The Development And Application Of Self-Management Scale For Asthma Children

Global Initiative for Asthma and the diagnosis of bronchial asthma in children and prevention guidelines have stressed the importance of health education and patient self-management and emphasized that it is an important factor in the overall control effect of asthma prevention and treatment. Therefore, medical staff carrred out children asthmatic self-management health education work according to these guides actively. However, the health education's effect and the level of children's self-management are hard to evaluate. By now, according to our knowledge, there was no specialized, omprehensive, valid, scientific evaluation tools for physical and mental health status of asthma children, especially the tools which was in compliance with the self-management theory and Global Initiative for Asthma program. This brought some problems to quantify the health education, to targeted training. This impedes the prevention and treatment of asthmatic children work to an advanced level. Therefore, an objective, scientific asthmatic children self-management tool is urgently needed.Objective: To develop asthmatic children self-management scale, investigate self-management behavior and analysis influential factors and differences for targeted training and evaluation of health education effect in asthmatic children.Methods:1. Based on the published literatures and interviews, formed an item pool containing 45 items .2. After numerous discussions and clinical research within a small sample size, primarily construct the self-management predictive scale which contains 38 items. Randomized 230 asthma children (7-17 years) were investigated. After some entries removal with item analysis and factor analysis, asthmatic children self-management scale was formed .3. The official scale was appied to 492 asthmatic children in our hospital. And the reliability and validity of the scale were verified. Furthemore, the influential factors and differences in asthmatic children were analyzed.Results :1.Developed asthma children self-management scale:34 items,3 subscales, daily living subscale had 7 items, medical management of disease subscale had 18 items, psychosocial management subscale had 9 items. Each index of scale met the psychometric requirements. The CR values of all scale items were significant . Values of item-total correlation are over 0.2, which indicated that the scale had a good discrimination. Exploratory factor analysis and confirmatory factor analysis implies the structure of the scale was rational with internal consistency 0.866, split-half reliability 0.902 and test-retest reliability 0.876. The internal consistency reliability of each subscale was 0.587 ~ 0.788, while re-test reliability was 0.657 ~ 0.827 and split-half reliability 0.595 ~ 0.863.2. There was obvious differences on the asthmatic children self-management behavior levels among different age groups, main supervisors'cultural level, courses(P<0.05). Age 10-12 group and 13-17group self-management behavior of asthmatic children was significantly higher than that in 7-9 years old group. On main caregivers'cultural level of self-management behavior of asthmatic children, the senior group and college group was significantly higher than that primary and junior group. Asthmatic children with longer (course≥5 years) had the highest score except daily life management. Asthmatic children with family history had a higher score than those without family history in the self-management total level and medical management. Children with asthma whose family adopt one spoiled rearing patterns had the lower self-management level than persuasion education and hitting patterns about self-management total level, medical management and social psychology management.Conclusion:1.Asthma children self-management scale has good reliability and validity, and can be used as a tool for scientific evaluation to children asthma health education effects.2.Age,cultural level of main caregivers', courses, family history , rearing patterns are significant factors affecting asthmatic children self-management behavior level, and should be considered , classified when self-management trainings were carried out.