Implementation and Evaluation of a School Nurse Toolkit to Reinforce Best Practices for Asthma Care in Schools.

A toolkit, developed by a multidisciplinary team of national and statewide professionals, was promoted among school nurses in Michigan to support use of the standards of care for asthma in schools. We evaluated the effectiveness of the toolkit to assist school nurses in providing support for students with asthma. We used a multimethod approach to assess use of the toolkit, changes in nursing practices as a result of using the toolkit, and challenges encountered when implementing the standards for asthma care. During a 12-month period, from July 2022 through June 2023, increases in time on web page and monthly page views aligned with efforts to promote toolkit use. School nurses reported using the toolkit and implementing practice changes pertaining to training and education, ensuring proper use of and access to asthma medications, and advocating for self-carry of asthma medications. Challenges to implementing the standards of asthma care were time, parental engagement, institutional support, and identifying students with asthma. We found that our promotional efforts prompted school nurses to access the toolkit, which helped school nurses to effectuate practice changes to improve support for students with asthma in schools.

Children and young people's self-reported experiences of asthma and self-management nursing strategies: An integrative review.

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.

Asthma policy in Illinois: A survey of school nursing and staff knowledge and implementation patterns.

OBJECTIVE: Our goal is to examine gaps in self-carry, asthma emergency protocol, and stock inhaler policy knowledge in Illinois schools. DESIGN: A 30-item REDCap cross-sectional survey developed by a team of stakeholders was disseminated. Questions assessed policy knowledge, awareness, and practices regarding asthma emergency protocols, self-carry, and stock inhalers. SAMPLE: Participants were Illinois school nurses belonging to a governmental organization listserv. MEASUREMENTS: Analysis utilized Chi-square tests, descriptive statistics, and t-tests. RESULTS: Nurses reported 36% of students on average self-carried asthma medication. Thirty percent of nurses were not aware of their emergency asthma policy and only 60% reported having an emergency asthma protocol in their school(s). Fifty-four percent of nurses were aware of stock inhaler programming. Of the 10.3% who reported a stock inhaler program, a lower frequency reported calling 911 for asthma emergencies. Perceived school asthma prevalence varied from 0%-87%. CONCLUSIONS: Our survey demonstrates large variation in knowledge and implementation of school-based asthma health policy. This is likely due to variations in health policy education dissemination. Future efforts should focus on the dissemination and implementation of school-based asthma health policies to improve their more universal adoption and better support school-based asthma management.

Nurses' Role in the Control and Treatment of Asthma in Adults: A Systematic Literature Review.

Bronchial asthma is a chronic pathology and a global public health problem. However, asthma can be controlled and treated for the most part by patients, so the Portuguese General Directorate of Health recommends shared medical appointments in primary health care (PHC). The present study aims to identify the role of PHC nurses in the control and treatment of asthma in adults. Using the MeSH platform, the following descriptors were validated: asthma, nurses, adults. An individual search was carried out in the following databases: CINAHL (ESBSCO host), MEDLINE (Pubmed host), Web of Science, and Scopus. Out of a total of 280 publications, 79 of which were duplicates and 185 publications which did not meet the inclusion criteria, 16 publications remained readable. Of the eligible articles, there were 13 specialist reports, one mixed study, one quasi-experimental study, and one randomized trial. Education was the intervention most identified in the scientific evidence analyzed, and patient assessment, application of an asthma control questionnaire, verification and training of inhalation technique, empowerment for self-management of the disease, support, promotion of seasonal influenza vaccination, and use of written action plans were also identified. The results reveal that, although the scientific evidence on the intervention of these professionals is poorly developed, nurses play a crucial role in the control and treatment of asthma. The scientific evidence analyzed allowed the identification of interventions that can help the organization of a nursing health appointment, providing nurses with a crucial role in the control and treatment of asthma in adults in the context of PHC.

Avaliação do conhecimento sobre a asma em servidores técnico-administrativos de uma universidade pública / Evaluación del conocimiento sobre el asma en servidores técnico-administrativos de una universidad pública / Evaluation of knowledge about asthma in technical-administrative public workers of a public university

Objetivo: estimar o nível de conhecimento sobre asma de servidores técnico-administrativos do curso de graduação e pós-graduação em Enfermagem de uma universidade pública em Salvador, Bahia. Método: estudo transversal, realizado com 18 servidores técnico-administrativos de uma universidade pública. A coleta de dados foi realizada mediante envio de e-mail com links do formulário no Google Forms, entre janeiro e maio de 2021. Os dados foram analisados por meio da estatística descritiva com uso do software SPSS, 28.0. Resultados: encontrou-se predominância do sexo feminino 77,8% (n=14), média de idade 42,11±10,98 anos. Verificou-se que 55,6% (n=10) da amostra apresentou conhecimento insatisfatório sobre asma na análise por domínio e pela média de acertos (X±DP=22,6±7,5 acertos). O tratamento da asma foi a temática mais desconhecida pela amostra (X±DP=2,77±1,73 acertos). Conclusão: o nível de conhecimento sobre asma dos servidores técnico-administrativos foi insatisfatório na maioria da amostra investigada.

Objetivo: estimar el nivel de conocimiento sobre asma de servidores técnico-administrativos del curso de graduación y posgrado en Enfermería de una universidad pública en Salvador, Bahía. Método: estudio transversal, realizado con 18 servidores técnico-administrativos de una universidad pública. La recopilación de datos se realizó mediante el envío de correos electrónicos con links del formulario en Google Forms, entre enero y mayo de 2021. Los datos fueron analizados por medio de la estadística descriptiva con uso del software SPSS, 28.0. Resultados: se encontró predominancia del sexo femenino 77,8% (n=14), media de edad 42,11±10,98 años. Se verificó que 55,6% (n=10) de la muestra presentó conocimiento insatisfactorio sobre asma en el análisis por dominio y por la media de aciertos (X±DE=22,6±7,5 aciertos). El tratamiento del asma fue la temática más desconocida por la muestra (X±DE=2,77±1,73 aciertos). Consideraciones finales: el nivel de conocimiento sobre asma de los servidores técnico-administrativos fue insatisfactorio en la mayoría de la muestra investigada.

Objective: to estimate the level of knowledge about asthma of technical-administrative public workers of graduate and postgraduate nursing courses of a public university in Salvador, Bahia. Method: cross-sectional study, conducted with 18 technical-administrative public workers of a public university. Data collection was performed by sending an email with links to the form in Google Forms, between January and May 2021. Data were analyzed using descriptive statistics using SPSS software, 28.0. Results: predominance of women, 77.8% (n=14), mean age 42.11±10.98 years. 55.6% (n=10) of the sample presented unsatisfactory knowledge about asthma in the analysis by domain and by the average of correct answers (X±SD=22.6±7.5 correct answers). Asthma treatment was the most unknown theme in the sample (X±SD=2.77±1.73 correct answers). Final considerations: the level of knowledge about asthma of technical-administrative workers was unsatisfactory in the majority of the sample investigated.

Cuidados de enfermería en paciente con crisis asmática utilizando el modelo de Virginia Henderson / Nursing care in patients with asthmatic crisis using the Virginia Henderson model

La incidencia del asma varía extensamente en diversas regiones del mundo, se tiene un estimado de que 334 millones de personas padecen de asma bronquial y que 250,000 muertes son producto de una complicación de esta enfermedad. En este caso clínico se implementaron las intervenciones por parte de los profesionales de enfermería aplicando el proceso de atención de enfermería (PAE) orientado en la teoría de Virginia Henderson la cual se basa en las necesidades de las personas sanas y enfermas ya sea en la familia, comunidad, ya que estas necesidades son la bases que orientan las cinco fases del cuidado: valoración, diagnóstico, planificación, ejecución y evaluación, cada una se implementó en paciente. El objetivo principal es: mejorar la salud del paciente utilizando la teoría de Virginia Henderson, e implementando su respectivo tratamiento y cuidados de enfermería, para que su respiración sea estable y su saturación sea de un 100%. Se presenta caso de paciente masculino de 22 años de edad con educación universitaria en curso, vive con su madre y hermana, con una economía adecuada y con las necesidades básicas cubiertas. Causa de la consulta dificultad respiratoria, presencia de dolor torácico acompañada de tos sin esputo, Se diagnostica paciente con una crisis moderada de asma bronquial, teniendo en cuenta que tiene antecedentes de asma bronquial, se le dió manejo con administración de oxígeno para mantener la saturación, incluyendo el tratamiento y cuidados de enfermería adecuado y oportuno los cuales mejoraran la salud del paciente dando una recuperación ideal...(AU)

Experiencia enfermera en la realización de espirometrías en un equipo pediátrico / Nurse experience in performing spirometry in a pediatric team

Introducción: en España el asma constituye la segunda causa de morbilidad y enfermedad crónica infantil. Es una de las causas más frecuentes de consulta en el ámbito de la Atención Primaria, y su diagnóstico y tratamiento precoz permiten el control de la enfermedad modificando el curso de esta y la calidad de vida de los pacientes. Objetivo: describir la experiencia en la realización de espirometrías en la población pediátrica e impulsar a otros centros de Atención Primaria la incorporación de esta prueba en su cartera de servicios. Material y métodos: se realizaron 81 espirometrías a 67 pacientes con edades comprendidas entre los 5 y 14 años, entre enero 2019 y febrero 2020. De las 81 espirometrías, el 16% fueron basales, el 32,1% basales con prueba broncodilatadora (PBD) y el 51,9% con ejercicio y PBD. Se realizaron con un espirómetro Sibelmed Datospir Touch 511-B00-MU1. Resultados: de las 26 espirometrías con PBD, 15 fueron negativas y 11 positivas. De las 32 espirometrías con ejercicio que se realizaron, 9 fueron positivas respecto a la espirometría basal, y en 23 no se obtuvieron diferencias significativas, pero 5 de ellas si dieron positivo al realizar PBD. Conclusiones: es posible realizar espirometrías forzadas con resultados de calidad en el ámbito de Atención Primaria pediátrica, si se disponen de recursos materiales y de personal especializado. De esta forma, se contribuye a reducir las listas de espera y favorece un mayor control de la enfermedad (AU)

Introduction: in Spain, asthma is the second leading cause of morbidity and chronic illness in the paediatric population, following obesity. Asthma is one of the most frequent presenting complaints at the primary care level, and its early diagnosis and treatment allow control of the disease, modifying its course and improving patient quality of life. Objective: the aim of the study was to describe our experience in performing spirometry in the paediatric population and encourage other primary care centres to offer this test to their patients. Material and methods: a total of 81 spirometry tests were performed in 67 patients aged 5 to 14 years between January 2019 and February 2020. Of the 81 tests, 16% were baseline tests, 32.1% were spirometry with bronchodilator responsiveness testing (BRT), and 51.9% spirometry with exercise challenge and BRT All tests were performed with a Sibelmed Datospir Touch 511-B00-MU1 spirometer. Results: twenty-six spirometry tests included a BRT, with negative results of the BRT in 15 and positive results in 11. Another 32 tests included an exercise challenge, which was positive compared to baseline in 9, while in 23 there were no significant differences relative to baseline, although in 5 of them the BRT was positive. Conclusion: it is possible to perform forced spirometry in paediatric patients with high-quality results at the primary care level if the necessary material resources and qualified personnel are available. Providing this service can reduce waiting lists and improve asthma control (AU)

Control del asma infantil: principales factores asociados / Controlo da asma infantil: principais fatores asociados / Child asthma control: main associated factors

INTRODUCCIÓN: El asma aparece como una enfermedad inflamatoria crónica de las vías respiratorias y se caracteriza por episodios de obstrucción bronquial reversible pudiendo ser desencadenada por varios factores. Se constituye como la enfermedad infantil más común, una importante causa de internamiento hospitalario y un problema de salud pública. Las directrices internacionales sobre la gestión del asma reconocen que el tratamiento reside en el control actual y en el riesgo de exacerbaciones, basándose en la gestión de los síntomas. En cuanto a la percepción del control del asma infantil, existen discrepancias entre la percepción de los cuidadores y las indicaciones internacionales. OBJETIVOS: Describir y analizar los datos clínicos, sociodemográficos y factores asociados al control del asma infantil. METODOLOGÍA: Estudio metodológico, cuantitativo y transversal, en una muestra de niños, entre los 6 y los 11 años, con asma y cuidadores. El control del asma ha sido evaluado por el instrumento Childhood Asthma Control Test. RESULTADOS: La muestra fue compuesta por 60 niños y cuidadores. 12% (n = 7) de los niños presentan asma no controlada y 53% (n = 32) asma parcialmente controlada. En el 38% (n = 23) de los cuidadores existieron discrepancias entre el grado clasificado mediante las pautas internacionales y su percepción. El análisis de Regresión Logística confirma que los niños con necesidades de terapia inhalatoria de rescate presentan 7 veces mayor probabilidad de que el asma no esté controlada. CONCLUSIÓN: Resulta perentoria la necesidad de aprehender la complejidad de los factores que interfieren en el control del asma, existiendo necesidad de programas de intervención de gestión de síntomas centrados en los cuidadores, en el niño y en las necesidades identificadas

INTRODUÇÃO: A asma apresenta-se como uma doença crónica e inflamatória das vias aéreas caracterizada por episódios de obstrução brônquica reversível podendo ser desencadeada por diversos fatores. Constitui-se como a doença infantil mais comum, uma importante causa de internamento hospitalar e um problema de saúde pública. As diretrizes internacionais sobre a gestão da asma reconhecem que o tratamento reside no controlo atual e no risco de exacerbações, sendo baseados na gestão de sintomas. Relativamente à perceção do controlo da asma infantil, existem discrepâncias entre a perceção dos cuidadores e as indicações internacionais. OBJETIVOS: Descrever e analisar os dados clínicos, sociodemográficos e fatores associados ao controlo da asma infantil. METODOLOGIA: Estudo metodológico, quantitativo e transversal, numa amostra de crianças, entre os 6 e os 11 anos, com asma e cuidadores. O controlo da asma foi avaliado pelo instrumento Childhood Asthma Control Test. RESULTADOS: A amostra foi composta por 60 crianças e cuidadores. 12% (n=7) das crianças apresentam asma não controlada e 53% (n=32) asma parcialmente controlada. Em 38% (n=23) dos cuidadores existiram discrepâncias entre o grau classificado mediante as guidelines internacionais e a sua perceção. A análise de Regressão Logística confirma que as crianças com necessidades de terapêutica inalatória de resgate apresentam 7 vezes maior probabilidade da asma estar não controlada. CONCLUSÃO: Torna-se perentório a necessidade de apreensão da complexidade dos fatores que interferem no controlo da asma, existindo necessidade de programas de intervenção de gestão de sintomas centrados nos cuidadores, na criança e nas necessidades identificadas

INTRODUCTION: Asthma is an airways chronic and inflammatory disease characterized by episodes of reversible bronchial obstruction and can be triggered by several factors. It is the most common childhood disease, an important hospitalization cause and a public health problem. International guidelines of asthma management recognize that treatment based on current management and exacerbations risk, which are based on symptom management. Regarding the control perception of childhood asthma, there are discrepancies between the caregiver's perception and the international indications. OBJECTIVES: To describe and analyze the clinical, sociodemographic and factors associated with childhood asthma control. METHODOLOGY: Methodological, quantitative and transversal study, in a sample of 60 children, between 6 and 11 years, and caregivers. Asthma control was evaluated by the instrument childhood Asthma Control Test. RESULTS: The sample consisted of 60 children and caregivers. 12% (n = 7) of the children had uncontrolled asthma, 53% (n = 32) partly controlled asthma. In 38% (n = 23) of the caregivers there were discrepancies between the grade classified through the international guidelines and their perception. Logistic Regression analysis confirms that children with inhalational rescue therapy needs 7 times more likely asthma to be uncontrolled. CONCLUSION: The complexity of the factors that interfere in the control of asthma is urgent and there is a need for symptom management intervention programs focused on the caregivers, the child and the identified needs

Impacto de la autoeficacia en la calidad de vida de niños con asma y sus cuidadores / Impact of Self-Efficacy on The Quality of Life of Children With Asthma and Their Caregivers

Introducción: La calidad de vida relacionada con la salud es una importante medida de resultado utilizada en la monitorización del control del asma. La autoeficacia es un determinante de las conductas de automanejo, por lo que puede contribuir a la mejora del control del asma y de la calidad de vida. Nuestro objetivo es analizar la relación entre la autoeficacia y la calidad de vida de niños con asma y la de sus cuidadores. Métodos: En un total de 176 pacientes entre 6-14 años con asma se ha determinado el nivel de autoeficacia identificando tres grupos (niveles bajo, medio y alto). Cada niño y su cuidador principal completan PAQLQ y PACQLQ, respectivamente. Resultados: PAQLQ rang = (1-7): 5,61 ± 1,11; PACQLQ rang = (1-7): 5,42 ± 1,35; autoeficacia rang = (0-60): nivel bajo 28,44 ± 4,58; nivel medio 37,41 ± 1,7 y nivel alto 47,50 ± 5,5. Diferencias significativas en calidad de vida según niveles de autoeficacia bajo-medio vs. alto. Dominios específicos relacionados: PAQLQ emociones y PAQLQ síntomas con autoeficacia en las habilidades para resolver problemas relacionados con el asma y autoeficacia para el tratamiento. PACQLQ emociones con autoeficacia en las habilidades para resolver problemas relacionados con el asma. Conclusiones: Un alto nivel de autoeficacia se asocia a una mejor calidad de vida de los niños y sus cuidadores. Basándonos en estos resultados, la medida de la autoeficacia podría ser incorporada en la evaluación de las intervenciones educativas en automanejo cuyo objetivo final es alcanzar la calidad de vida diana del paciente y su familia

Introduction: Health-related quality of life is an important outcome measurement in the monitoring of asthma control. Self-efficacy is a determinant of self-management behaviors that can contribute to the improvement of asthma control and quality of life. Our objective was to analyze the relationship between self-efficacy and quality of life in children with asthma and their caregivers. Methods: We included 176 patients aged 6-14 years with asthma, and determined their level of self-efficacy according to three groups (low, medium and high levels). Each child and their main caregiver completed the PAQLQ and PACQLQ questionnaires, respectively. Results: PAQLQ range = 1-7: 5.61 ± 1.11; PACQLQ range = 1-7: 5.42 ± 1.35; self-efficacy range = 0-60: low level 28.44 ± 4.58; average level 37.41 ± 1.7, and high level 47.50 ± 5.5. Significant differences were observed in quality of life according to low-medium vs. high levels of self-efficacy. Specific related domains: PAQLQ emotions and PAQLQ symptoms with self-efficacy in problem-solving skills related to asthma and treatment self-efficacy; PACQLQ emotions with self-efficacy in problem-solving skills related to asthma. Conclusions: A high level of self-efficacy is associated with a better quality of life for children and their caregivers. Based on these results, the measurement of self-efficacy could be incorporated in the assessment of educational interventions in self-management targeted at the quality of life of the patient and his or her family

Ser-criança com asma: assumindo suas particularidades e lidando com restrições / Being-child with asthma: assuming its particularities and dealing with restrictions

Estudo objetivou compreender como crianças com asma e suas famílias se percebem no convívio com a doença crônica e desenvolvem seus modos de enfrentamento e cuidado. Trata-se de pesquisa fenomenológica, realizada com cinco famílias de crianças com asma moderada ou grave. A coleta de dados ocorreu por meio de entrevistas, realizadas junto às crianças e seus familiares, durante visitas domiciliares, entre setembro de 2013 e janeiro de 2014. Sob a ótica da criança, ficou clara a dificuldade em lidar com medos, frustrações e constrangimentos relacionados à doença e ao tratamento, especialmente na escola. Os familiares enfatizaram restrições impostas na vida da criança e no ambiente familiar, além de referirem atitudes de cuidado que demonstram superproteção. Profissionais envolvidos na atenção a asma infantil precisam valorizar potencialidades da criança e autonomia da família nas ações de cuidado, favorecendo o convívio com a doença crônica e o empoderamento para o cuidar.

The study aimed to comprehend how children with asthma and their families perceive themselves in their experience with the chronic disease and, how they develop their coping ways and care. We conducted a phenomenological study, with five families of children with moderate or severe asthma. Data collection occurred through interviews with the children and their families, during home visits, between September of 2013 and January of 2014. From the child's perspective, the difficulty of dealing with fears, frustrations, and constraints related to the disease and treatment was apparent, especially at school. Family members emphasized the restrictions imposed in the child's life and family environment, besides mentioning care attitudes demonstrating overprotection. Professionals involved in attention to childhood asthma need to value the child's potentialities and the family autonomy in care actions, favoring the experience with the chronic disease and the empowerment for care.

Con E de enfermera Unidad de Asma Grave / With E for nurse Severe Asthma Unit

Yolanda García y Carmen Campos son enfermeras en la Unidad de Asma Grave del Hospital Fundación Alcorcón, ubicado en la Comunidad de Madrid. Según cuentan ellas mismas, en estos servicios se desarrollan actividades asistenciales, de educación y también de gestión de la unidad. “Al ser un equipo multidisciplinar, los diferentes tratamientos biológicos que tienen prescritos los pacientes necesitan una coordinación con la unidad de farmacia”, para abordar a este tipo de pacientes “complejos, habitualmente con comorbilidades, como obesidad, síndrome de apnea del sueño, ansiedad… en los que su enfermedad interfiere de manera importante con las actividades de la vida diaria” y cuyo principal factor de riesgo es el tabaquismo, pero también son importantes la enfermedad respiratoria exacerbada por AAS, la exposición a alérgenos, el asma inducido por ejercicio o el asma relacionado con el puesto de trabajo u ocupacional”, explican. Nos atienden para hablar de su labor diaria en la Unidad de Asma Grave, de las principales necesidades de los pacientes, a los que les puede costar aceptar que el asma es una enfermedad crónica, y de la importancia de la Educación para la Salud y la adherencia a los tratamientos, especialmente a los biológicos, ya que “la mejoría tanto clínica como subjetiva de la mayoría de los pacientes que inician este tipo de terapia es muy grande”, en el manejo de esta patología.(AU)

Avaliação clínica de crianças e adolescentes asmáticos: relevância da atenção interdisciplinar / Clinical evaluation of asthmatic children and adolescents: relevance of interdisciplinary attention

Estudo descritivo, retrospectivo, que objetivou avaliar as condições clínicas de crianças e adolescentes com asma, ao iniciarem o tratamento e após seis meses de acompanhamento por equipe multiprofissional, com foco na atenção interdisciplinar. Pesquisa desenvolvida em ambulatório de referência terciária para a atenção à asma infantil, em Goiânia, Goiás, Brasil. Foram coletados dados de 101 prontuários entre janeiro e março de 2013. As crianças e adolescentes eram predominantemente do sexo masculino (70,3%), com idade entre dois e cinco anos (31,7%) e classificadas como casos de asma persistente moderada (47,6%). Após o acompanhamento durante seis meses, verificou-se que a maioria (64,4%) obteve controle total ou parcial da doença, redução de todos os sintomas identificados na primeira consulta e apresentaram alta adesão ao tratamento farmacológico proposto (70,3%). A atenção interdisciplinar pode resultar na melhoria do manejo clínico e contribuir para o avanço na qualidade da assistência a crianças e adolescentes asmáticos.

Descriptive, retrospective study, aimed to evaluate clinical conditions of asthmatic children and adolescents at the beginning of treatment and after six months of accompaniment by a multi-professional team, focused on interdisciplinary attention. A research developed in a reference ambulatory for tertiary attention of infant asthma, in Goiânia, Goiás, Brazil. Data was collected from 101 medical records from January and March 2013. Children and adolescents were predominantly male (70,3%), aged between two and five years (31,7%) and clinically classified as moderated persistent asthma (47,6%). After following them for six months, it was seen that most (64,4%) obtained total or partial control of the disease, reduction of all symptoms identified in the first consultation and presented high adherence to the proposed pharmacological treatment (70,3%). Interdisciplinary attention can result in improved clinical control and contribute to advances in assistance quality to asthmatic children and adolescents.

Bronquiectasias y asma / No disponible

No disponible

Enfermería y la adherencia al tratamiento en el asma / No disponible

La adherencia al tratamiento es fundamental para el control de la enfermedad. En nuestro caso, del asma. En una revisión bibliográfica acerca de la adhesión del paciente al tratamiento en el asma por parte de Enfermería, nos hemos encontrado con pocos estudios que ponen de manifiesto cuál es nuestra actuación y contribución en esta materia. La mayor parte de ellos hacen referencia a la educación como la base fundamental con la que conseguir la mayor adherencia posible al tratamiento por parte del paciente. Educación de la que la enfermera es parte fundamental, siendo pieza clave en la relación con el paciente y con el médico que pauta el tratamiento. Por lo tanto, es necesario a nivel de Enfermería realizar más trabajos de investigación que refuercen la educación terapéutica como camino principal hacia la adherencia al tratamiento en el asma

Treatment adherence is critical for disease control. In a literature review about Nursing and adherence treatment in asthma we have found few studies that demonstrate our performance and contribution in this matter. Most of research refers to education as the base to achieve the greatest treatment adherence by patients. Nursing education is essential, as part of the relationship between the patient and the professional that does the prescription of medical treatment. Therefore, Nursing's research is necessary to strengthen therapeutic education as the main tool to better treatment adherence in asthma

Compreensão da família acerca da asma infantil em uma unidade de urgência e emergência pediátrica / Family understanding of childhood asthma in an emergency unit and pediatric emergency

Objetivou-se compreender o significado da asma infantil por familiares durante a exacerbação dos sintomas. Estudo qualitativo realizado em Fortaleza-Ce. A coleta dos dados ocorreu entre agosto e novembro de 2014, mediante 14 entrevistas semiestruturadas. Foi reali-zada a análise de conteúdo e posteriormente, emergiram as categorias: significados atribuídos à asma; gatilhos que exacerbam os sintomas da asma; Impressão da família acerca dos entraves cotidianos da criança com asma. Os profissionais de saúde que atuam numa emergência pediátrica precisam conhecer as reais necessidades desta clientela, com o intuito de melhorar o atendimento e consequentemente minimizar os eventos agudos e as exacerbações.

Aimed to understand the meaning of childhood asthma by family members during the exacerbation of symptoms. Qualita-tive study in Fortaleza-Ce. Data collection took place between August and November 2014 by 14 semi-structured interviews. Content analysis was performed, and then, the following categories emerged: meanings attributed to asthma; triggers that exacerbate asthma symptoms; Family impression about the daily obstacles of children with asthma. Health professionals working in a pediatric emergency need to know the real needs of this clientele, in order to improve customer service and thereby minimize acute events and exacerbations.

Este artículo tiene como objetivo caracterizar la organización estructural de las unidades básicas de la Estrategia Salud de La Familia (ESF), con vistas a efectivación de la assistência em la prevención de los cánceres de la mama e del cuello uterino. Estudio transversal, de enfoque cuantitativo, desarollado em 61 unidades del ESF. Los resultados revelaran la falta de algunos recursos de la infraestructura importantes para la execución del trabajo de lo enfermero, así como la falta de algunos profesionales. La falta de los espacios apropriados para la efecacia de la asistencia a prevención de ambos los cánceres interfiere diretamente em la calidad prestada.

Resources to handle childhood asthma in Spain: The role of plans and guides and the participation of nurses

BACKGROUND: Describe the assistance provided to asthmatic patients by Primary Care Paediatricians (PCP) in Spain and the material and human resources available for diagnosis and follow-up. METHODS: A cross-sectional descriptive study using an on-line survey, sent to PCP regarding the availability of diagnostic resources, carrying out programmed and educational activities, collaboration of nursing staff and their relationship with existing institutional plans to care for children with asthma. A latent class model (LCM) was used to describe the differences among paediatricians based on the variables studied. RESULTS: Of the 708 answers, 675 were considered valid; 76% of the paediatricians had a spirometer, 75% specific IgE, 17% prick-test, 95% had placebo inhalers and 97% inhalation chambers. 57% performed programmed activities with their patients, while 56% shared their care of asthmatic patients with their nursing staff, but only 25% of the nurses were involved in the follow-up and 12% in education. LCM identified four patterns. The two groups with greater access to diagnostic resources counted on institutional plans/guidelines. However, the only variable differentiating the groups with more programmed and educational activities was the participation of nurses. CONCLUSIONS: The availability of asthma plans/guidelines and resources for diagnosis and follow-up is not sufficient to improve important aspects of primary care for children with asthma. Organisational changes are necessary to include programmed asthma-related visits and paediatric teams with greater involvement of the nurses when caring for these patients

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¿Cómo viven la ventilación no invasiva los enfermos y sus cuidadores? Revisión bibliográfica sistemática de investigaciones cualitativas / How do sick people their caregivers live non-invasive ventilation? Systematic literature review of qualitative research

Introducción. Sabemos que la ventilación no invasiva (VNI) es un soporte ventilatorio de elección, aunque a veces fracasa, por intolerancia, falta de adherencia, incumplimiento, etc. ¿Cómo podemos anticiparnos a ese fracaso? Objetivo. Explorar la evidencia cualitativa sobre las vivencias de las personas en tratamiento con VNI y sus cuidadores formales e informales. Método. Revisión bibliográfica sistemática de artículos originales indexados entre 2005 y 2015 que estudian la VNI en población adulta con metodología cualitativa, en seis bases de datos. Evaluación por pares de la calidad científica con herramienta del Programa CASPe. Metasíntesis cualitativa de los hallazgos. Resultados. 15 artículos cumplen criterios de selección, basados en la Teoría Fundamentada y en Fenomenología, que utilizan: entrevistas, observación y grupo focal, tanto a enfermos como a familias y profesionales de salud. Destaca la sensación de angustia y pérdida de control, aunque la VNI les alivia la disnea (ambivalencia). Búsqueda del bienestar cotidiano a través de rutinas y participación activa. Interacción dependencia/autonomía, sobre todo en la toma de decisiones, y se encuentran divergencias que hacen complejo el proceso de información y voluntades anticipadas. La sabiduría práctica de enfermería se describe como básica, y se manifiestan dificultades: falta de tiempo, sobrecarga de trabajo, tecnocentrismo, inexperiencia. Conclusiones. La evidencia cualitativa del tratamiento con VNI, aunque escasa, es variada, pues se exploran diferentes parcelas (situaciones agudas, crónicas, terminales), y desde diferentes puntos de vista. Integrar esos hallazgos en nuestra práctica profesional nos ayudará a aumentar la adherencia y el éxito del tratamiento, pero sobre todo a mejorar la calidad de vida de los pacientes ventilados y sus familias (AU)

Introduction. We know that non-invasive ventilation (NIV) is a basic ventilator support, but sometimes it fails, because of intolerance, lack of adherence, breach, etc. How can we anticipate that failure? We intend to explore the qualitative evidence on the experiences of people with this treatment and their formal and informal caregivers. Method. Systematic literature review of original articles indexed from 2005 to 2015, which study the NIV in adult population with qualitative methodology in six databases. Peer review of scientific quality with tool of the CASPe Program. Qualitative metasynthesis of the findings. Results. 15 articles met selection criteria, based on Grounded Theory and Phenomenology, which use interviews, observation and focus group, directed both patients, and families and health professionals. Its studies emphasize the feeling of anxiety and loss of control, although the NIV relieves them dyspnea (ambivalence). Search daily well-being through routines and active participation. Interaction dependence/autonomy, especially in decision-making, finding differences that make complex the process information and advance directives. Practical wisdom of nursing care 24 hours with patients is described basic, and difficulties being narrated: lack of time, overload of work, technocentrism, inexperience. Conclusions. The qualitative evidence of treatment with VNI is varied although scarce; different plots (acute situations, chronic, terminals) are explored, from different points of view. The integration of these findings in our practice will help us to increase adherence and become the treatment successful, but especially to improve the quality of life of ventilated patients and their families (AU)

Indicators for childhood asthma in Spain, using the Rand method

OBJECTIVE: To develop quality indicators to measure asthma care in primary health care. METHOD: A modified RAND was used, which included the systematic review of the literature in Embase, Cochrane and Pubmed Quality Agencies and Database. The work group identified the indicators, translated them into Spanish and resolved any duplicates. Each indicator is composed of several dimensions (access to care, clinical effectiveness, patient-centred quality and patient safety). A multidisciplinary panel of 98 professionals from all over Spain were invited to score each indicator using a Likert scale. After calculating the average and median of each indicator, this information was sent to those who responded (n = 38) for a second round and further scoring. The agreement percentage for the group was obtained for each indicator. RESULTS: Of the 105 asthma indicators reviewed, we selected 46 that were presented to the panel of experts. In both Delphi phases, 37.1% of the members of the initial panel of experts responded. Of these, 26 were primary care paediatricians, six were pulmonologists, three were nurses, two were pharmacists and one was an allergist. For 32 indicators, agreement exceeded 70% and seven of those scored highest for the various care aspects for asthmatic children. CONCLUSION: Quality indicators are presented for the follow-up of asthma and their implementation in primary care, which have undergone a strict selection and agreement process by a multidisciplinary work group

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O cuidado materno no manejo da asma infantil: contribuição da enfermagem transcultural / Maternal care in the management of child asthma: the contributions of transcultural nursing / El cuidado materno en el manejo del asma infantil: contribución de enfermería transcultural

O objeto deste estudo são as práticas culturais do cuidado materno no manejo da asma infantil. Objetivos: descrever oconhecimento e o cuidado materno sobre a asma infantil e analisar o cuidado materno no manejo da asma infantil. Estudodescritivo-exploratório desenvolvido a partir de questionários e entrevistas com mães de crianças com asma, no período desetembro de 2008 janeiro de 2009. Após análise temática dos dados, emergiram três categorias: 1) Conceito e manejo da asmana visão das mães cuidadoras; 2) Asma como sofrimento e risco para a vida dos filhos; 3) Plantas medicinais, simpatias ereligiosidade no cuidado do filho com asma. Concluiu-se que é importante respeitarmos a cultura das mães cuidadoras dascrianças com asma, para que seus valores possam ser preservados, acomodados e reestruturados junto ao cuidado profissional.

Freqüência de publicações sobre a asma em periódicos de enfermagem indexados em bases de dados brasileiras: uma revisão da literatura / Frequency of publication of asthma studies in Nursing journals indexed in Brazilian databases: a literature review

Objetivo. Analisar a freqüência das publicações sobre asma nos periódicos de enfermagem estrangeiros, presentes nos índices de referências informatizados da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior e nacionais indexados em bases de dados informatizadas, considerando-se origem, índice de referência, periódico, ano de publicação, método utilizado, tipo de publicação e objeto de estudo. Métodos. Os dados foram coletados através de formulário, utilizando-se os descritores de assunto asthma e asma para busca das produções. Resultados. Foram identificados 56 artigos estrangeiros e três nacionais nos anos de 1994 a 2004. Os estudos sobre asma aparecem com maior freqüência nos anos de 2002 (12 estrangeiros e 1 nacional) e 2004 (14 estrangeiros). Conclusões. Este trabalho revelou a necessidade de maior produção e/ou divulgação do conhecimento produzido, principalmente em publicações brasileiras.