Developing a Patient-driven Arts-based Knowledge Translation Tool for Parents of Children with Asthma


Book Description

Background: Family-centered education is critical to managing childhood asthma, the most common chronic disease of childhood in North America. Parents are largely responsible for the day-to-day management of their child's asthma; as such, finding effective ways to educate parents about asthma is essential to improving childhood asthma outcomes. It is known that the information needs of parents of children with asthma are not being met through current educational approaches despite the availability of high quality evidence on childhood asthma management. Patient-driven educational materials that leverage the power of the arts show promise in communicating health information, and may be useful for parents of children with asthma. However, arts-based knowledge translation approaches are in their infancy, and no such strategy has been developed for parents of children with asthma. Purpose: The purpose of this dissertation is to identify the information needs of parents of children with asthma, use these data to develop an arts-based educational material (i.e., arts- based knowledge translation tool), and thereby contribute to the emerging knowledge base of arts-based knowledge translation. Methods: This dissertation consists of four prototypes of an arts-based knowledge translation tool and four related papers: (I) a state-of-the- science review of the literature to determine the information needs of parents of children with asthma; (II) an interpretive descriptive qualitative study on the information needs and experiences of 21 parents of children with asthma, representing diverse backgrounds and stages of the illness trajectory; (III) a methods paper which outlines the process and challenges associated with developing a patient-driven arts-based knowledge translation tool; and (IV) a theoretical paper where a classification schema for arts- based knowledge translation strategies is developed. Findings and Conclusions: The following four knowledge gaps were identified and addressed through this dissertation: (I) knowledge about the information needs of parents of children with asthma was lacking in previous research; (II) the information needs of parents of children with asthma are not being addressed through current educational approaches; (III) innovative educational approaches to knowledge translation, such as arts-based approaches, may hold promise in childhood asthma but have not been developed or discussed; and (IV) the theoretical basis of arts-based knowledge translation approaches is underexplored. In this dissertation I address these limitations by identifying extant research on parents information needs in childhood asthma (paper one), using these findings to inform a qualitative research study of parents' information needs (paper two), developing four prototypes of a patient-driven arts-based knowledge translation tool for parents of children with asthma based on qualitative findings and best evidence about asthma management (paper three; appendices A through E), and developing an arts-based knowledge translation classification schema based on the mechanisms underlying these approaches (paper four). Through this research, I illustrate that parents of children with asthma have pervasive, unmet information needs and information deficits of varying types, which negatively impacts asthma management, child and family well-being. I demonstrate support for developing the patient-driven arts-based knowledge translation tool and present conceptual and pragmatic complexities associated with this process. These findings contribute to childhood asthma management through a creative and patient-centered approach, while substantively contributing theoretical and procedural knowledge to the growing domain of arts-based knowledge translation.




An Evidence-Based Education Program to Promote Health Outcomes in Asthmatic Children


Book Description

This dissertation, "An Evidence-based Education Program to Promote Health Outcomes in Asthmatic Children" by Yuk-ling, Ng, 伍玉玲, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: Asthma is a common chronic disease for children and is a leading cause for their hospitalization. Despite its negative health impact, a local survey has shown that children with asthma as well as their parents have a lack of understanding for asthma management (Wong, Wong, Chung & Lau, 2001). However, to help asthmatic children to better cope with their condition, it is important for health care professional such as nurses to enhance their knowledge in asthma management. Recent empirical research has shown that education promoting knowledge of asthma management can improve health outcomes in asthmatic children. Therefore, it is important to develop an evidence-based asthma education guideline for them. This dissertation aims to evaluate the empirical evidence of the education program for asthmatic children, with the age ranging from 5 to 18, and their parents. The goal of the proposed program is to reduce their re-hospitalization rate by enhancing their knowledge of asthma care. A translational nursing research was conducted and 10 studies focusing on asthma education program for children and their parents were identified from electronic databases. Critical appraisal was performed using the recognized assessment tool, named the Scottish Intercollegiate Guidelines Network (SIGN) (2008). Recommendations were developed based on the data extracted from the review. Based on the literatures reviewed, it was found that a 45-to-60 minute one-to-one educational intervention conducted by nurses using self-management plan is the most effective method for improving the health outcomes for asthmatic children. A plan of translating the empirical information extracted from the review into practice was developed and the potential of implementation was assessed. Based on the assessment, it was found that there is high transferability of the findings from the review and the proposed innovation is feasible in the selected clinical setting. In addition, the benefits generated from the proposed innovation also outweigh its cost. An evidence-based guideline was then developed based on the high and medium level of evidence. The grades of the recommendation were stated as well. A comprehensive communication plan targeting on various stakeholders was prepared. A pilot study was designed to examine the feasibility of the proposed innovation before the full-scale implementation. The outcomes of the proposed innovation include the re-hospitalization rate of asthmatic children, the patients' and nurses' level of knowledge in asthma care, the satisfactory level of patients and nurses towards the innovation, the competency of nurses in conducting the innovation, and the utilization rate and the cost of the innovation. They would be evaluated using appropriate methodologies. The proposed innovation would be considered as effective if the primary outcome, the re-hospitalization rate of asthmatic children is reduced. DOI: 10.5353/th_b4833598 Subjects: Asthma in children Evidence-based nursing




The Role of Patient Navigators in Improving Caregiver Management of Childhood Asthma


Book Description

Childhood asthma is a significant public health problem in the United States. Barriers to effective asthma management in children include the need for caregivers to identify and manage diverse environmental triggers and promote appropriate use of preventive asthma medications. Although health care providers may introduce asthma treatments and care plans, many providers lack the time and capacity to educate caregivers about asthma in an ongoing, sustained manner. To help address these complexities of asthma care, many providers and caregivers rely on patient navigators (defined as persons who provide patients with a particular set of services and who address barriers to care) (Dohan & Schrag, 2005). Despite growing interest in their value for chronic disease management, researchers and providers know little about how or what benefits patient navigators can provide to caregivers in managing asthma in children. To explore this issue, we conducted a mixed-method evaluation involving focus groups and a survey with caregivers of children with moderate-to-severe asthma who were enrolled in the Merck Childhood Asthma Network Initiative (MCAN). Findings suggest that patient navigators may support children’s asthma management by providing individualized treatment plans and hands-on practice, improving caregivers’ understanding of environmental triggers and their mitigation, and giving clear, accessible instructions for proper medication management. Study results may help to clarify and further develop the role of patient navigators for the effective management of asthma in children.




Asthma Information Resource (AIR) for Parents


Book Description

"The purpose of this paper is to develop an online educational tool to assist health care providers in the education of parents of children with asthma in the outpatient setting. The literature review elicited research which examined the knowledge deficits of these parents. Additional research examined different types of educational interventions used with parents of children with asthma. A gap in the research was found in regard to the use of technology to educate parents about asthma....This online education tool, called Asthma Information Resource (AIR) for Parents (c) will supplement not replace education done by health care providers. The structure of this tool will use the four phase theoretical framework of Zimmerman, Bonner, Evans, and Mellins (1999) called the Asthma Self-regulation Theory." --Introduction, leaves 4 and 5.




School Nurse Driven Asthma Education Program for Parents and Teachers


Book Description

" Asthma exacerbation in school continues to be a problem that affects the health and education of students who suffer with asthma. Children with uncontrolled asthma miss more school days and have less hours of educational instruction due to frequent visits to the school nurse for asthma management. Evidence shows that school nurse-provided education to parents and teachers can increase the knowledge level of parents and teachers and reduce asthma exacerbations of the children in schools. This evidence-base practice change project consisted of a school nurse-driven asthma educational program for parents and teachers. Outcomes were knowledge of asthma and asthma management and asthma exacerbations in the school setting. A Pre-Asthma Knowledge Quiz was administered to all participants. Each participant was given three-one hour individual asthma education sessions that focused on asthma triggers, prevention and medications. After the educational sessions were completed, each participant was given the same Asthma Knowledge Quiz. Results showed an increase in asthma knowledge in both participant groups (teachers by 13% and parents by 16.6%) and an 82% decrease in asthma exacerbations of students, both outcomes exceeding the benchmark. The implication is that providing asthma education to parents and teachers can be effective in increasing the knowledge of parents and teachers and reducing asthma exacerbations for students in the school setting. Recommendations include implementation of school nurse-driven asthma educations programs for parents and teachers in schools with a high population of students diagnosed with asthma and in schools where there is a high incidence of asthma exacerbation during school hours. Key words: childhood asthma, asthma exacerbations in school, asthma education, parents, teachers " -- Abstract




Ethical Conduct of Clinical Research Involving Children


Book Description

In recent decades, advances in biomedical research have helped save or lengthen the lives of children around the world. With improved therapies, child and adolescent mortality rates have decreased significantly in the last half century. Despite these advances, pediatricians and others argue that children have not shared equally with adults in biomedical advances. Even though we want children to benefit from the dramatic and accelerating rate of progress in medical care that has been fueled by scientific research, we do not want to place children at risk of being harmed by participating in clinical studies. Ethical Conduct of Clinical Research Involving Children considers the necessities and challenges of this type of research and reviews the ethical and legal standards for conducting it. It also considers problems with the interpretation and application of these standards and conduct, concluding that while children should not be excluded from potentially beneficial clinical studies, some research that is ethically permissible for adults is not acceptable for children, who usually do not have the legal capacity or maturity to make informed decisions about research participation. The book looks at the need for appropriate pediatric expertise at all stages of the design, review, and conduct of a research project to effectively implement policies to protect children. It argues persuasively that a robust system for protecting human research participants in general is a necessary foundation for protecting child research participants in particular.




Fiction as Research Practice


Book Description

The turn to fiction as a social research practice is a natural extension of what many researchers and writers have long been doing. Patricia Leavy, a widely published qualitative researcher and a novelist, explores the overlaps and intersections between these two ways of understanding and describing human experience. She demonstrates the validity of literary experimentation to the qualitative researcher and how to incorporate these practices into research projects. Five short stories and excerpts from novellas and novels show these methods in action. This book is an essential methodological introduction for those interested in studying or practicing arts-based research.




Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies


Book Description

This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.




Bulletin of the Atomic Scientists


Book Description

The Bulletin of the Atomic Scientists is the premier public resource on scientific and technological developments that impact global security. Founded by Manhattan Project Scientists, the Bulletin's iconic "Doomsday Clock" stimulates solutions for a safer world.