UVM Theses and Dissertations
Format:
Print
Author:
Iftekhar, Nazia
Title:
Dept./Program:
Nursing
Year:
2011
Degree:
MS
Abstract:
The goal of this study is to determine whether assisting parents in rural Vermont in reducing environmental triggers in the home improves their child's asthma outcomes in the long term. Further, this study explores the perception of parents of children with asthma regarding their relationship with their child's health care provider and investigates if it is in compliance with the goals of Modeling and Role-Modeling (MRM) theory. Participant families from the Maltby et al. (2006) pilot study were used for this follow-up study. Previously, participant families completed an asthma survey, received a Healthy Homes evaluation, and equipment that included: HEPA-filtered vacuum cleaners, hypoallergenic bed covers, hygrometers, and HEPA-filtered air purifiers. Participants were subsequently contacted at 4,6, and 12 months to assess environmental condition and respiratory health. In this study, 5 years after contact, the same participants were surveyed using a telephone questionnaire.
The final sample consisted of 5 households with 6 children and had significant loss to follow-up. Although it lacked statistical significance, this study has expanded knowledge into the role of environmental remediation. Five out of 6 children did not have unscheduled emergency department or clinic visits in the past year, did not have asthma symptoms in the past 2 weeks, and did not need to use their rescue inhaler in the past 2 weeks. All households felt that the original intervention was helpful and continue to use HEPA-filtered vacuum cleaners, air purifiers, and hypoallergenic bedding. Four households rated that they were generally happy with their child's primary care provider, while one household was unhappy and felt that their child's steroid dosage was too high. Overall, there was a general correlation between all MRM indicators of the parent-provider relationship, with the most important indicator identified as trust.
The role of the Advanced Practice Nurse incorporates assisting families to eliminate asthma triggers in the home, exploring the role of MRM theory in improving the parent-provider relationship, making timely and appropriate referrals, and developing health policy in-the area of pediatric chronic illness. Loss to follow-up is difficult to reduce and is one of the biggest obstacles for researchers. Further MRMbased research on volitional nonadherence in asthma is also needed.
The final sample consisted of 5 households with 6 children and had significant loss to follow-up. Although it lacked statistical significance, this study has expanded knowledge into the role of environmental remediation. Five out of 6 children did not have unscheduled emergency department or clinic visits in the past year, did not have asthma symptoms in the past 2 weeks, and did not need to use their rescue inhaler in the past 2 weeks. All households felt that the original intervention was helpful and continue to use HEPA-filtered vacuum cleaners, air purifiers, and hypoallergenic bedding. Four households rated that they were generally happy with their child's primary care provider, while one household was unhappy and felt that their child's steroid dosage was too high. Overall, there was a general correlation between all MRM indicators of the parent-provider relationship, with the most important indicator identified as trust.
The role of the Advanced Practice Nurse incorporates assisting families to eliminate asthma triggers in the home, exploring the role of MRM theory in improving the parent-provider relationship, making timely and appropriate referrals, and developing health policy in-the area of pediatric chronic illness. Loss to follow-up is difficult to reduce and is one of the biggest obstacles for researchers. Further MRMbased research on volitional nonadherence in asthma is also needed.