Evaluation Of The Effect Of Standardized Asthma Management For Children Aged 6-14 Years In Yan’an City Based On The Chinese Childen’s Asthma Action Plan

Objective:The Chinese Children’s Asthma Action Plan(CCAAP)was used to manage asthmatic children aged 6-14 years in Yan’an City,and to evaluate the effects from the perspectives of lung function,asthma control,and quality of life of asthmatic children,and to provide a reference basis for the standardized management of bronchial asthma in children in Yan’an City.Methods:One hundred and eighty-two children aged 6-14 years who attended the pediatric standardized asthma clinic at Yanan University Affiliated Hospital from August2021 to October 2022,had a confirmed diagnosis of bronchial asthma and were included in the study.Using a random number table method,children were randomized to receive paper-based CCAAP instruction(CCAAP management group,n = 86)or no plan(control group,n = 96)on top of their conventional asthma treatment.Lung function,asthma control and quality of life of children with asthma were compared between the two groups;and quality of life factors were analysed for the 182 children recruited.Results:1.Demographic data such as gender,age and family status of children in the CCAAP management and control groups were more comparable in the CCAAP management group than in the control group(P>0.05).2.Comparison of lung function between children in the CCAAP management group and control group:There was no significant difference in each parameter of pulmonary function between children in the managed and control groups before management(P>0.05);FVC,FEV1/FVC,PEF,FEF25,FEF50,FEF75,and MMFF indicators were better in children in the CCAAP management group than in the control group after 1 month of management(P < 0.05);There was no significant difference in FEV1 between the two groups of children(P > 0.05);after 3 months of management children in the CCAAP management group had better FVC,FEV1,FEV1/FVC,PEF,FEF25,FEF50,FEF75,and MMFF than children in the control group(P<0.05);repeated measures ANOVA at different time points: the two groups of children had statistically significant FVC,FEV1,FEV1/FVC,FEV1 M,PEF,FEF25,FEF50,FEF75,and MMFF had statistically significant time effects in both groups of children(P< 0.001).Time and group interaction:there was an interaction effect with time for FVC,FEV1,FEV1/FVC,PEF,FEF25,FEF50,and MMFF in the two groups of children with asthma(P < 0.05),and a non-significant interaction effect for FEF75(P > 0.05).3.Comparison of asthma control levels between children in the CCAAP management group and the control group: asthma control rates in the management group were better than those in the control group after 1 month and 3 months of management(?2=11.071,P<0.05;?2=11.652,P<0.05).4.Comparison of quality of life between children in the CCAAP management group and the control group: after one month of management,children in the CCAAP management group had better scores on the emotional and activity dimensions of quality of life than children in the control group(P<0.05).After three months of management,children in the management group had significantly better scores on all dimensions of quality of life than children in the control group(P<0.001).5.Quality of life scores of children with asthma: the mean overall quality of life score of children with asthma was 5.51 ± 1.11(total score 1-7),and the mean scores of the entries for the dimensions of activity,symptoms and affect were 5.50 ± 1.16;5.37 ±1.21;and 5.67 ± 1.13,respectively.6.Comparison of the quality of life dimension scores of children with different levels of asthma control: the better the level of asthma control,the higher the quality of life dimension scores of children with asthma(F=10.252,P<0.001)、(F=16.503,P<0.001)、(F=11.704,P<0.001).7.Analysis of factors related to quality of life dimensions in children with asthma revealed that the activity dimension of quality of life was influenced by the number of hospitalizations for asthma within one year,history of asthma in first-degree relatives,level of asthma control,cost of asthma treatment,children living with both parents,and current residence of the family.These factors accounted for 37.3% of the variance in quality of life.The symptom dimension of quality of life,on the other hand,was affected by asthma control level,number of hospitalizations for asthma within one year,history of asthma in first-degree relatives,current residence of the family,and mother’s education.These factors accounted for 36.8% of the variance in the symptom dimension of quality of life.Family financial situation,as well as the number of hospitalizations for asthma within one year,asthma control level,and history of in first-degree relatives,were found to significantly impact the emotional dimension of quality of life,explaining 30.9% of the variance.Conclusion: 1.The Chinese Children′s Asthma Action Plan(CCAAP),which is an asthma self-management tool,has shown its effectiveness in improving lung function parameters,asthma control rates,and the quality of life for asthmatic children aged 6-14 years old.2.The overall quality of life of children with asthma aged 6-14 years in Yan’an is at a high level.The main factors influencing the quality of life of children with asthma were:level of asthma control,number of hospitalizations,and history of asthma in first-degree relatives.