Effect of parental knowledge and attitude in the control of childhood asthma

Abstract

Original Research Article Effect of parental knowledge and attitude in the control of childhood asthmaSreeram Venugopal*, Aparna Namboodiripad INTRODUCTIONAsthma is a chronic inflammatory condition of the lung airways resulting in episodic airflow obstruction. 1 Asthma affects boys more than girls in pre-pubertal age group; more in poor families, more in modern metropolis locales, and its prevalence strongly correlates with that of atopic eczema and allergic rhino conjunctivitis. Non-communicable disease (NCD) forms 43% of all the world's diseases and is on the rise, particularly in low economic countries.3 Asthma is a chronic NCD affecting 300 million individuals all over the world. 4 The prevalence of asthma increases as the community adopts an urban lifestyle. 5Around 25,0000 asthma-related deaths are reported all over the world, and most are preventable, being due to suboptimal long term control and delay in obtaining medical care during the final attack. 3 The economic burden of asthma is measured both in terms of direct medical costs(cost of hospitalization and medication) and indirect cost (lost productive time and premature death). Children with asthma tends to miss school more often than their healthy peers and the mean school absenteeism increases with the severity of asthma. Parents of children ABSTRACT Background: Asthma is responsible for 250,000 deaths and 1% of all the DALY (disability-adjusted life year) worldwide. It is a leading cause of school absenteeism among children and incurs a large financial burden. Parents of children with asthma have varied beliefs and knowledge about asthma and its treatment which may affect the control of asthma. Methods: A cross-sectional study was carried out among parents of children who attended the asthma clinic of a tertiary care centre in central Kerala, India using a questionnaire. Results: A total of 303 parents were enrolled in the study. The mean age of the asthmatic children was 5.36±1.8 years with a male to female ratio of 1.16:1. In the study group 48.18% (146/303) of the parents correctly answered >60% (at least 7 correct answers out of 11) of the knowledge questions (mean = 6.57±2.06) while only 17.16% (52/303) of the parents correctly answered >60% (at least 4 correct answers out of 7) of the attitude questions (mean = 3.20±1.33). A statistically significant association (P = 0.0035) was found between knowledge levels (<or> 60% of the knowledge questions correctly answered) and control of asthma. And a similar association (P = 0.0135) was also seen between attitude levels (<or> 60% of the attitude questions correctly answered) and control of asthma. Conclusions: Even though parents had better knowledge of asthma than attitude, the control of asthma was related to the level of both knowledge and attitude of parents.

Parental knowledge and attitudes regarding asthma in their children: Impact of an educational intervention in an Indian population

“…This was in‐spite of multiple visits, frequent contacts with physicians (physicians in asthma clinic inform about the child's illness regularly), and family history of asthma/allergy and atopy in one‐third. This is similar to observations in other studies from India, Pakistan, and other countries, thus implying a need for interventions to improve parental knowledge 12,16,17,26‐28 . Since most parents/caregivers were literate (92%), poor parental education cannot be blamed for lack of knowledge.…”

“…Parents in intervention group showed a significant improvement in 8 out of 10 attributes in attitude questionnaire postintervention as compared with hardly any change in the control group. This was similar to studies showing association between educational intervention and improved attitudes/self‐management skills 6,8,16,24 . In the Global Initiative for Asthma guidelines, it is proposed that an indicator of asthma control is being able to participate in as much sport as healthy children 4 .…”

“…Our study showed a significant improvement in parental knowledge and attitudes after the educational intervention; however, there were no differences in asthma severity and control. These results are comparable with other studies that showed improvement in knowledge, self‐efficacy, and attitudes after educational intervention; however, evidence regarding postintervention clinical outcomes has been conflicting 3,6‐9,16‐25 …”

“…With an increase in the prevalence of asthma, awareness of asthma amongst caregivers is expected to be increasing, especially in those with long‐standing disease. However, baseline knowledge in our study population was low (only 32.14% had adequate knowledge score of >9 or >60%) 15,16 . This was in‐spite of multiple visits, frequent contacts with physicians (physicians in asthma clinic inform about the child's illness regularly), and family history of asthma/allergy and atopy in one‐third.…”

“…The mean scores at baseline and follow‐up were 8.45 and 11.06, respectively. Only 32% (27/84 cases) of the caregivers had adequate knowledge of asthma (>9 score or >60%) 15,16 . After intervention in just one group, it increased to 59/75 (78.67%).…”