Smartphone guide to asthma self-management ages 5 to adult (patient education materials)

This free, colorful, interactive, and evidence-based PDF is designed to support online or in-person education about asthma, with formatting that is smartphone friendly. The patient teaching guide covers key content of asthma self-management education in 15 single-page mini-modules. Help your patients to understand what really asthma is, how uncontrolled asthma scars the lungs, different types of asthma medications, and how to use them correctly. Also includes a customizable action plan and a patient friendly asthma attack algorithm. Text it, email it, fill it in and make it your own! English Version. References: Mammen JR, Rhee H, Atis S, Grape A. Changes in asthma self-management knowledge in inner city adolescents following developmentally sensitive self-management training. Patient Education & Counseling 2018;101:687-95. Mammen JR, Java JJ, Halterman J, et al. Development and preliminary results of an Electronic Medical Record (EMR)-integrated smartphone telemedicine program to deliver asthma care remotely. J Telemed Telecare 2019;0:1-14 Mammen JR, Schoonmaker JD, Java JJ, et al. Going mobile with primary care: Smartphone-telemedicine for asthma management in young urban adults (TEAMS). . Journal of Asthma 2020;0. PLEASE NOTE: This form does not work in Safari and may be corrupted by Safari download. Please use Google Chrome or other browser to access and download

Ecological Factors Associated with Middle School Students’ Experiences of Cyberbullying

Thesis (Ph.D.)--University of Rochester. School of Nursing. Dept. of Health Practice Research, 2016.Cyberbullying among youth has become a major social issue and public health concern, yet scientific understanding of the phenomenon is minimal. An ecological systems framework has been used when studying traditional forms of bullying, yet its application within the research of cyberbullying is limited. The purpose of this study was to examine ecological factors associated with cyberbullying across multiple ecological system levels. Anonymous paper surveys were administered to 1059 middle school students in grades 6 (35.3%), 7 (32.6%), and 8 (32.1%) from suburban (58.9%), rural (30.3%) and urban (10.8%) public schools within the northeastern region of the United States. Ecological factors assessed in the study included sociodemographic characteristics, relationships with parents, peers and teachers and school climate. Bivariate analyses and multinomial logistic regressions were completed to assess relationships between the various ecological variables and cyberbullying status. Subject were categorized as either bully (5.1%, n=54), victim (23.7%, n=251), bully-victim (37.1%; n=393), or not involved (32.9%, n=348). Bullies were more likely to be in 8th grade (OR=2.60, p=.02) and report a negative school climate (OR=.90, p=.002); while victims were more likely to report parental rejection (OR=1.16, p<.001), parental overprotection (OR=1.07, p=.02), parental emotional warmth (OR=1.09, p=.01) and poor peer relationships (OR=.94, p=.001). Youth who identified as bully-victims were more likely to be female (OR=1.62, p<.01), in 7th (OR=1.82, p<.01) or 8th grade (OR=2.16, p<.01), from an urban location (OR=4.04, p<.001), and report having a health condition (OR=1.63, p<.01). Parental rejection (OR=1.18, p<.001), negative school climate (OR=.96, p=.03), and poor relationships with teachers (OR=.96, p=.04) and peers (OR=.96, p=.03) were also identified as risk factors for bully-victim status. A significant interaction effect was found (p<.001) as the prevalence of bully, victim, and bully-victim statuses across grade level differed by geographic location. This study provides support for the ecological systems theory as a comprehensive model explaining youths’ experiences with cyberbullying. Clinical interventions and policies aimed at decreasing the prevalence of cyberbullying among youth must incorporate a multisystem ecological approach. Additional research is warranted to explore the effects of cyberbullying on health and developmental outcomes among bullies, victims, and bully-victims

Teens’ Experiences of Asthma Self-Management

Thesis (Ph.D.)--University of Rochester. School of Nursing. Dept. of Health Practice Research, 2016.Background: Asthma is the most common chronic disease in teens. Teens in general, and minority teens in particular, have a higher risk of asthma related morbidity and mortality than other age groups, as they often fail to recognize and respond to symptoms appropriately. This has historically been attributed to poor asthma self-management. To date, the vast majority of research on asthma self-management in this population has emphasized clinicians’ and researchers’ perspectives, typically focusing on the ways in which teen asthma self-management is inadequate to achieve asthma control. Yet, very little is known about the process of asthma self-management from teens’ own perspectives. Given that teens are the central figures in their asthma management, it is imperative to recognize their perspectives, what they do to self-manage, underlying rationales for behaviors, and variations in choices across diverse situations. This type of contextually specific knowledge can promote sharing of health information in ways that are developmentally appropriate and meaningful to teens, identify areas for intervention, support effective self-management behaviors, and thus contribute to improved health outcomes. Therefore, the purpose of this study was to explore teens’ experiences and perceptions of asthma self-management across their different life-contexts through use of asthma self-management diaries and in-depth qualitative interviews with teens and their parents. Objectives:The specific aims of this study were to (1) describe how teens manage their asthma and what is important from the perspective of teens and their parents; (2) compare the asthma self-management of teens with well-controlled vs. those with not-wellcontrolled asthma, and among minority versus non-minority teens. Methods: A theoretically informed case-based, qualitative-descriptive design was used. Fourteen teen-parent dyads (N=28) participated across four data collection points: (1) a primary open-ended teen interview; (2) a parent interview; (3) a two-week selfmanagement voice-diary; and (4) a follow-up teen interview incorporating symptomresponse card-sorting to map asthma symptoms and associated self-management responses. Coding was conducted in three phases, occurring contiguously with data collection: first phase starting with open coding, second phase incorporating process coding, and third phase utilizing pattern coding techniques as described by Saldana. Analyses included comparison of asthma self-management between teens with controlled and uncontrolled asthma, as well as between minority and non-minority teens. Results: Teens viewed their asthma symptoms as normal or unusual relative to baseline patterns of symptoms. Those with uncontrolled asthma were more likely to normalize higher levels of asthma symptoms compared to their counterparts with controlled asthma. Second, teens’ decisions to treat active symptoms of asthma with rescue medication were based on benefits, burdens and accessibility of medication balanced against perceived normalcy of symptoms. Teens with uncontrolled asthma had substantially higher treatment thresholds and delayed responses to symptoms compared to better controlled peers. Third, teens did not reported normal symptoms of asthma to parents or providers, who were thus only aware of unusual or visible/audible symptoms. Discussion: Teens with asthma do not treat or report “normal” symptoms to their providers. Consequently, many are inadequately controlled and undertreated. Tendency to ignore, undertreat, and underreport asthma symptoms hinges upon perception of symptom severity and understanding of normal symptoms. Treatment thresholds may be modifiable through interventions that could alter symptom perception and the balance of perceived benefits and burdens of using medication. Conclusion: Improving self-management will likely entail modifying symptom perceptions and patterns of responses to achieve healthier self-management patterns, including earlier recognition of and response to symptoms

Visual analogue scale (VAS) as a monitoring tool for daily changes in asthma symptoms in adolescents: a prospective study

Abstract Background Success in asthma management hinges on patients’ competency to detect and respond to ever-changing symptom severity. Thus, it is crucial to have reliable, simple, and sustainable methods of symptom monitoring that can be readily incorporated into daily life. Although visual analogue scale (VAS) has been considered as a simple symptom assessment method, its utility as a daily symptom monitoring tool in adolescents is unknown. This study was to determine the concurrent validity of VAS in capturing diurnal changes in symptoms and to examine the relationships between VAS and asthma control and pulmonary function. Methods Forty-two adolescents (12–17 years old) with asthma completed daily assessment of symptoms twice per day, morning and bedtime, for a week using VAS and 6-item symptom diary concurrently. Asthma control was measured at enrollment and 6 month later, and spirometry was conducted at enrollment. Pearson correlations, multilevel modeling and regression were conducted to assess the relationships between VAS and symptom diary, asthma control and FEV1. Results Morning and evening VAS was positively associated with symptom diary items of each corresponding time frame of the day (r = 0.41–0.58, p < 0.0001). Morning VAS was significantly predicted by morning diary data reflecting nocturnal wakening (β = 2.13, p = 0.033) and morning symptoms (β = 4.09, p = 0.002), accounting for 57% of the total variance of morning VAS. Similarly, changes in four evening diary items, particularly shortness of breath (β = 2.60, p = 0.028), significantly predicted changes in evening VAS, accounting for 55% of the total variance. Average VAS scores correlated with asthma control (r = 0.65, p < 0.001) and FEV1 (r = −0.38, p = 0.029), and were predictive of asthma control 6 months later (β = 0.085, p = 0.006). Conclusions VAS is a valid tool capturing diurnal changes in symptoms reflected in a multi-item symptom diary. Moreover, VAS is a valid measure predicting concurrent and future asthma control. The findings suggest VAS can be a simple alternative to daily dairies for daily symptom monitoring, which can provide invaluable information about current and future asthma control without substantially increasing self-monitoring burdens for adolescent patients. Clinical Trial Registration NCT01696357. Registered 18 September 201

Parent and Child Independent Report of Emotional Responses to Asthma-Specific Vignettes: The Relationship Between Emotional States, Self-Management Behaviors, and Symptoms

Purpose Little is known about the emotional intelligence (EI) of parents and their children with asthma. Objectives of this study were to assess: 1) parent\u27s and children\u27s report of emotions in response to an asthma vignette (proxy for EI) and 2) the relationship between emotions, self-management behaviors, and symptoms. Design and Methods We conducted a descriptive, mixed methods study of children 7–12 years old with asthma. Parent–Child dyads (n = 104) responded to an asthma vignette to gain insight into emotions, symptoms, and self-management behaviors. Additional questions assessed confidence and worry using a 5-point Likert scale. Thematic analyses and descriptive statistics were used to assess qualitative and quantitative outcomes. Results Children were predominantly male (58%), 7–9 (58%), and White (46%). The most common negative emotions reported by children were scared and sad. Children who sought help from an adult were less likely to report using medications compared to children who did not seek help (39.5% vs. 62.3%, p = .029). Children with low worry and high confidence had fewer symptoms compared to children reporting high worry and low confidence (symptoms: days 3.24 vs. 6.77, p = .012, nights 2.71 vs. 5.36, p = .004). Conclusions Children provided appropriate emotional responses to the asthma vignette; emotions were related to self-management behaviors and symptoms. More studies are needed to specifically assess EI in this population. Practice Implications Parents and children with greater EI may be better able to understand their needs, engage in self-management behaviors, and communicate with their nurses, to improve their support network and ability to access services

Parents’ Experiences and Perceptions of Healthcare Transition in Adolescents with Asthma: A Qualitative Study

Adolescence marks a significant transition from pediatric to adult healthcare, and parents play critical roles in supporting their adolescents with chronic conditions through this process. However, little is known about parents’ experiences, perceptions, and needs during this healthcare transition. This qualitative study explores the experiences and perceptions of parents regarding the care transition of their 16–17-year-old adolescents with asthma. Nineteen mothers participated in either a focus group or individual interviews, and a content analysis was conducted on the data. Parents expressed negative emotions and various concerns about their teens’ transition readiness and asthma management. A need for early transition training for both adolescents and parents was discussed. Overall, the complexity and challenges associated with the healthcare transition of adolescents with asthma take a toll on parents, particularly when their teens are not adequately prepared to manage asthma independently. Parents need appropriate anticipatory guidance regarding the transition and skills to navigate changing roles and negotiate asthma care responsibilities with their teens. Timely interventions and support strategies for both adolescents and parents are needed to ensure the successful healthcare transition of adolescents with asthma

Are Mid to Late Adolescents with Asthma Ready for Transition of Care? A Qualitative Study

This qualitative descriptive study explores experiences and perspectives of mid-to-late adolescents about growing up with asthma, and the roles of parents and providers as they transition. Purposeful sampling was used to recruit and enroll adolescents aged 16&ndash;20 years with asthma. Forty-one adolescents participated in a focus group or individual interview, and content analysis was conducted to analyze the data. The mean age of participants was 17.7 years, the majority (56%) of whom were Black. Themes that emerged included concerns about becoming an adult with asthma and its self-management, parental involvement, and communication with providers. Adolescents felt burdened by asthma, few considered becoming adults with asthma, and their future outlook was pessimistic with concerns related to worsening symptoms, inadequacy in symptom self-management and limitations on career choices due to asthma. Deficiencies in self-management were noted, parents still played major roles in adolescents&rsquo; asthma care, and transition of care was seldom discussed with the providers. Mid-to-late adolescents with asthma are inadequately prepared for transition of care, and parents and providers insufficiently engage adolescents in the preparation. Parent, provider, and adolescent partnership is critical to achieve adolescent readiness for independence in asthma management and to ensure proper asthma care continuity post transition