A Nurse-Led Web-Based Home Asthma Education Program for Children and their Families: A Randomized Controlled Trial.

BACKGROUND: Education is the most essential component for effective asthma control and is endorsed by guidelines worldwide. However, multiple caregivers are often jointly involved in child care, and educating them is often a challenging task. This study determines the effectiveness of a web-based asthma education program in enhancing knowledge, attitude and practice of caregivers and reducing unscheduled hospital visits of children for asthma. METHODS: A two-arm, randomized controlled trial was carried out between November 2018 and December 2019. Child-parent dyads were recruited when the children (4-11 years of age) were admitted due to asthma exacerbations. A nurse-led web-based home asthma education program was developed and implemented before discharge. Outcomes included parents' knowledge, attitude and practice regarding asthma and frequency of unscheduled visits and readmissions in children. RESULTS: 112 child-parent dyads were enrolled. The parents' knowledge, attitude and practice and the number of unscheduled visits of the children were found to be significantly different between two groups at different time points (Ps < 0.001) with a large effect size (Cohen's d > 0.8). CONCLUSION: This intervention was shown to be an effective strategy to educate caregivers who are jointly involved in their child's asthma control after discharge from hospital. TRIAL REGISTRATION: The Chinese Clinical Trial Registry, World Health Organization (ChiCTR1800019706).

The unannounced patient in the corridor: trust, friction and person-centered care.

In this study, a Swedish cancer clinic was studied where three to four unscheduled patients sought support from the hospital on a daily basis for pain and nutrition problems. The clinic was neither staffed nor had a budget to handle such return visits. In order to offer the patients a better service and decrease the workload of the staff in addition to their everyday activities, a multidisciplinary team was established to address the unscheduled return visits. The team was supposed to involve the patient, build trust, decrease the friction, and contribute to a successful rehabilitation process. Data were collected from the patients and the staff. Patients who encountered the team (intervention) and patients who encountered the regular ad hoc type of organization (control) answered a questionnaire measuring trust and friction. Nurses in the control group spent 35% of their full-time employment, and the intervention group staffed with nurses spent 30% of their full-time employment in addressing the needs of these return patients. The patients perceived that trust between them and the staff was high. In summary, it was measured as being 4.48 [standard deviation (SD) = 0.82] in the intervention group and 4.41 (SD = 0.79) in the control group using the 5-point Likert scale. The data indicate that using a multidisciplinary team is a promising way to handle the problems of unannounced visits from patients. Having a team made it cost effective for the clinic and provided a better service than the traditional ad hoc organization. Copyright © 2015 John Wiley & Sons, Ltd.