Acute Asthma in Children: An Investigation of Hospital Care and Its Effect on Outcome

Madge, Philippa (1995) Acute Asthma in Children: An Investigation of Hospital Care and Its Effect on Outcome. MSc(R) thesis, University of Glasgow.

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Adult studies suggest that treatment and outcome of acute asthma is better for patients treated in specialist respiratory wards. The situation for children is less clear as there are no similar large scale studies. We performed a prospective study of 727 asthma admissions (occurring in 572 children) in two health board areas in the West and Central Scotland between January 93 and January 94. The aims of the study were to assess treatment and outcome in terms of continuing morbidity and readmissions. The results showed that the acute treatment was excellent with over 93% of children receiving nebulised bronchodilators and oral steroids. Discharge planning was less good with only 10% receiving written information at time of discharge. Readmissions were common and accounted for 21.3% of the yearly admissions. A morbidity questionnaire completed by a random sample of 25% of parents within one month of discharge showed a number of children suffering ongoing asthma symptoms. Final analysis showed there was no difference in outcome of children cared for by a specialist respiratory team, or between health board areas. In response to these specific deficiencies an enhanced discharge package was developed for use in Royal Hospital for Sick Children, Glasgow. A "Home management package", which included an asthma education booklet, a written asthma management plan, follow-up at a nurse run asthma clinic and an asthma help-line, was then evaluated in a controlled randomised study over a one year period. Children with acute asthma were randomised at time of admission to either an intervention or control group. Outcome was assessed by monitoring readmissions and a morbidity questionnaire completed by the parents. In all, 201 children were randomised, 96 into the intervention group and the 105 into the control group. Although, both groups received the same hospital care, there were both fewer readmissions and fewer reported symptoms in the intervention group. In conclusion, a structured "Home management package" achieved significant reductions in readmissions and improvements in asthma morbidity.

Item Type: Thesis (MSc(R))
Qualification Level: Masters
Additional Information: Adviser: Di Carter
Keywords: Medicine, Nursing
Date of Award: 1995
Depositing User: Enlighten Team
Unique ID: glathesis:1995-75798
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 19 Dec 2019 09:15
Last Modified: 19 Dec 2019 09:15

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