The Suitability of Self-management Materials for School-age Children with Asthma
Date Issued
2011
Date
2011
Author(s)
Tzeng, Yu-Fen
Abstract
Background: As the prevalence of asthma has been increasing over the years, it has been recognized as a problem having the highest prevalence and cost to children’s health worldwide. Many scholars discussed the effects of self-management programs for asthma control among school-age children. It was shown that the suitability of materials will affect the performance of asthma management and guidance. As a result, the suitability of materials has begun to receive attention in the past decade over studies abroad. However, the investigating for the suitability of materials for school-age children has never yet been done in Taiwan.
Objective: The purpose of this study is to discuss the suitability of asthma materials to clinical school-age children, and whether are they learning materials which can be accepted, comprehended and expected to school-age children having asthma.
Methods: A mixed methods research design combing two stage approaches was conducted. The first stage was based on questionnaire survey, in which materials of asthma in children all across the country were publicly collected, followed by inviting 5 asthma care specialists to assess the suitability of materials based on the Suitability Assessment of Materials in Taiwan. The second stage applied semi-structured interviews to collect the learning experience and feedback among 3 materials which the experts selected as the most suitable for school-age children with asthma.
Results: A total of 25 pieces of asthma materials suitable to school-age children were collected. The materials consisted of 9 brochures, 11 single sheets, and 5 DVD-ROMs. The year of publication of the collected materials was from 2000 to 2010; only 6 of materials notified the data source, 14 were published by drug manufacturers and 11 were published by asthma care institutions. The brochures and DVD-ROMs had a rather integrated content, whereas the single sheets were based on a single topic. The results from the specialist assessment indicated 7 out of the 9 brochures were rated as superior material, where 2 were adequate material. Only 1 brochure was considered by the specialists to have a reading grade level suitable for 5 years of schooling level or lower, whereas the remaining materials have been considered by one or more specialists to be only suitable for 6 years of schooling level or higher; 5 out of the 11 single sheets was rated as superior material, where 6 were adequate material. All of the single sheets were considered by one or more specialists to be only suitable for 6 years of schooling level or higher; all of the 5 DVD-ROMs were rated as superior material. The relation between the basic attributes and suitability of materials were analyzed by using nonparametric statistics. Results showed that the DVD-ROMs had higher suitability scores than brochures and single sheets; the materials published by asthma care institutions had higher suitability scores than published by drug manufacturers; the materials which are more integrated and content rich resulted with a higher suitability scores; the items issued by asthma care institutions were higher than drug manufacturers; the items in DVD-ROMs were higher than those in brochures and single sheets.
The results of qualitative interviews summarized two phenomena: The concept of asthma is constructed as a trilogy and escalator. The “trilogy construction in asthma concepts” includes three themes: (1) Perception of asthma, with subthemes in: Recognizing asthma symptoms from self experience, think about the relationship between asthma and chronic airway inflammation, recognize the function of a peak expiratory flow meter, imagine and experience wheezing, knowing that asthma is not contagious, and realizing the benefits of taking medication regularly; (2) Proposed questions after thinking, with subthemes in: Do I use inhalation type asthma drugs or anti-inflammatory drugs? What''s the difference between allergen and non-allergen irritants? Why do we need to rinse our mouth after inhaling drugs? What are the pharynx, bronchus and alveolar? (3) Identifying the difficulties in self care, with subthemes in: Find help for calculating the peak expiratory flow rate, and find help to confirm my drug inhaling techniques. The “escalator construction in asthma concepts” includes three themes: (1) Receive guidance from adults, with subthemes in: Tell me what is asthma, teach me about the respiratory tract, and learning to rinse one’s mouth after inhaling drugs; (2) Learning with fun, with subthemes in: Blending cartoon animations and stories into the video, combine interactive computer games with print-based education material; (3) Stay close to the children''s learning needs, with subthemes in: Pronunciation code characters are easy to read, learning operating skills while watching a video, and want to learn more about oneself.
Conclusion: From the results by quantitative and qualitative research, it can be found that DVD-ROMs had a higher suitability scores, having an integrated content, and deeply appealing and liked by school-age children. The designing of materials suitable to children is required to be based on the children’s disease concept, cognitive development and reading abilities. Once the designing of the education material is finished, the suitability level of the material needs to be tested. In addition, children should be invited to collect feedback opinions of their perspectives to the education material. The final step is revising the material for developing an asthma education material suitable for school-age children.
Subjects
school-age child with asthma
self-management
suitability of materials
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