Family Learning on Asthma Topics

Joyce A Baker, Spencer Weir, M. Gleason, Naomi Miyazawa, S. Szefler
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Abstract

Background: Utilizing group education promotes problem solving, stimulates conversation, and provides shame free environments to decrease stigmas. Providing comprehensive education by an experienced certified asthma educator (AE-C) is an important step in supporting patients diagnosed with asthma. Methods: Patients 2 to 17 years of age who were prescribed ≥2 systemic steroid courses, had ≥ 2 emergency department visits, and/or ≥1 hospitalization for asthma exacerbation the preceding 12 months were identified having poorly controlled asthma. These patients and their legal guardian/caregiver were recruited from pulmonary clinic or inpatient services to participate in classroom asthma education provided by a AE-C to address real life problem-solving and promote self-awareness regarding medication use. Post card consent was obtained for the patient and legal guardian to attend 1-2 classes over a four-month period; complete a pre/post asthma knowledge assessment; and receive text/phone call reminders prior to each class. The classroom education materials included audio and visual learning tools written at a fifth-grade reading level in both English and Spanish. Results: Our goal was to recruit 50-75 patients over a 9-month period. Only eight patients were recruited for the study, four of them with their caregivers participated in the classroom education. Patients and caregivers who attended the class coincided with a clinic visit. Two of the four families completed the pre and post asthma knowledge survey. Revisit/readmissions were reviewed as a part of our outcome measures. None of the patients who participated in the classroom education had a revisit/readmission for asthma within 90 days and 100% of them attended their pulmonary clinic visit. One of the four patients who did not attend the classroom education had a revisit within 90 days and none of them have a scheduled specialist visit since enrolling. Conclusions: Due to the low enrollment and completion of the program we were not able to effectively evaluate the program. Caregivers felt the classroom education was well worth their time. Many families are not willing to participate in any educational sessions outside of scheduled clinic visits. Obtaining pre or post survey results was found to be successful only when provided in person rather than via phone call, email, or text. We believe convenience played a significant role in patient and caregivers’ engagement and participation.
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哮喘主题的家庭学习
背景:利用团体教育促进问题解决,刺激对话,并提供无羞耻感的环境来减少耻辱感。由经验丰富的认证哮喘教育者(AE-C)提供全面的教育是支持被诊断患有哮喘的患者的重要一步。方法:2 ~ 17岁的患者,如果在过去12个月内接受了≥2个全身性类固醇治疗,急诊次数≥2次,和/或因哮喘加重住院次数≥1次,则确定为哮喘控制不良。这些患者及其法定监护人/照顾者从肺部门诊或住院服务部门招募,参加由AE-C提供的课堂哮喘教育,以解决现实生活中的问题,并提高对药物使用的自我意识。获得患者及其法定监护人在4个月期间参加1-2节课程的明信片同意;完成哮喘前后知识评估;并在每次上课前收到短信/电话提醒。课堂教学材料包括用英语和西班牙语编写的五年级阅读水平的视听学习工具。结果:我们的目标是在9个月的时间内招募50-75名患者。研究只招募了8名患者,其中4名患者和他们的护理人员一起参加了课堂教育。参加课程的患者和护理人员与诊所访问时间一致。4个家庭中有2个家庭完成了哮喘前后知识调查。重新审视/再入院作为我们结果测量的一部分。参加课堂教育的患者在90天内没有因哮喘再访或再入院,100%的患者参加了肺部门诊就诊。未参加课堂教育的4例患者中有1例在90天内进行了复查,自入组以来均未安排专科就诊。结论:由于该项目的低入组率和完成率,我们无法对该项目进行有效评估。看护人觉得课堂教育很值得他们花时间。许多家庭不愿意参加任何教育课程以外的预定诊所访问。调查前或调查后的调查结果只有亲自提供,而不是通过电话、电子邮件或短信获得。我们相信,便利性在患者和护理人员的参与和参与中发挥了重要作用。
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