Review Article

Effectiveness of Community-Based Nursing Intervention for Asthmatic Children: A Systematic Review and Meta-Analysis

Abstract

Background: Preventive care can support and direct the nurse's efforts to deliver an asthma intervention for children as part of nursing interventions. Despite the significance, there have been few meta studies demonstrating the effectiveness of nursing interventions for the treatment of childhood asthma that includes only randomised controlled trials (RCTs). Therefore, this meta study was conducted to comprehensively evaluate the efficacy of nursing care interventions for the management of childhood asthma.

Methods: STATA 14.2 (StataCorp, College Station, TX, USA) was used to conduct the meta-analysis. From 1964 to July 2022, we searched Medline, the Cochrane library, EMBASE, Scopus Science Direct, and Google Scholar. Depending on the type of outcome, a meta-analysis was performed using a random-effects model, pooled weight mean difference (WMD), standardised mean difference (SMD), and/or risk ratio (RR) with stated 95 percent confidence intervals (CIs). PRISMA guidelines were followed for conducing this study.

Results: Nine studies were analysed in total. The pooled RR for emergency visits was 0.49 (95%CI: 0.32 to 0.77), for hospitalizations was 0.64 (95%CI: 0.21 to 1.89). The pooled SMD for frequency of asthma attacks was -2.88 (95%CI: -3.22 to -2.54), quality of life was 0.49 (95%CI: 0.22 to 0.75) and asthma control was 1.25 (95%CI: -0.77 to 3.28).

Conclusion: Paediatric asthma patients who received nursing interventions reported an improved quality of life and a decrease in emergencies and acute attacks due to asthma. Future RCTs should focus on uncovering the short- and long-term effects of these nursing interventions to provide optimal management and care.

1. World Health Organization, Asthma. (2019). WHO. [Internet] [cited 25 April 2022]. Available from: https://www.who.int/news-room/fact-sheets/detail/asthma
2. Global Initiative for Asthma. (2019). Glob-al strategy for asthma management and prevention. Available from: https://ginasthma.org/gina-reports
3. Cicutto L To T, Murphy S (2013). A ran-domized controlled trial of a public health nurse-delivered asthma program to elementary schools. J Sch Health, 83(12):876-884.
4. Nurmagambetov T, Kuwahara R, Garbe P (2018). The economic burden of asthma in the United States, 2008–2013. Ann Am Thorac Soc, 15(3): 348–356.
5. Isik E, Fredland N M, Freysteinson WM (2019). School and community-based nurse-led asthma interventions for school-aged children and their parents: A systematic literature review.J Pediatr Nurs,44:107–114.
6. Grover C, Goel N, Armour C, et al (2016). Medication education program for In-dian children with asthma: A feasibility study. Niger J Clin Pract, 19(1): 76–84.
7. Horner SD, Brown A, Brown SA, Rew DL (2016). Enhancing asthma self-management in rural school-aged chil-dren: A randomized controlled trial. J Rural Health, 32(3): 260–268. doi: 10.1111/jrh.12150
8. Kintner EK, Cook G, Marti CN, Allen A, et al (2015). Effectiveness of a school- and community-based academic asthma health education program on use of ef-fective asthma self-care behaviors in older school-age students. J Spec Pediatr Nurs, 20(1): 62–75.
9. Halterman JS, Fagnano M, Tajon RS, et al (2018). Effect of the school-based tele-medicine enhanced asthma manage-ment (SB-TEAM) program on asthma morbidity: A randomized clinical trial. JAMA Pediatr, 172(3): e174938.
10. Sterne JAC, Savović J, Page MJ, et al (2019). RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ, 366: l4898. doi: 10.1136/bmj.l4898
11. Higgins JP and Green S (2008). Cochrane Handbook for Systematic Reviews of In-terventions. John Wiley & Sons, Ltd, Chichester, UK.
12. Chen J, Chen Y (2021). A nurse-led hierar-chical management model for the out-of-hospital management of children with bronchial asthma: a prospective randomized controlled study. Am J Transl Res, 13(6):6488-6497.
13. Harrington CB, Langhans E, Shelef DQ, Savitz M, Whitmore C, Teach SJ (2018). A pilot randomized trial of school-based administration of inhaled corti-costeroids for at-risk children with asthma. J Asthma, 55(2):145–151. doi: 10.1080/02770903.2017.1323915.
14. Lv S, Ye X, Wang Z, et al (2019). A random-ized controlled trial of a mobile appli-cation‐assisted nurse‐led model used to improve treatment outcomes in children with asthma. J Adv Nurs, 75(11):3058–3067. doi: 10.1111/jan.14143.
15. Madge P, McColl J, Paton J (1997). Impact of a nurse-led home management train-ing programme in children admitted to hospital with acute asthma: a random-ised controlled study. Thorax, 52(3):223-8. doi: 10.1136/thx.52.3.223.
16. Ng JSK, Chau JPC, Chan AWK, Lui JKC, Cheng JWCH (2021). A Nurse-Led Web-Based Home Asthma Education Pro-gram for Children and their Families: A Randomized Controlled Trial. J Pediatr Nurs, 59:158-163. doi: 10.1016/j.pedn.2021.04.014.
17. Persaud DI, Barnett SE, Weller SC, Baldwin CD, Niebuhr V, McCormick DP (1996). An Asthma Self-Management Program for Children, Including Instruction in Peak Flow Monitoring by School Nurs-es. J Asthma, 33(1):37–43. doi: 10.3109/02770909609077761.
18. Xu C, Jackson M, Scuffham PA, et al (2010). A randomized controlled trial of an in-teractive voice response telephone sys-tem and specialist nurse support for childhood asthma management. J Asth-ma, 47(7):768-73. doi: 10.3109/02770903.2010.493966.
19. Chan M, Gray M, Burns C, et al (2021). Community-based interventions for childhood asthma using comprehensive approaches: a systematic review and me-ta-analysis. Allergy Asthma Clin Immunol, 17(1):19. doi: 10.1186/s13223-021-00522-9
20. Kindi ZA, McCabe C, McCann M (2022). Impact of Nurse-Led Asthma Interven-tion on Child Health Outcomes: A Scop-ing Review. J Sch Nurs, 38(1):84-97. doi: 10.1177/10598405211003303.
Files
IssueVol 52 No 10 (2023) QRcode
SectionReview Article(s)
DOI https://doi.org/10.18502/ijph.v52i10.13840
Keywords
Childhood asthma Nursing Nurses Meta-analysis

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Liu C, He F. Effectiveness of Community-Based Nursing Intervention for Asthmatic Children: A Systematic Review and Meta-Analysis. Iran J Public Health. 2023;52(10):2025-2035.