| Objective:The aim of this study was to develop an individualized discharge planning that could provide continuity of care for children with bronchial asthma.And to explore the effect of the discharge plan program in children with bronchial asthma,complete the smooth transition from hospital to family,improve the quality of life of children,and achieve the best health outcome of children.Methods:1.Research study: Using a convenient sampling method,a total of 60 children with bronchial asthma who were hospitalized from September 2016 to February 2017 in a tertiary hospital were selected to investigate the family's demand for continuity of care services.The survey content mainly includes the general information of children and their families,the content of continuing nursing services after discharge,and the demand of providers.2.Construction program: Consult the literature,refer to the overseas discharge planning guide,and combine the guideline for the diagnosis and prevention of pediatric bronchial asthma revised in 2011-6 to initially determine the contents of the discharge plan plan,and then consult a clinical nurse expert to revise the discharge plan plan.3.Intervention study: Using a convenient sampling method,a total of 66 children were selected from the March 2017 to November 2017 in a tertiary hospital for a total number of children who met the inclusion and exclusion criteria.According to the hospital number,the enrolled infants were randomly divided into intervention group and control group with 33 patients.The control group was given routine treatment and nursing,and the intervention group received intervention from the discharge plan based on routine treatment and nursing.Baseline data was collected within 24 hours of hospital admission,and at the time of discharge from the hospital and at the end of the first month and the third month after discharge from the hospital,the hospital's length of stay,hospitalization costs,recurrence rate,pulmonary ventilation function(PEF%),medication compliance,and quality of life were measured.After the data collection is completed,a database is created with Excel and SPSS 18.0 statistical software is used for data processing and analysis.Results:1.Survey findings: A total of 60 questionnaires were issued and collected,of which58 were valid and the effective rate was 96.67%.All 58 children were looking for continuity of care,and the demand rate was 100%.The services the child's family would like to receive most are risk factors for asthma induction,medication guidance,and dietary guidance;the form of service that the child's family would most like to receive is the telephone follow-up and the instruction of the health education manual;the child's family most hopes to provide continuity of care services for the third months and the first month after the child is discharged from the hospital;the child's family also hopes to be provided by a professional team.2.Intervention study results: A total of 65 children were successfully followed up,including 32 in the intervention group and 33 in the control group.There was no significant difference in general data between the two groups(P>0.05).(1)Comparison of length of stay,hospitalization costs,and recurrence rate within 3months after discharge: There was no significant difference in hospitalization time and hospitalization costs between the two groups(P>0.05);The recurrence rate of asthma in the intervention group within 3 months after hospitalization was lower than that in the control group(P<0.05).(2)Comparison of medication adherence: There was no statistically significant difference in medication compliance between the two groups at admission(P>0.05).The intervention group had stronger medication use at 1 and 3 months after discharge than the control group(P<0.05).(3)Comparison of pulmonary ventilation function indicators(PEF%): There was no significant difference in PEF% between the two groups of patients when they were admitted to hospital and when they were discharged(P>0.05).The PEF% of the infants in the intervention group was significantly better than that of the control group at 1 month and 3 months after discharge(P<0.05).(4)Comparison of Paediatric Asthma Quality of Life Questionnaire(PAQLQ)Scores:There was no significant difference in PAQLQ scores on admission between the twogroups(P>0.05).PAQLQ scores in the intervention group were better than those in the control group at 1 month and 3 months after discharge(P<0.05).Conclusion:1.It is necessary to provide continuity of care for children with bronchial asthma,and according to the specific needs of children with rich and diverse forms of continuity of care services.2.To establish continuity of care services in the form of a discharge planning model for children with asthma by constructing individualized discharge planning for children with bronchial asthma.It can reduce the recurrence rate of asthma in children,improve the medication compliance of children,improve the children's pulmonary ventilation function,and improve the children's quality of life.The program completed a smooth transition from the hospital to the family,which is worth promoting. |
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