Effects of Nursing Instruction on Asthma Knowledge and Quality of Life in Schoolchildren with Asthma

護理指導影響氣喘學齡期兒童氣喘知識與生活品質之探討

楊寶圜(Bao-Huan Yang)；陳月枝(Yueh-Chih Chen)；江伯倫(Bor-Luen Chiang)；張玉坤(Yue-Cune Chang)

護理指導 ； 氣喘知識 ； 生活品質 ； Nursing instruction ； asthma knowledge ； quality of life

The Journal of Nursing Research

13卷3期（2005 / 09 / 01）

174 - 183

英文

The issue of whether nursing instruction efforts could improve asthma knowledge and quality of life among schoolchildren was investigated using a quasi-experimental design. The key instruments were the Asthmatic Knowledge Questionnaire and the Childhood Asthma Questionnaire-Form B. Asthmatic knowledge increased among children who received instruction from nurses (Mean(subscript pre/post)=22.20/31.87, P＜.05). These children also experienced significant improvements in their active quality of life (Mean(subscript pre/post)=27.53/30.20, p＜.05), and decreased distress (Mean(subscript pre/post)=24.04/10.86, P＜.05) and asthma severity (Mean(subscript pre/post)=13.27/8.3, P＜.05). This study finds nursing instruction helpful in improving asthma knowledge. However, in terms of quality of life, elevated knowledge has a marked (negative) correlation only with levels of distress and severity. It shows no detectable relationship with active or passive life quality. Therefore, though nursing instruction can improve schoolchildren's knowledge about asthma, the improvement in knowledge only relates to reducing distress and severity and thus improving quality of life. This result can provide guidance for nursing personnel in developing nursing instruction to improve active quality of life in child patients.

The issue of whether nursing instruction efforts could improve asthma knowledge and quality of life among schoolchildren was investigated using a quasi-experimental design. The key instruments were the Asthmatic Knowledge Questionnaire and the Childhood Asthma Questionnaire-Form B. Asthmatic knowledge increased among children who received instruction from nurses (Mean(subscript pre/post)=22.20/31.87, P＜.05). These children also experienced significant improvements in their active quality of life (Mean(subscript pre/post)=27.53/30.20, p＜.05), and decreased distress (Mean(subscript pre/post)=24.04/10.86, P＜.05) and asthma severity (Mean(subscript pre/post)=13.27/8.3, P＜.05). This study finds nursing instruction helpful in improving asthma knowledge. However, in terms of quality of life, elevated knowledge has a marked (negative) correlation only with levels of distress and severity. It shows no detectable relationship with active or passive life quality. Therefore, though nursing instruction can improve schoolchildren's knowledge about asthma, the improvement in knowledge only relates to reducing distress and severity and thus improving quality of life. This result can provide guidance for nursing personnel in developing nursing instruction to improve active quality of life in child patients.

1. Chen, S. R.,Chang, W. Y.,Pan, M. J.,Jeng, C.(2002).Physical activities, self-efficacy, and quality of life among children with asthma.Journal of Health Science,4(1),1-12.
   連結：
2. Chen, S. R.,Chang, W. Y.,Jeng, C.(2001).Exercise instructions for asthmatic children.Chang Gung Nursing,12(3),234-238.
3. Chiang, L. C.,Hung, J. L.,Lu, C. M.(1999).A study of predisposing factors and self-management behaviors of school-age children with asthma and the impact of summer asthma camp.The Journal of Nursing Research,7(4),307-321.
4. Christiansen, S. C.,Martin, S. B.,Schleicher, N. C.,Koziol, J. A.,Mathews, K. P.,Zuraw, B. L.(1997).Evaluation of a school-based asthma education program for inner-city children.Journal of Allergy & Clinical Immunology,100(5),613-617.
5. Christie, M. J.,French, D.,Sowden, A.,West, A.(1993).The development of child-centred, disease-specific, questionnaires for contemporary appraisals of living with asthma.Psychosomatic Medicine,55,541-548.
6. Christie, M. J.,French, D.,Weatherstone, L.,West, A.(1991).The patients' perceptions of chronic disease and its management: Psychosomatics, holism and quality of life in contemporary management of childhood asthma.Psychotherapy and Psychosomatics,56,197-203.
7. French, D. J.,Carroll, A.,Christie, M. J.(1998).Health-related quality of life in Australian children with asthma: Lessons for the cross-cultural use of quality of life instruments.Quality of Life Research,17,409-419.
8. French, D. J.,Christie, M. J.,Sowden, A. J.(1994).The reproducibility of the childhood Asthma Questionnaires: Measures of quality of life for children with asthma aged 4-16 years.Quality of Life Research,3,215-224.
9. Gabe, J.,Bury, M.,Ramsay, R.(2002).Living with asthma: The experiences of young people at home and at school.Social Science & Medicine,55(9),1619-1633.
10. Galvin, K.,Webb, C.,Hillier, V.(2001).Assessing the impact of a nurse-led health education intervention for people with peripheral vascular disease who smoke: The use of physiological markers, nicotine dependence and withdrawal.International Journal of Nursing Studies,38,91-105.
11. Gebert, N.,Hummelink, R.,Konning, J.,Staab, D.,Schmidt, S.,Szczepanski, R.(1998).Efficacy of a self-management program for childhood asthma-A prospective controlled study.Patient Education & Counseling,35(3),213-220.
12. Guevara, J. P.,Wolf, F. M.,Grum, C. M.,Clark, N. M.(2003).Effects of educational interventions for self management of asthma in children and adolescents: Systematic review and meta-analysis.British Medical Journal,326,1308-1309.
13. Gupta, S.,Mitchell, I.,Giuffre, R. M.,Crawford, S.(2001).Covert fears and anxiety in asthma and congenital heart disease.Child: Care, Health & Development,27(4),335-481.
14. Hsieh, K. H.(1995).Prevention and management of asthma in children.Acta Paediatrica Taiwanica,36(B),9-20.
15. Juniper, F. F.,Guyatt, G. H.,Epstein, R. S.,Ferrie, P. J.,Jaeschke, R.,Hiller, T. K.(1995).Evaluation of impairment of health related quality of life in asthma: Development of questionnaire for use in clinical trials.Thorax,47,76-83.
16. Lai, H. R.(2001).Psychosomatic symptoms, social adjustment, school performance and physical activity in adolescents with asthma.Journal of Health Education,16,45-75.
17. Lee, B. J.(2000).Taipei,National Taiwan University.
18. MeGhan, S. L.,Wong, E.,Jhangri, G. S.,Wells, H. M.,Michaelchuk, D. R.,Boechler, V. L.(2003).Evaluation of an education program for elementary school children with asthma.Journal of Asthma,40(5),523-533.
19. Musto, P. K.(2003).General principals of management: Education.Nursing Clinics of North America,38(4),621-633.
20. National Heart, Lung, & Blood Institute(1997).National Asthma Education and Prevention Program Expert Panel Report 2: Guidelines for the Diagnosis and Management of Asthma(No. 97-4051.).
21. Patrick, D. L.,Bergner, M.(1990).Measurement of health status in the 1990s.Annual Reviews of Public Health,11,165-183.
22. Roe, B.,Wilson, K.,Doll, H.(2001).Public awareness and health education: Findings from an evaluation of health services for incontinence in England.International Journal of Nursing Studies,38,79-89.
23. Rubin, D. H.,Bauman, L. J.,Lauby, J. L.(1989).The relationship between knowledge and reported behavior in childhood asthma.Journal of Developmental & Behavioral Pediatrics,10(6),307-312.
24. Ryan-Wenger, N. M.,Walsh, M.(1994).Children's perspectives on coping with asthma.Pediatric Nursing,20(3),224-228.
25. van Veldhoven, N. H.,Vermeer, A.,Bogaard, J. M.,Hessels, M. G.,Wijnroks, L.,Colland, V. T.(2001).Children with asthma and physical exercise: Effects of an exercise programme.Clinical Rehabilitation,15(4),360-370.
26. Vazquez, M. I.,Buceta, J. M.(1993).Effectiveness of self-management programmes and relaxation training in the treatment of bronchial asthma: Relationships with trait anxiety and emotional attack triggers.Journal of Psychosomatic Research,37(1),71-81.
27. Whitener, L. M.,Cox, K. R.,Maglich, S. A.(1998).Use of theory to guide nurses in the design of health messages for children.Advanced Nursing Science,20,21-35.
28. Online WHO
29. Yang, M. L.,Chiang, C. H.,Yao, G.,Wang, K. Y.(2003).Effect of medical education on quality of life in adult asthma patients.Journal of the Formosan Medical Association,102(11),768-774.
30. Young, N. L.,Foster, A. M.,Parkin, P. C.,Reisman, J.,MacLusky, I.,Gold, M.(2001).Assessing the efficacy of a school-based asthma education program for children: A pilot study.Canadian: Journal of Public Health. Revue Canadienne de Santé Publique,92(1),30-34.