences, Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Brazil
- Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Brazil
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Kemble H, Foster M, Blamires J, Mowat R. Children and young people's self-reported experiences of asthma and self-management nursing strategies: An integrative review. J Pediatr Nurs 2024; 77:212-235. [PMID: 38598994 DOI: 10.1016/j.pedn.2024.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/16/2024] [Accepted: 03/17/2024] [Indexed: 04/12/2024]
Abstract
AIM To explore children and young people's (CYP) (5-24 years of age) self-reported experiences of asthma self-management strategies (ASMS) with nursing involvement across various settings. BACKGROUND Childhood asthma is an increasingly significant health issue, highlighting the importance of acquiring self-management skills to optimise future health outcomes. Registered nurses play a pivotal role in delivering appropriate, personalized self-management support. METHODS This integrative review searched four electronic databases: Cumulated Index to Nursing and Allied Health Literature via Elton B. Stephens Company, Medical Literature Analysis and Retrieval System Online (MEDLINE), Object, View and Interactive Design (OVID), and PubMed, that followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis flowchart. Included studies were critically appraised using the Joanna Briggs Institute critical appraisal tools. Braun and Clarks thematic analysis was used to generate themes, and sub-themes. FINDINGS Fifteen studies were included for review. Thematic analysis generated three themes being healthy literacy; health and wellbeing; and tools and working together. CONCLUSIONS Asthma continues to have negative physical, psychological, and social implications among CYP. CYP are both willing and capable of engaging in ASMS and learning self-management skills, however, continue to have unmet self-management needs. IMPLICATIONS TO PRACTICE Strategies must bolster health literacy, improve physical and psychological health, and harness interactive, youth-centric, and informative tools to facilitate communication and decrease the burden of self-management. Applications pose a promising avenue for self-management support. This age group remains under-explored and future research should enable meaningful engagement with CYP to better understand their perspectives and improve strategy success.
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Affiliation(s)
- H Kemble
- Auckland University of Technology, School of Clinical Sciences, Auckland, New Zealand; Auckland University of Technology, School of Clinical Sciences (Nursing), 90 Akoranga Drive, Northcote, Auckland 0627, New Zealand
| | - M Foster
- Auckland University of Technology, School of Clinical Sciences, Auckland, New Zealand; Edith Cowan University, School of Nursing and Midwifery, Perth, Western Australia, Australia; Auckland University of Technology, School of Clinical Sciences (Nursing), 90 Akoranga Drive, Northcote, Auckland 0627, New Zealand.
| | - J Blamires
- Auckland University of Technology, School of Clinical Sciences, Auckland, New Zealand; Auckland University of Technology, School of Clinical Sciences (Nursing), 90 Akoranga Drive, Northcote, Auckland 0627, New Zealand.
| | - R Mowat
- Auckland University of Technology, School of Clinical Sciences, Auckland, New Zealand; Auckland University of Technology, School of Clinical Sciences (Nursing), 90 Akoranga Drive, Northcote, Auckland 0627, New Zealand.
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Sleath B, Carpenter D, Davis SA, Garcia N, Reuland DS, Tudor G, Loughlin CE. Adolescent asthma management self-efficacy and responsibility: impact on asthma control and quality-of-life. J Asthma 2023; 60:331-338. [PMID: 35286174 DOI: 10.1080/02770903.2022.2051541] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the extent to which adolescent asthma management self-efficacy, outcome expectations, and asthma responsibility were associated with asthma control and quality-of-life. Adolescent self-efficacy and outcome expectations are important components of social cognitive theory, which guided this research. METHODS English- and Spanish-speaking adolescents ages 11-17 with persistent asthma were recruited at four pediatric clinics. Adolescents were interviewed and parents completed questionnaires. Multiple linear regression was used to analyze the data. RESULTS Three hundred and fifty-nine adolescents were recruited. Older adolescent age, male gender, and higher adolescent asthma management self-efficacy were significantly associated with higher adolescent responsibility; outcome expectations were not significantly associated with responsibility. Adolescent ratings of their own responsibility were higher than parent ratings of their child's responsibility for almost all asthma management tasks. Adolescents with higher reported asthma management self-efficacy were significantly more likely to have better quality-of-life and controlled asthma. Adolescents with more positive outcome expectations were significantly more likely to have controlled asthma. Being Native American was associated with worse quality-of-life and asthma not being controlled. Being Black was associated with asthma not being controlled. CONCLUSIONS Parents and providers should work to improve adolescent self-efficacy in managing their asthma because it is associated with asthma responsibility, asthma control, and quality-of-life. Providers need to especially work with Native American and Black adolescents to improve quality-of-life and asthma control.
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Affiliation(s)
- Betsy Sleath
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Delesha Carpenter
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Scott A Davis
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nacire Garcia
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Daniel S Reuland
- Division of General Internal Medicine and Clinical Epidemiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gail Tudor
- Health Professions, Southern New Hampshire University, Manchester, NH, USA
| | - Ceila E Loughlin
- Department of Pediatric Pulmonology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Sonney J, Cho EE, Zheng Q, Kientz JA. Refinement of a Parent-Child Shared Asthma Management Mobile Health App: Human-Centered Design Study. JMIR Pediatr Parent 2022; 5:e34117. [PMID: 35175214 PMCID: PMC8895285 DOI: 10.2196/34117] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/22/2021] [Accepted: 01/12/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The school-age years, approximately ages 7 through 11, represent a natural transition when children begin assuming some responsibility for their asthma management. Previously, we designed a theoretically derived, tailored parent-child shared asthma management mobile health app prototype, Improving Asthma Care Together (IMPACT). OBJECTIVE The purpose of this study was to use human-centered design (HCD) to iteratively refine IMPACT to optimize user experience and incorporate evidence-based longitudinal engagement strategies. METHODS This study used a mixed methods design from December 2019 to April 2021. Our app refinement used the HCD process of research, ideation, design, evaluation, and implementation, including 6 cycles of design and evaluation. The design and evaluation cycles focused on core app functionality, child engagement, and overall refinement. Evaluation with parent-child dyads entailed in-person and remote concept testing and usability testing sessions, after which rapid cycle thematic analyses identified key insights that informed future design refinement. RESULTS Twelve parent-child dyads enrolled in at least one round of this study. Eight of the 12 child participants were male with a mean age of 9.9 (SD 1.6) years and all parent participants were female. Throughout evaluation cycles, dyads selected preferred app layouts, gamification concepts, and overall features with a final design prototype emerging for full-scale development and implementation. CONCLUSIONS A theoretically derived, evidence-based shared asthma management app was co-designed with end users to address real-world pain points and priorities. An 8-week pilot study testing app feasibility, acceptability, and preliminary efficacy is forthcoming.
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Affiliation(s)
- Jennifer Sonney
- Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle, WA, United States.,Department of Human Centered Design and Engineering, University of Washington, Seattle, WA, United States
| | - Emily E Cho
- Department of Human Centered Design and Engineering, University of Washington, Seattle, WA, United States
| | - Qiming Zheng
- Department of Human Centered Design and Engineering, University of Washington, Seattle, WA, United States
| | - Julie A Kientz
- Department of Human Centered Design and Engineering, University of Washington, Seattle, WA, United States
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Bjorgaas HM, Elgen IB, Hysing M. Illness perception in children with cerebral palsy, a longitudinal cohort study. Heliyon 2021; 7:e08558. [PMID: 34917821 PMCID: PMC8666649 DOI: 10.1016/j.heliyon.2021.e08558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 08/18/2021] [Accepted: 12/02/2021] [Indexed: 11/24/2022] Open
Abstract
Background The perception of a disorder could be of importance both in problem solving behaviors, and in the emotional approach towards a disorder. Aims In this paper, we wanted to assess changes in illness perception in children with Cerebral Palsy (CP) over a four-year interval, to compare parental and self-ratings, and to assess illness perceptions according to co-occurring medical and psychiatric disorders. Methods Parents in a cohort of children with CP (N = 36), filled in the Illness Perception Questionnaire at age seven and again at age eleven, and self-reports were gathered at age eleven. Stability across time, informant differences and scores according to motor function, intellectual disability and the prevalence of psychiatric disorders were assessed. Results We found stable parental perceptions across a four –year interval. Parents reported significantly higher impact of CP on the child, than that reported by the child itself. In children with a more severe motor disability and/or co-occurring psychiatric disorders, parents reported significantly higher median scores for perceived impact of the CP condition on symptoms, duration of the condition, and impact on leisure activities, compared to those who had less severe motor disability and/or intellectual abilities within the normal range. Conclusions We propose that illness perception should be included in the follow-up of children with CP, as it may provide a mutual understanding between the child/family and professionals involved in follow-up services, with possible impact on treatment adherence and outcome of the condition. Parents reported significantly more negative impact of CP than their children. Parents reported stable perception of their child's CP across a four-year period. Parents and children reported significant impact of CP on leisure activities. Impact of CP was significant in children with co-occurring psychiatric disorders.
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Affiliation(s)
- Hanne Marit Bjorgaas
- Dept. of Pediatric Neurology, Habu Stavanger, Stavanger University Hospital, Stavanger HF, Pb. 8100, 4068, Stavanger, Norway
| | | | - Mari Hysing
- Dept. of Psychosocial Science, Pb. 7807, 5020, Bergen, Norway
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Hynes L, Durkin K, Ewell T, Lilly C, Williford DN, Ahrabi-Nejad C, Noel D, Kothari V, Skoner D, Duncan CL. Pictorial versus written asthma action plans for youth: initial impact on regimen knowledge, medication adherence, symptom control, and family satisfaction. J Asthma 2021; 59:1885-1898. [PMID: 34424115 DOI: 10.1080/02770903.2021.1968427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Asthma action plans (AAP) are recommended to guide asthma management. Written AAPs (WAAPs) are under-utilized and can be difficult to understand. Our study designed and tested a simplified pictorial AAP (PAAP). We hypothesized that better outcomes would be obtained for youth with the PAAP. METHODS One hundred and sixty-nine (169) youth (aged 8-17; AAP-naïve) were screened for this pilot, 2-arm randomized controlled trial. Feasibility, usability and preliminary efficacy of PAAP compared to a WAAP, for improving outcomes (inhaled corticosteroid (ICS) adherence, symptom control, AAP knowledge, AAP satisfaction) were assessed quantitatively. Youth received an AAP from their physician after completing baseline measures and completed measures at three additional time points (1-, 3-, and 6-month). RESULTS Forty-five youth were recruited (PAAP = 22; WAAP = 23). Youth AAP knowledge was higher for the PAAP group compared to the WAAP group (p = .017). ICS adherence did not differ between groups, over time, or based on prescribed dosing; however, for WAAP participants, adherence was lower with a higher daily prescription (4 puffs) relative to a lower dose (p = .006). Symptom control improved with both AAPs, but the change was not statistically significant. Lung function did not change significantly by AAP type or time, and literacy variables were not related significantly to outcomes. Youth satisfaction with AAP improved significantly for the PAAP group compared to the WAAP group (p = .03). CONCLUSIONS Higher AAP knowledge and satisfaction among youth in the PAAP group suggests that structured education from a physician using a PAAP is beneficial. Intervention and study design insights gained will guide future research.
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Affiliation(s)
- Lisa Hynes
- Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - Kristine Durkin
- Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - Thomas Ewell
- Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - Christa Lilly
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA
| | | | | | - Destiny Noel
- Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - Viral Kothari
- Department of Pediatrics, School of Medicine, West Virginia University, Morgantown, WV, USA
| | - David Skoner
- Department of Pediatrics, School of Medicine, West Virginia University, Morgantown, WV, USA
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Sonney JT, Thompson HJ, Landis CA, Pike KC, Chen ML, Garrison MM, Ward TM. Sleep intervention for children with asthma and their parents (SKIP Study): a novel web-based shared management pilot study. J Clin Sleep Med 2021; 16:925-936. [PMID: 32056537 DOI: 10.5664/jcsm.8374] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
STUDY OBJECTIVES The objective of this study was to describe the feasibility, acceptability, and preliminary efficacy of a novel Sleep Intervention for Kids and Parents (SKIP). Parent and child primary sleep outcomes were total sleep time, wake after sleep onset (WASO), sleep efficiency (SE), and bedtime range. METHODS Children 6-11 years of age with asthma and 1 parent, both with behavioral sleep disturbance, enrolled in this single-group pilot. The 8-week shared management intervention included weekly online educational modules, goal setting, and progress reporting. Feasibility was measured by the number of dyads who were eligible, enrolled, and retained. Acceptability was measured by survey and semistructured interview. Total sleep time, WASO, SE, and bedtime range were measured by actigraphy at baseline, after the intervention, and 12-week follow-up. Mixed-effects regression models were used to determine change in sleep outcomes from baseline. RESULTS Thirty-three of 39 eligible dyads enrolled; of 29 dyads that started the intervention, 25 (86%) completed all study visits. SKIP was acceptable for 61% of children and 92% of parents. Compared with baseline, at follow-up, children had significantly improved WASO (-37 minutes; 95% confidence interval [CI], -44.5 to -29.7; P < .001), SE (5.4%; 95% CI, 4.2-6.5; P < .001), and bedtime range (-35.2 minutes; 95% CI, -42.9 to -27.5; P < .001). Parents also had significantly improved WASO (-13.9 minutes; 95% CI, -19.5 to -8.2; P < .001), SE (2.7%; 95% CI, 1.7-.7; P < .001), and bedtime range (-35.3 minutes; 95% CI, -51.0 to -19.7; P < .001). CONCLUSIONS SKIP was feasible, acceptable, and we observed improved child and parent sleep outcomes except total sleep time. Following refinements, further testing of SKIP in a controlled clinical trial is warranted. Clinical Trial Registration: Registry: ClinicalTrials.gov; Name: Sleep Intervention for Kids and Parents: A Self-Management Pilot Study; URL: https://www.clinicaltrials.gov/ct2/show/study/NCT03144531; Identifier: NCT03144531.
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Affiliation(s)
- Jennifer T Sonney
- Department of Child, Family, and Population Health Nursing, University of Washington School of Nursing, Seattle, Washington
| | - Hilaire J Thompson
- Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, Washington
| | - Carol A Landis
- Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, Washington
| | - Kenneth C Pike
- Office of Nursing Research, University of Washington School of Nursing, Seattle, Washington
| | - Maida L Chen
- Pulmonary and Sleep Medicine, Seattle Children's Hospital, Seattle, Washington
| | - Michelle M Garrison
- Department of Health Services, University of Washington School of Public Health, Division of Child and Adolescent Psychiatry, University of Washington School of Medicine, Seattle, Washington.,Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Teresa M Ward
- Department of Child, Family, and Population Health Nursing, University of Washington School of Nursing, Seattle, Washington
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Han L, Shangguan J, Yu G, Li T, Wu Y, Zhou Y, Liu P, Wang A. Association between family management and asthma control in children with asthma. J SPEC PEDIATR NURS 2020; 25:e12285. [PMID: 31825168 DOI: 10.1111/jspn.12285] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/10/2019] [Accepted: 11/19/2019] [Indexed: 01/26/2023]
Abstract
PURPOSE The purpose of this study is to investigate the association between family management and asthma control in children with asthma. DESIGN AND METHODS This cross-sectional descriptive study recruited 142 children with asthma and their parents. We used the Family Management Measure (FaMM), the Childhood Asthma Control Test (C-ACT), and fractional exhaled nitric oxide (FeNO) detectors to assess family management and asthma control. The McNemar's test was used to determine the proportional difference between C-ACT and FeNO in evaluating asthma control. Pearson correlation analysis and multiple linear regression analysis were used to assess the relationship between family management and asthma control in children with asthma. RESULTS There was no significant difference in the proportion of C-ACT and FeNO in evaluating asthma control (McNemar's test p = .593). Child's Daily Life, Condition Management Ability, and Parental Mutuality were positively correlated with C-ACT (r = 0.398 to 0.655; all p < .05) and negatively correlated with FeNO (r = -0.245 to -0.402; all p < .05); Condition Management Effort, Family Life Difficulty, and View of Condition Impact were negatively correlated with C-ACT (r = -0.416 to -0.672; all p < .05) and positively with FeNO (r = 0.248 to 0.427; all p < 0.05). Child's Daily Life, Condition Management Effort, and View of Condition Impact dimensions significantly predicted the C-ACT results, and the Condition Management Effort and View of Condition Impact dimensions significantly predicted the FeNO results (p < .05). PRACTICAL IMPLICATIONS Pediatric nurses could provide family management education for parents to improve asthma control in children. In addition, pediatric nurses might assess asthma control condition of asthmatic children in combination with C-ACT and FeNO levels.
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Affiliation(s)
- Li Han
- School of Nursing, Qingdao University, Qingdao, China
| | - Jing Shangguan
- Department of Medical Technology, Zaozhuang Vocational College of Science and Technology, Zaozhuang, China
| | - Guiling Yu
- Department of Nursing, Qingdao Women and Children's Hospital, Qingdao, China
| | - Ting Li
- Department of Nursing, Qingdao Women and Children's Hospital, Qingdao, China
| | - Yujie Wu
- School of Nursing, Qingdao University, Qingdao, China
| | - Yunping Zhou
- School of Nursing, Qingdao University, Qingdao, China
| | - Panpan Liu
- School of Nursing, Qingdao University, Qingdao, China
| | - Aimin Wang
- School of Nursing, Qingdao University, Qingdao, China
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