Dissertations / Theses on the topic 'Asthma self mangement education'

Excerpt Chapter 2 - A review of the literature has revealed that asthma management practices in the Australian community are currently suboptimal resulting in significant morbidity and mortality. In adolescent asthma there are added challenges, with problems of self-image, denial and non-adherence to therapy where self-management skills assume a greater importance (Forero et al 1996, Price 1996, Brook and Tepper 1997, Buston and Wood 2000, Kyngäs et al 2000). In rural and remote areas in Australia, asthma management practices have been shown to be poorer and mortality rates from asthma are considerably higher compared to metropolitan areas (AIHW ACAM 2005, AIHW 2006). Limited access and chronic shortages of specialist services in rural areas are shifting the burden more and more towards the primary sector (AIHW 2006). It becomes paramount that people with asthma in rural settings become involved in self-management of their asthma and that community based health care providers be more proactive in facilitating these self-management behaviours by appropriate education and counselling. Health promotion activities, which are a broad range of activities including health education, have been acknowledged as having the potential to improve the health status of rural populations (National Rural Health Alliance 2002). Community pharmacy settings have been shown to be effective sites for the delivery of health promotion, screening and education programs (Anderson 2000, Elliott et al 2002, Cote et al 2003, Hourihan et al 2003, Watson et al 2003, Boyle et al 2004, Goode et al 2004, Paluck et al 2004, Sunderland et al 2004, Chambers et al 2005, Saini et al 2006). In the case of asthma, outreach programs have been shown to have beneficial effects in terms of reducing hospital admissions and emergency visits and improved asthma outcomes (Greineder et al 1995, Stout et al 1998, Kelly et al 2000, Legorreta et al 2000, Lin et al 2004). We proposed to extend the role of the community pharmacist beyond the traditional realm of the “pharmacy” into the community in rural Australia with the first asthma outreach programs designed for community pharmacy. The outreach programs were designed to include two health promotion strategies, the first targeting adolescents in high schools and the second targeting the general community. The project aimed firstly, to assess the feasibility of using community pharmacists to deliver two asthma outreach programs, one targeting adolescents and one for the wider community in a rural area and secondly, to assess the programs’ impact on adolescent asthma knowledge and requests for information at the community pharmacy. Excerpt Chapter 3 - Patient education is one of the six critical elements to successful long-term asthma management included in international and national asthma management guidelines, which have emphasised education as a process underpinning the understanding associated with appropriate medication use, the need for regular review, and self-management on the part of the person with asthma (Boulet et al 1999, National Asthma Council 2002, National Asthma Education and Prevention Program 2002, British Thoracic Society 2003, NHLBI/WHO 2005). The ongoing process of asthma education is considered necessary for helping people with asthma gain the knowledge, skills, confidence and motivation to control their own asthma. Since most health care professionals are key providers of asthma education, their knowledge of asthma and asthma management practices often needs to be updated through continuing education. This is to ensure that the education provided to the patient conforms to best practice guidelines. Moreover, health care professionals need to tailor this education to the patients’ needs and determine if the education provided results in an improvement in asthma knowledge. A review of the literature has revealed that a number of questionnaires have been developed that assess the asthma knowledge of parents of children with asthma (Parcel et al 1980, Fitzclarence and Henry 1990, Brook et al 1993, Moosa and Henley 1997, Ho et al 2003), adults with asthma (Wigal et al 1993, Allen and Jones 1998, Allen et al 2000, Bertolotti et al 2001), children with asthma (Parcel et al 1980, Wade et al 1997), or the general public (Grant et al 1999). However, the existing asthma knowledge questionnaires have several limitations. The only validated asthma knowledge questionnaire was developed in 1990 and hence, out of date with current asthma management guidelines (Fitzclarence and Henry 1990). The shortcomings of the other knowledge questionnaires relate to the lack of evidence of the validity (Wade et al 1997, Grant et al 1999, Bertolotti et al 2001), being outdated 81 with current concepts of asthma (Parcel et al 1980) or having been tested on small or inadequately characterised subject samples e.g. subject samples consisting of mainly middle class and well educated parents (Brook et al 1993, Wigal et al 1993, Moosa and Henley 1997, Allen and Jones 1998, Allen et al 2000, Ho et al 2003). Furthermore, most of the published asthma knowledge questionnaires have been designed to assess the asthma knowledge of the consumer (i.e. a lay person with asthma or a parent/carer of a person with asthma). There is no questionnaire specifically developed to assess the asthma knowledge of health care professionals, who are key providers of asthma education. It is hence important to have a reliable and validated instrument to be able to assess education needs and to measure the impact of training programs on asthma knowledge of health care professionals as well. An asthma knowledge questionnaire for health care professionals might also be used to gauge how successful dissemination and implementation of guidelines have been. Excerpt Chapter 4 - Asthma self-management education for adults that includes information about asthma and self-management, self-monitoring, a written action plan and regular medical review has been shown to be effective in improving asthma outcomes (Gibson et al 1999). These interventions have been delivered mostly in a hospital setting and have utilised individual and/or group formats. Fewer interventions have been delivered in a primary care setting, usually by qualified practice nurses and/or general practitioners or asthma educators and, to date, their success has not been established (Fay et al 2002, Gibson et al 2003). Community pharmacy provides a strategic venue for the provision of patient education about asthma. Traditionally, patient education provided by community pharmacists has been individualised. However, group education has been shown to be as effective as individualised education with the added benefits of being simpler, more cost effective and better received by patients and educators (Wilson et al 1993, Wilson 1997). While small group education has been shown to improve asthma outcomes (Snyder et al 1987, Bailey et al 1990, Wilson et al 1993, Yoon et al 1993, Allen et al 1995, Kotses et al 1995, Berg et al 1997, de Oliveira et al 1999, Marabini et al 2002), to date, no small-group asthma education provided by pharmacists in the community pharmacy setting has been implemented and evaluated.

Doctor of Philosophy
Excerpt Chapter 2 - A review of the literature has revealed that asthma management practices in the Australian community are currently suboptimal resulting in significant morbidity and mortality. In adolescent asthma there are added challenges, with problems of self-image, denial and non-adherence to therapy where self-management skills assume a greater importance (Forero et al 1996, Price 1996, Brook and Tepper 1997, Buston and Wood 2000, Kyngäs et al 2000). In rural and remote areas in Australia, asthma management practices have been shown to be poorer and mortality rates from asthma are considerably higher compared to metropolitan areas (AIHW ACAM 2005, AIHW 2006). Limited access and chronic shortages of specialist services in rural areas are shifting the burden more and more towards the primary sector (AIHW 2006). It becomes paramount that people with asthma in rural settings become involved in self-management of their asthma and that community based health care providers be more proactive in facilitating these self-management behaviours by appropriate education and counselling. Health promotion activities, which are a broad range of activities including health education, have been acknowledged as having the potential to improve the health status of rural populations (National Rural Health Alliance 2002). Community pharmacy settings have been shown to be effective sites for the delivery of health promotion, screening and education programs (Anderson 2000, Elliott et al 2002, Cote et al 2003, Hourihan et al 2003, Watson et al 2003, Boyle et al 2004, Goode et al 2004, Paluck et al 2004, Sunderland et al 2004, Chambers et al 2005, Saini et al 2006). In the case of asthma, outreach programs have been shown to have beneficial effects in terms of reducing hospital admissions and emergency visits and improved asthma outcomes (Greineder et al 1995, Stout et al 1998, Kelly et al 2000, Legorreta et al 2000, Lin et al 2004). We proposed to extend the role of the community pharmacist beyond the traditional realm of the “pharmacy” into the community in rural Australia with the first asthma outreach programs designed for community pharmacy. The outreach programs were designed to include two health promotion strategies, the first targeting adolescents in high schools and the second targeting the general community. The project aimed firstly, to assess the feasibility of using community pharmacists to deliver two asthma outreach programs, one targeting adolescents and one for the wider community in a rural area and secondly, to assess the programs’ impact on adolescent asthma knowledge and requests for information at the community pharmacy. Excerpt Chapter 3 - Patient education is one of the six critical elements to successful long-term asthma management included in international and national asthma management guidelines, which have emphasised education as a process underpinning the understanding associated with appropriate medication use, the need for regular review, and self-management on the part of the person with asthma (Boulet et al 1999, National Asthma Council 2002, National Asthma Education and Prevention Program 2002, British Thoracic Society 2003, NHLBI/WHO 2005). The ongoing process of asthma education is considered necessary for helping people with asthma gain the knowledge, skills, confidence and motivation to control their own asthma. Since most health care professionals are key providers of asthma education, their knowledge of asthma and asthma management practices often needs to be updated through continuing education. This is to ensure that the education provided to the patient conforms to best practice guidelines. Moreover, health care professionals need to tailor this education to the patients’ needs and determine if the education provided results in an improvement in asthma knowledge. A review of the literature has revealed that a number of questionnaires have been developed that assess the asthma knowledge of parents of children with asthma (Parcel et al 1980, Fitzclarence and Henry 1990, Brook et al 1993, Moosa and Henley 1997, Ho et al 2003), adults with asthma (Wigal et al 1993, Allen and Jones 1998, Allen et al 2000, Bertolotti et al 2001), children with asthma (Parcel et al 1980, Wade et al 1997), or the general public (Grant et al 1999). However, the existing asthma knowledge questionnaires have several limitations. The only validated asthma knowledge questionnaire was developed in 1990 and hence, out of date with current asthma management guidelines (Fitzclarence and Henry 1990). The shortcomings of the other knowledge questionnaires relate to the lack of evidence of the validity (Wade et al 1997, Grant et al 1999, Bertolotti et al 2001), being outdated 81 with current concepts of asthma (Parcel et al 1980) or having been tested on small or inadequately characterised subject samples e.g. subject samples consisting of mainly middle class and well educated parents (Brook et al 1993, Wigal et al 1993, Moosa and Henley 1997, Allen and Jones 1998, Allen et al 2000, Ho et al 2003). Furthermore, most of the published asthma knowledge questionnaires have been designed to assess the asthma knowledge of the consumer (i.e. a lay person with asthma or a parent/carer of a person with asthma). There is no questionnaire specifically developed to assess the asthma knowledge of health care professionals, who are key providers of asthma education. It is hence important to have a reliable and validated instrument to be able to assess education needs and to measure the impact of training programs on asthma knowledge of health care professionals as well. An asthma knowledge questionnaire for health care professionals might also be used to gauge how successful dissemination and implementation of guidelines have been. Excerpt Chapter 4 - Asthma self-management education for adults that includes information about asthma and self-management, self-monitoring, a written action plan and regular medical review has been shown to be effective in improving asthma outcomes (Gibson et al 1999). These interventions have been delivered mostly in a hospital setting and have utilised individual and/or group formats. Fewer interventions have been delivered in a primary care setting, usually by qualified practice nurses and/or general practitioners or asthma educators and, to date, their success has not been established (Fay et al 2002, Gibson et al 2003). Community pharmacy provides a strategic venue for the provision of patient education about asthma. Traditionally, patient education provided by community pharmacists has been individualised. However, group education has been shown to be as effective as individualised education with the added benefits of being simpler, more cost effective and better received by patients and educators (Wilson et al 1993, Wilson 1997). While small group education has been shown to improve asthma outcomes (Snyder et al 1987, Bailey et al 1990, Wilson et al 1993, Yoon et al 1993, Allen et al 1995, Kotses et al 1995, Berg et al 1997, de Oliveira et al 1999, Marabini et al 2002), to date, no small-group asthma education provided by pharmacists in the community pharmacy setting has been implemented and evaluated.

An attempt has been made in this study to critically appraise, systematically review and gather together the results obtained in individual trials and examine the strength of evidence supporting the component for Education for a Partnership in Asthma Care of the National Asthma Education and Prevention Program (NAEPP) to test whether health outcomes are influenced by education and self-management programs.

In the United States, asthma remains a major cause of frequent urgent care visits, hospitalizations, and preventable deaths among children. Nationwide, the chronic disease continues to fall disproportionately on minorities, mostly residing in urban localities. When a child is diagnosed with asthma, the parents are typically tasked with managing the child's condition. Establishing a collaborative partnership between parents and their child's primary physician is significant for improving asthma self-management among youth. Using the theory of reasoned action as a theoretical framework, this mixed-methods study examined whether a relationship exists between parental perceptions of physician cultural sensitivity and parental care in asthma treatment adherence. Phenomenology was used to explore the real-world experiences of study five ethnic minority parents and one guardian grandparent of asthmatic children aged 0–17 who shared similar perspectives. Descriptive surveys were used in combination with in-depth interviews to develop an understanding of parental perceptions on physician cultural sensitivity related to asthma treatment adherence. Overall, 108 minority parents were eligible to complete the survey. The study findings revealed that parents who feel recognized, valued, and respected by their child's physician were more likely to be engaged in shared decision-making about treatment. The findings support the potential for positive social change in terms of modifying the health care behaviors of minority parents with asthmatic children, increasing parental self-efficacy in managing their child's asthma, and improving the cultural sensitivity of physicians who serve the needs of diverse minority families.

Bakgrund: Astma är en folksjukdom som ökar kraftigt bland den svenska befolkningen. Sjukdomens svårighetsgrad kan påverka livskvalitet och arbetsförmågan.För att kunna hantera sjukdomen och minska besvären kan sjuksköterskan lära ut handlingar för egenvård. Syfte: Att belysa hur sjuksköterskor undervisar vuxna patienter med astma bronkiale. Metod: Litteraturstudien grundade sig på tidigare forskning och användes 10 vetenskapliga artiklar från Cinahl, PubMed och Psykinfodatabas. Artiklarna har varit både kvalitativa och kvantitativa. Resultat: Litteraturstudie visade sig på tre olika huvudkategorier. Sjuksköterskan förmedlar kunskap om egenvård genom att göra patienten delaktig, utforma individuellt anpassad utbildning och involvera anhöriga. Att upprätta handlingsplan görs tillsammans med patienten med hjälp av sjuksköterskan. Att kommunicera och ge stöd är en viktig komponent i patientens behandling. Slutsats: Inom vården kan man utgå från Orems och Suzie Kims domäner för en god egenvård. Egenvård bör utföras så gott som möjligt för att främja patientens välbefinnande.
Background: Asthma is a widespread disease that is increasing dramatically among the Swedish population. Diseases severity may affect quality of live and working ability. Inorder to cope with the disease and improve health nurse can teach acts of self-care. Aim: To illuminate how nurses teach adult patients with asthma bronchial. Method:The literature review is based on previous research and used 10 scientific articles from database, Cinahl, PubMed and PsycInfo. The review has encompassed both qualitative and quantitative reference. Results: The analysis of the articles revealed three different main categories. The nurse conveys knowledge about self-care by making patient involvement, develop individualized education and involve relatives. The preparation of action plan with the patient is positive for the treatment. To communicate and provide support is an important component of patient treatment. Conclusion: In healthcare it can be assumed Orems and Suzie Kims domains for a good self-care. Self-care should be performed as best as possible to promote patient comfort.

Introdução: A educação em saúde é considerada essencial no controle da asma. A implantação de um programa de educação (PE) com automanejo tem impacto positivo na melhora da qualidade de assistência em asma. Entretanto, os benefícios de um PE ainda são controversos em função das barreiras estruturais. Objetivo: Avaliar o controle clínico de pacientes submetidos a um programa de automanejo associado automonitorização e auto-tratamento comparando-os com dois grupos em atendimento ambulatorial de rotina, com e sem aplicação de um PE. Ainda, mensurar o conhecimento da doença e técnica inalatória, os índices de qualidade de vida, sintomas de ansiedade e depressão e a alfabetização funcional em saúde. Métodos: Trata-se de um estudo aleatorizado, controlado, de grupos paralelos, alocados em três grupos: grupo controle (GC), educação (GE) e automanejo (GA) durante um período de doze meses. Foram incluídos 110 pacientes com asma persistente moderada e grave. O PE foi oferecido para pequenos grupos nos dias de consulta, e consistiu de aulas expositivas divididas em módulos: (1) fisiopatologia e controle ambiental; (2) sinais/sintomas da asma; (3) tratamento e treinamento da técnica inalatória. O GA ainda recebeu um diário de sintomas e um plano de ação individualizado por escrito. Para avaliar o controle da doença foi utilizado a média de pontos do teste de controle da asma (ACT) e o percentual de pacientes com escore 20. Outros questionários incluídos foram: conhecimento sobre a doença (QCA), qualidade de vida relacionada à asma (AQLQ-s), escala hospitalar de ansiedade e depressão (HADS) e o teste de alfabetização funcional (s-TOFHLA). Resultados: Em dois anos, 84 pacientes completaram o estudo. Os grupos eram homogêneos em relação às características basais. A média do ACT aumentou de 14 para 18 pontos, sendo que 48% dos pacientes do GA atingiram o controle da asma. Os GA e GE aumentaram o conhecimento da doença e técnica inalatória para 100%. E os sintomas de ansiedade diminuíram em 14% e 12%, respectivamente. O escore do AQLQ-s foi clinicamente relevante com aumento significativo maior que 0,5 pontos nos dois grupos. O s-TOFLHA foi classificado como alfabetização em saúde adequada com escore médio de 76 pontos. Conclusões: PE associado automanejo durante a rotina de atendimento ambulatorial mostrou impacto relevante sobre a melhora clínica de pacientes portadores de asma moderada e grave. O PE aumentou o conhecimento sobre a doença e tratamento medicamentoso, com melhora da qualidade de vida relacionada à saúde e os sintomas de ansiedade. Nesta população os pacientes apresentaram adequada alfabetização funcional em saúde.
Background: Health education is considered essential in asthma control. The implementation of an education program (EP) with self-management has a positive impact on improving the quality of care in asthma. However, the benefits of an EP are still controversial according of structural barriers. Objective: Evaluate the clinical control of patients submitted a self-management program associated with selfmonitoring and self-treatment comparing with two groups during the routine outpatient visits with and without the EP application. Also, measure the disease knowledge and inhalation technique, the indices of quality of life, symptoms of anxiety and depression and functional health literacy. Methods: This was a randomized study, controlled, divided into three groups: control group (CG), education (EG) and self-management (AG) during twelve months. The study included 110 patients with moderate and severe persistent asthma. The EP was applied to small groups on outpatient visit days, consisted of lectures divided into three parts: (1) pathophysiology and environmental control; (2) asthma symptoms; (3) treatment and training in the inhalation technique. The AG also received a symptoms diary card and written personal asthma action plan. Disease control was measured by the score of asthma control test (ACT) and the percentage of patients with scores 20. Other questionnaires included: disease knowledge (UDQ), asthma quality of life (AQLQ-s), hospital anxiety and depression scale (HADS) and functional literacy health test (s- TOFHLA). Results: In two years, 84 patients completed the study. Groups were similar in baseline characteristics. The mean ACT increased from 14 to 18 points, with 48% of patients in the AG achieved better control of asthma. The AG and EG increased disease knowledge and inhalation technique up to 100%. And the anxiety symptoms decreased 14% and 12%, respectively. The AQLQ-s score was clinically relevant with a significant increase of more than 0.5 points in both groups. The s- TOFLHA was classified as adequate health literacy with a mean score of 76 points. Conclusions: EP associated with self-management during routine outpatient visit showed significant impact on the clinical improvement in patients with moderate to severe asthma. The EP increased knowledge about the disease and drug treatment, with improvement in quality of life and symptoms of anxiety. In this population patients had adequate functional health literacy.

Trabalho Final do Mestrado Integrado em Medicina apresentado à Faculdade de Medicina
A asma é uma doença respiratória crónica com alta prevalência tanto a nível mundial como a nível europeu, caracterizada por episódios de dispneia, tosse, sensação de opressão torácica e sibilos.A asma, e principalmente a asma não controlada, acarreta perda de qualidade de vida para os doentes e para os seus cuidadores, assim como custos económicos para os sistemas de serviços de saúde, ao ser uma causa de hospitalizações e atendimentos hospitalares não programados.Desta forma, o controlo clínico desta patologia, nomeadamente prevenindo as suas exacerbações, é um dos principais objetivos da terapêutica, que compreende uma abordagem farmacológica e não-farmacológica.Nos últimos anos, muito foco tem sido dado ao papel da educação destes doentes. Atualmente, existe evidência de que doentes asmáticos que apresentam um melhor conhecimento sobre a sua doença e, desta forma, lidam melhor com ela, apresentam um melhor controlo clínico e melhor qualidade de vida. Associadamente, estes doentes têm um menor risco de recorrer de forma não programada aos cuidados de saúde, o que leva a uma redução dos custos monetários relacionados com esta patologia.O TEdASM, projeto criado para submissão a candidatura EIT-Health, é um projeto de base educacional, com uma componente de telemedicina, dirigido a doentes asmáticos e aos seus cuidadores, de modo a que estes consigam lidar melhor com a doença e as suas exacerbações.Após um semestre em que os recursos digitais do projeto serão criados, ocorrerão consultas de telemedicina mensais, com os doentes e seus cuidadores, em que estes mesmos recursos serão aplicados. Finalmente, e em conjunto com um parceiro tecnológico, uma plataforma digital seria desenvolvida de modo a que, no futuro, todos estes recursos se possam agregar, podendo, a longo prazo, contribuir para uma distinta abordagem de follow-up para estes doentes.
Asthma is a highly prevalent chronic respiratory disease both worldwide and in Europe, characterized by episodes of dyspnea, coughing, chest tightness and wheezing.Asthma, and in particular uncontrolled asthma, entails quality of life loss for sufferers and their caregivers, as well as an economic burden for healthcare services by being a cause of unscheduled hospitalizations and appointments.Therefore, clinical control of this pathology and prevention of exacerbations are the main objectives of its treatment, which comprises a pharmacological and a non-pharmacological approach.In recent years, much focus has been given to the role of education of these patients. Currently, there is evidence that asthma sufferers who have better knowledge of their illness and, hence, manage it better, have a better control over their asthma and an improved quality of life. Additionally, these patients have a lower risk of unplanned recourse to healthcare, which in turn leads to a reduction in the associated monetary costs.TEdASM, a project created to submit an EIT-Health application, is an educational-based project, with a telemedicine component, aimed at asthma patients and their caregivers, so that they can better cope and manage asthma exacerbations.After a semester in which the project’s digital resources will be created, monthly telemedicine consultations will take place with the patients and their caregivers, where these same resources will be applied. Finally, and together with a technological partner, a digital platform will be developed so that, in the future, all these resources can be aggregated and, in the long term, contribute to a distinct follow-up approach of asthma sufferers.

碩士
國立臺灣師範大學
特殊教育學系
104
The purpose of this study is to understand the emotion mangement and teaching self- efficacy of teachers with administrative duties in special education schools, and provide conclusions and suggestions accordingly. Questionnaire investigation to was adopted " The questionnaire of emotion mangement and teaching self- efficacy of teachers with administrative duties in special education schools", and quota sampling is used on teachers with administrative duties in public special education schools in Taiwan. There are 152 copies of valid questionnaire, and the questionnaire efficiency is 91.56%. The resulting survey data, with approaches as descriptive statistics, t-test, one-way ANOVA, Pearson product-moment correlation and multiple regression analysis, the conclusions are summarized as follows: 1. Emotional awareness, emotional expression and emotional adjustment for teachers with administrative duties in special education schools were higher degree. 2. Teaching preparation, textbook presents, teaching fluency, classroom management and classroom atmosphere for teachers with administrative duties in special education schools were higher degree. 3. Background variables of different age, administrative seniority for teachers with administrative duties in special education schools on emotion management were significant differences. 4. Background variables of different gender and age for teachers with administrative duties in special education schools on teaching self- efficacy were significant differences. 5. Teachers with administrative duties in special education schools on emotion management and teaching self- efficacy showing a significant correlation. 6. Emotional expression and emotional adjustment for teaching self-efficacy has predictive power. Finally, according to findings and conclusions of practitioners and researchers make recommendations respectively.

碩士
長庚大學
護理學研究所
94
Asthma morbidity has been increasing in the past few years. According to the data presented by Department Of Health, the mortality rate of asthma was 7.04-9.10 per 100,000 population during 1998-2002. Hospital stay number caused by asthma increased by 16％, and the related expense greatly increased by 44％. Asthma is a chronic disease, which affects patient’s activity ability and increases use of healthcare resources. The purpose of this study was exploring the self-care ability, behavior, efficacy and prognosis for moderate and severe asthma patients, and examining the effectiveness of it by self-care and prognosis for moderate-severe asthma adult patients. This study adopted experimental design and randomly sampled 148 moderate-severe asthma patients. The subjects were categorized into three groups: comparison group, experimental 1 and experimental 2. The comparison received standard care; experimental 1 and experimental 2 received the intervention project of asthma education. Observation started in the first and the third month after educating. The subjects were measured in structure questionnaires, which included demographic data, asthma patient self-care agency scale, asthma patient self-efficacy scale, asthma patient self-care behavior scale and social support scale. The data analysis used SPSS for Windows 10 and SAS 8.1 software, including description statistics and deduction statistics data analysis. The major finding of this study revealed with different asthma education interventions are: 1. In “The knowledge of aspect in asthma self-care ability”: the experimental group are better than comparison group (F＝9.746, p＜.001); In ”The attitude of aspect in asthma self-care ability”: three groups are changing along with time ( F＝27.553, p＜.001). Also the average scores of experimental 1 and 2 groups are both higher than the comparison group; In ”The skill of aspect in asthma self-care ability”: three group are change along with time. (F＝20.402, p＜.001) 2.In “asthma self-care behavior”: experimental 2 is significantly higher than the comparison group and experimental 1. (F＝77.515, p＜.001) 3. In “asthma self-efficacy”: the comparison group is significantly lower than experimental 1 and experimental 2 groups. (F＝31.366, p＜.001) 4. In “social support”: the comparison group is significantly lower than experimental 1 and experimental 2 groups. (F＝5.052, p＝.001) 5. In “clinical result”: (1) lung function: PEFR (F＝2.497, p＝.086), FEV1(F＝0.723, p＝.487), FVC (F＝0.435, p＝.648), FEV1/ FVC (F＝1.882, p＝.156) all the three groups are not significant in statistic. (2) asthma control indicator: the experimental 2 group is better than the experimental 1 and the comparison groups. (F＝2.840, p＝.025) (3) use of unscheduled medical resources: all three groups are not significant in statistic. (p＝.544；p＝.169) (4) drug category and frequency: In “drug category”, all three groups are significant in the first and the third months. (p＝.025, p＝.033); In “drug frequency “, all three groups are not significant in statistics. (p ＝.375, p ＝.064) This study significantly verified the effect of individualized intervention project of asthma education in self-care and prognosis on moderate-severe asthma patients. This study could serve as a reference for future the nursing clinical experiments in asthma self-care.

This cross-sectional mixed-method study with a small sample of 62 mothers of children with asthma is a pilot evaluating a new brief online e-health intervention: The Asthma Knowledge Test for Parents (TAKT-40), with all true answers. The TAKT-40 was highly recommended (77.4%) by mothers to others parents with children with asthma. The sample had a mean number of children of 2.31, a mean age of 39.13, with 66.1% (n= 41) White, 24.2% Black, and 9.7% (n=6) Hispanic—with 88.7% living with a partner (n=55). The mean level of education was between Some College and Master’s degrees, with 61.3% employed (n=38) and a mean annual household income for between $100,000 and $199,999. The mean age for children was 9.06, with a mean of 7.51 years since the asthma diagnosis, with 98.4% (n=61) prescribed medication, and 80.6% (n=50) currently taking it. Suggestive of the TAKT-40 being a potential brief online intervention of value, paired t--tests showed: mother’s self-ratings for level of knowledge were higher after they had taken the TAKT-40 with all true answers when compared to self-ratings of knowledge before taking it; and, mother’s self-efficacy for taking care of their child with asthma and helping their child achieve asthma control was higher after they had taken the TAKT-40 when compared to self-ratings after taking it. While controlling for social desirability, backwards stepwise regression showed (1) a higher asthma knowledge (on the TAKT-40), was significantly predicted by: Higher annual household income; Lower number of children; Greater extent of negative impacts from asthma on child, parent, and family—30.0% of the variance predicted with this model. Secondly, backwards stepwise regression found (2) a high asthma self-efficacy (on the Scale 2-Asthma Self-efficacy) for the three key behaviors was significantly predicted by: Fewer Barriers to Child’s Health Care—with 60.0% of variance being predicted. Qualitative data supplemented the quantitative findings, supporting the resultant implications and recommendations.

碩士
中國醫藥大學
醫務管理學系碩士班
102
Diabetes is a common and complicated chronic disease. When inappropriately controlled, it will generate multiple and serious complications. The number of patients as well as costs for medical treatment continue to rise. However, patients are able to enhance their self-management behavior and stabilize control diabetes through sanitary education. Accordingly, this research hopes to discuss, through the perspective of relationship bonds, health education personnel communication behavior’s influence on type II diabetes patient’s self-management behavior. This research is a cross-sectional questionnaire survey which is convenient for the selection of several diabetes health promotion institutions that come with diabetes clinics in the central Taiwan area. This research also utilizes type II diabetes patients accepting health education in sample health institutions as objects for research. Self-designed structural questionnaire is used as a research tool which has been gone through credibility process and passed research committee’s ethics review. Trained interviewers conducted one-on-one questionnaire interview for this research which has collected a total of 270 questionnaires with the retrieving rate of 98.2％. Questionnaires retrieved are then analyzed by this research in structured program mode. Research result indicates that health education personnel’s communication behavior poses significant influence over social bond and structure bond between them and diabetes patients. Meanwhile, structure bond between health education personnel and diabetes patients also poses significant influence over patient’s self-management behavior. However, communication bond does not have significant influence over self-management behavior and structural bond between health education personnel and patients does not have media effect on the influence path. Conclusion from this research considers that good communication behavior only serves to enhance social bond of average social interaction between health education personnel and patients. Communication behavior does not have direct influence over patient’s self-management behavior. Furthermore, health education personnel’s follow-up on patients will be reduced if there is good communication between both parties in the health education process. Through health education personnel’s disease follow-up as well as structural bond from patients’ participation into diabetes related nursing programs, patient’s self-management behavior will therefore be enhanced. This research suggests that health education personnel should encourage patients to participate in diabetes related nursing programs, and should regularly follow up on patients as well as their disease control condition for the purpose of enhancing patient’s self-management behavior over their diseases.