A School Nurse–Led Asthma Intervention for School-Age Children: A Randomized Control Trial to Improve Self-Management

Abstract

Asthma is a common disease in children, and obtaining basic knowledge and skills to manage asthma symptoms is critically important. This study examined the effectiveness of a theoretically based school nurse–led asthma intervention on asthma symptoms, self-management, peak flow meter usage, daily activities, and school absences in children 7–12 years old. A randomized controlled, two-group, repeated measures design was conducted in eight public schools. Data collection occurred at three time points. The treatment group had statistically significant differences in reported symptoms ( p < .001), asthma control with a peak flow meter usage ( p < .001), and daily activities ( p < .001) at 6 weeks and at 12 weeks. Although difference in school absences was not statistically significant, the treatment group missed fewer school days than the control group. Self-management is a complex process, and school nurses can provide essential learning steps and continuity of care for school-age children living with asthma.

Impact of Nurse-Led Asthma Intervention on Child Health Outcomes: A Scoping Review

“…The purpose of this review was to identify the current evidence on the impact of school nurse-led asthma intervention programs. The school nurse’s role in the included studies varied between providing educational interventions for asthmatic children ( D. M. Carpenter et al, 2016 ; Isik et al, 2020 ; Persaud et al, 1996 ; Simoneau et al, 2020 ), supervising the administration of preventive asthma medication ( Harrington et al, 2018 ; Trivedi et al, 2018 ), and running a school asthma clinic ( Salisbury et al, 2002 ).…”

“…The sample size ranged from 25 to 490. The target population of the included studies was children alone (D. M. Carpenter et al, 2016;Harrington et al, 2018;Isik et al, 2020;Salisbury et al, 2002;Trivedi et al, 2018), children with their parents (Persaud et al, 1996), or children and school nurses (Simoneau et al, 2020). Notably, none of the studies included in this review indicated the qualification of the school nurses who led the interventions.…”

“…There were 102 students with asthma who completed two inhaler technique assessments over the 2 academic years: one at baseline and one at the end of the academic year. Isik et al (2020) investigated the effectiveness of a theoretically based school nurse-led asthma intervention on symptoms, asthma self-management with peak flow meter (PFM) usage, daily activities, and school absenteeism among elementary school children aged 7-12 years. Participants were randomly assigned to receive a school nurse-led asthma intervention (treatment N ¼ 37) or usual care (control N ¼ 36).…”

“…For chronic conditions such as asthma, management is achieved through medical intervention combined with self-care. As asthma is a lifelong disease, there is a demand to prioritize self-management strategies to promote positive outcomes and prevent asthma exacerbation ( Isik et al, 2020 ).…”

“…Implementing school nurse-led asthma intervention programs outside of the hospital setting enables students with asthma to learn about their condition, develop asthma self-management skills, and reduce school absence and missed class time ( Isik et al, 2020 ; Yoder, 2019 ). However, school-based asthma interventions are often conducted by researchers outside the school setting ( Isik et al, 2019 ).…”