A randomized controlled trial of a nurse-led education pathway for asthmatic children from outpatient to home.

BACKGROUND: Education for asthmatic children in the outpatient department is insufficient. AIM: To evaluate the efficacy of a nurse-led education pathway, a standard education programme, on children with asthma. METHODS: One hundred and eighty participants enrolled and were randomly assigned to either the control group or the intervention group. The intervention group received predetermined step-by-step education sessions based on the self-designed education pathway, while the control group received usual care. Asthma control, health-related quality of life, and health-care utilization measures were taken at baseline and at follow-up visits between February 2016 and May 2018. RESULTS: Significantly higher scores for health-related quality of life and inhaler technique at the third-month visit and asthma control test at the sixth-month visit were seen in the intervention group. The numbers of unscheduled physician visits and school absences were lower in the intervention group than in the control group within 6 months. However, no significant differences were observed in emergency department visits and hospitalizations. CONCLUSION: The nurse-led education pathway could be considered effective for children with asthma visiting the outpatient department.

The effect of goal setting in asthma self-management education: A systematic review.

BACKGROUND: Asthma self-management education combining with behavior therapy is considered to be more effective. Goal setting is a common behavior change technique used to help patients self-manage their symptoms. However, empirical evidence around its effectiveness on asthma management lacks clarity. AIMS: To systematically integrate and appraise the evidence for effectiveness of goal setting interventions on asthma outcomes. METHODS: Databases included CENTRAL, PubMed, EMBASE, CINAHL and Proquest Psychology Database were systematically searched for relevant intervention studies employing goal setting technique as a method in asthma education program for self-management. Characteristic of studies and outcomes in clinical, psychosocial and healthcare utilization outcome were extracted. RESULTS: From a total of 2641 citations, 45 full-text articles were assessed for eligibility and 9 studies met the inclusion criteria. Eight studies were randomized controlled trial and one was before-after study. None studies have a high methodological quality. Goal-setting based intervention appeared to improve symptom control, quality of life and self-efficacy in adult patients with asthma. CONCLUSION: This systematic review highlighted the potential of a goal setting technique in the asthma self-management education. However, due to the limitations of the quality and quantity of the included literature, more rigorous studies are needed. In the future, better effective study protocol combining with goal setting approach and other behavior technique is needed to further investigate.

Predictive accuracy of the Braden Q Scale in risk assessment for paediatric pressure ulcer: A meta-analysis.

AIMS: Paediatric pressure ulcers are a serious problem to healthcare service. Thus, effective and early identification of the risk of developing pressure ulcer is essential. The Braden Q scale is a widely used tool in the risk assessment of paediatric pressure ulcer, but its predictive power is controversial. Hence, we performed a meta-analysis to evaluate the predictive power of the Braden Q scale for pressure ulcer in hospitalised children and offer recommendations for clinical decision. METHODS: Studies that evaluated the predictive power of the Braden Q scale were searched through databases in English and Chinese, including Medline, Cochrane Library, Embase, CINAHL, SinoMed, CNKI, Wangfang and VIP. The studies were screened by two independent reviewers. QUADAS-2 was used to assess the risk of bias of eligible studies. Demographic data and predictive value indices were extracted. The pooled sensitivity, specificity and receiver operating characteristics (ROC) were calculated by MetaDiSc 1.4 using random-effects models. RESULTS: Cochran Q = 26.13 (P = 0.0036) indicated the existence of heterogeneity; the I2 for pooled DOR was 61.7%, suggesting significant heterogeneity among the included studies. The pooled sensitivity and specificity were 0.73 (95% CI: 0.67-0.78) and 0.61 (95% CI: 0. 59-0.63), respectively, yielding a combined DOR of 3.47 (95% CI: 2-6.01). The area under the ROC curve was 0.7078 ± 0.0421, and the overall diagnostic accuracy (Q*) was 0.6591 ± 0.0337. Sensitivity analysis showed the results were robust. CONCLUSION: The Braden Q scale has moderate predictive validity with medium sensitivity and low specificity for pressure ulcers in hospitalised children. Further development and modification of this tool for use in paediatric population are warranted.