الفهرس 
Overview about AsthmaOnly 14 pages are availabe for public view
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Abstract
Asthma is a major cause of chronic morbidity and mortality throughout the world, especially in children. Asthma causes more hospital stays than any other childhood disease. It is treatable, but not yet curable. Asthma is not the same as allergies, but allergies cause asthma, asthma can be life-threatening if it is not controlled. Barriers to reducing the burden of asthma include generic barriers like poverty, poor disease education, poor health services and environmental barriers like indoor and outdoor air pollution. Mothers play pivotal role in the child adjustment to the illness, especially children who suffer from severe episodic manifestations of asthma have been found to experience increased amounts of stress and anxiety over their illness and have difficulty in maintaining a sense of well-being.
Bronchial asthma is the most common chronic disease of childhood. Asthma constitutes a serious public health problem all over the world. The optimal asthma control would include minimal chronic symptoms, minimal exacerbations, and no limitation of activities.
Aim of the Study:
This study aimed to assess impact of asthma management guidelines on children having asthma.
Subjects and Methods:
The technical design includes research design, setting, subjects and tools of data collection.
II. Technical Design
It includes the research design, settings, subject and tools of data collect.
• Research Design:
A quasi experimental design was utilized in this study.
• Research Settings:
This study was conducted at Outpatient Department of Princess Rahmah Hospital and king Hussein Medical City (Jordanian Royal Medical Services). These places were selected because it is well known established places that provide care for such children and also due to its high flow rate of attendance.
• Research Subjects:
A purposive sample consisted of one hundred (100) children out of three hundred child(300) were included in the study, those represent 10% of the total estimated admitted number of children in the year 2013 those suffering from asthma episode(3000) accompanied with their mothers attending to the previously mentioned settings one year period under the eligible criteria:
• Age: from 6-12 years.
• Children suffering from asthma attending out patient in a regular basis accompanied by their mothers.
Tools of data collection:
The data was collected through using the following tools:
First tool: An interviewing questionnaire Sheet: (Appendix II)
It was designed by the researcher after reviewing the current available the relevant literature It was written in simple Arabic language to suit the children and mothers level of understanding, it consists of the following parts:
Part I:
It concerned with characteristics of children include: age, gender educational level, ranking, residence. Also it concerned with characteristics of mothers of children include: age, educational level, occupation.
Part II:
It related with assessment children’ knowledge about asthma such as (definition, types, Factors predisposing asthma, etiology, and steps for asthma treatment regimen. This tool was used three times, pre implementation of guideline content and immediately post and after one year as follow-up.
Scoring system for knowledge:
Each question was evaluated as 2 scores for correct answer or1 score for incomplete answer and zero for incorrect, the total correct knowledge score was calculated as more than 60% while less than 60% was incorrect, it was utilize pre and post intervention.
Second tool: An observation check list to assess the actual children practice for the usage of inhaler (Appendix III) pre.post at the follow up the guideline implementation. The observation check list contains the step by step the children follow during the usage of inhaler. Adopted from hockenberry, M.wilson, D.& winkelstin, M.(2005): wongs essential of pediatric nursing. 7th .ed. Elsevier mosby company: U.S.A. p:822.
Ethical Considerations:
The research approval was obtained from scientific research ethical committee in faculty of nursing at Ain Shams University before starting the study, the researcher was clarified the objective and aim of the study to the children and their accompanied mothers included in the study and was assured maintaining anonymity and confidentiality of the subject data and the children and the mothers were informed that they were allowed to choose to participate or not in the study and that they had the right to withdraw from the study at any time
11. Operational Design:
Operational design included preparatory phase, content validity, pilot study, and field work.
Preparatory phase:
A review of the past, current related literature covering various aspects of the research problem was done by using available articles, periodicals, magazines, and books to be acquainted with the research problem, develop the study tools and content.
Content Validity:
The content revised by three expertise’s in Pediatric Nursing Field to test applicability, feasibility and clarity of the study tool for further required modifications.
• Pilot Study:
A pilot study conducted by the research on ten percent to evaluate the clarity and applicability of tools and estimate the time consume for each tools. The revised final form was used. All the result of pilot study was not included in the sample of the study.
Field Work:
The actual field work started from July 2014 up to October 2015.The researcher explained the aim of the study and took the children and their mothers’ approval to participate in the study prior to any data collection. The research was available 2 days/week from 9 Am to 1 Pm in each study setting on Sunday and Monday, the researcher collected the data from 4-5 children every week from the two study settings, the aim of the study and the expected outcomes were explained for the studied children and their mothers. The researcher interviewed each child and the mother individually using the study tools for 10-20 minutes. Each month the researcher performs the baseline assessment for 20 children and their mothers. After the baseline assessment the researcher starts to discuss and explain the content of the guideline for each child and the accompanied mother individually. Accordingly the researcher had 20 children per month, so the researcher considered them as a group, continued to collect the data each month an additional group started till the total number of children recruited in the study received the guideline.
Result:
The current study revealed that more than one third of children, their age ranged between 8 ˂ 10 years. more than half of children had family history of asthma. more than half of children fathers were smokers. There was highly statistically significant difference between urban and rural areas regarding pollution source outside the house.
Conclusion:
On the light of the study finding it could be concluded that the guideline had a positive impact on children adherence to treatment regimen pre and post implementation of asthma management guideline
Recommendations:
-The current study recommended the utilization of an guideline at different health services to overcome challenges of asthma control.
- Further research is recommended to be applied on another setting on larger sample.