A case study of asthma care in school age children using nurse-coordinated multidisciplinary collaborative practices

Challenges in uncontrolled asthma in pediatrics: important considerations for the clinician

INTRODUCTION

Despite symptoms control being the primary focus of asthma management according to guidelines, uncontrolled asthma is still an issue worldwide, leading to huge costs and asthma deaths at all ages. In childhood, poor asthma control can be even more harmful, as it can irreversibly compromise the children's lung function and the whole family's well-being.

AREAS COVERED

Given the problem extent, this review aims to discuss the leading modifiable causes of uncontrolled asthma in Pediatrics, giving some practical insights regarding the critical role of families and the main tools for monitoring control and drug adherence, even at a distance. The most recent GINA documents were used as the primary reference, along with the latest evidence regarding the management of asthma control and the impact of the COVID-19 pandemic on asthma.

EXPERT OPINION

In managing pediatric asthma, a multidisciplinary, multi-determinant, personalized approach is needed, actively involving families, schools, and other specialists. In addition to current strategies for implementing control, electronic health strategies, new validated asthma control tools, and the identification of novel inflammatory biomarkers could lead to increasingly tailored therapies with greater effectiveness in reaching asthma control.

Psychoeducational Strategies During Outpatient Transition to Extended-Release Naltrexone for Patients With Opioid Use Disorder

BACKGROUND: The United States is experiencing an opioid epidemic. Better approaches to encourage outpatient utilization of Food and Drug Administration-approved medications for the treatment of opioid use disorder, including extended-release naltrexone (XR-NTX), are needed. Withdrawal management before initiation of XR-NTX is challenging for clinicians and patients and represents a major barrier to treatment. AIMS: To review psychoeducational strategies that support patients during outpatient withdrawal management and transition to XR-NTX. METHOD: We reviewed the literature on psychoeducational strategies used during opioid withdrawal management and described the role that nurses can play in facilitating transition to XR-NTX in a Phase 3, placebo-controlled, outpatient trial comparing induction regimens. RESULTS: Supportive interventions include general psychoeducation on addiction, overcoming ambivalence, treatment adherence, anticipating XR-NTX induction, managing psychological and physiological aspects of opioid withdrawal, risks of opioid use, and sources of support during recovery. CONCLUSIONS: Psychoeducational strategies led by nurses can promote treatment adherence during withdrawal management and induction onto XR-NTX.

A model to facilitate collaborative social support for pregnant students in secondary schools

Pregnancy among secondary school students remains a public health problem and is associated with school dropout as well as poor maternal and child health outcomes. Schools in South Africa no longer expel pregnant students as was the case before 2000. Instead, the government encourages them to remain in class to complete their education, but pregnant students often face stigma, and some drop out of school as a result. To remain in class and access antenatal care, pregnant students require social support from teachers, parents and professional nurses. Unfortunately, teachers, parents and professional nurses support pregnant students on an ad hoc basis, and this calls for a model to facilitate collaborative social support. The purpose of this paper is to present and describe a model to facilitate collaborative social support for pregnant students attending secondary schools in South Africa, using the model description steps of Chinn and Kramer. The model is designed as a tool to enable pregnant students to remain in school, attend antenatal care and in the end, deliver healthy babies. The professional nurse, as a member and leader of the school health team which visits secondary schools to provide a package of school health services, is the agent or facilitator of the model.

Integrality of care: challenges for the nurse practice

ABSTRACT Objective: to understand the role of the nurse in the collegiate management model of a teaching hospital, in the integrality of care perspective. Method: a single case study with multiple units of analysis, with the theoretical proposition "integrality of care is a result of the care offered to the user by multiple professionals, including the nurse". Data were obtained in a functional unit of a teaching hospital through interviews with 13 nurses in a non-participant observation and document analysis. Results: from the analytical categories emerged subcategories that allowed understanding that the nurse promotes integrality of care through nursing management, team work and integration of services. Final considerations: the theoretical proposition was confirmed and it was verified that the nursing management focus on attending to health care needs and is a strategy to provide integrality of care.

The school as a health promoter for children with asthma: The purpose of an education programme

BACKGROUND

Not only is asthma one of the leading causes of hospitalisation in children under 15 years and one of the main reasons for primary care outpatient visits, it also accounts for 13 million lost days of school annually, which can affect children's learning, integration at school and overall academic achievements.

MATERIAL AND METHODS

This review article highlights the important role of the school in helping children and adolescents to control and manage their asthma through integrated and coordinated actions of health professionals, school staff, family, and the community.

RESULTS

We recommended key elements for a multidisciplinary team asthma school programme that can be replicated and implemented especially in developing countries where children and adolescents are in a more disadvantaged environment.

CONCLUSION

This multidisciplinary asthma school intervention when demonstrated with efficacy can be applied in the context of the real world, where many children and families who need care the most currently do not receive it.