Influence Of Follow-up Education Based On Forgetting Curve On Inhaler Technique In Children With Asthma

Objective:1.To investigate the current situation of drug inhalation technology in children with asthma and analyze its influencing factors,so as to provide reference for improving inhalation technology.2.Construct the inhalation technology intervention program based on forgetting curve,and evaluate the application effect of the program on inhalation technology,parents’ disease cognition,medication compliance,family self-management and asthma control level of asthmatic children,so as to provide reference for medical staff to effectively implement asthma management.Method:1.Cross sectional study:from May to October in 2019,428 children with asthma were selected from a children’s Hospital in Chongqing.The self-designed general information questionnaire and inhalation technology evaluation form were used to investigate the mastery of inhalation technology in children with asthma.The influencing factors of inhalation technology were discussed by single factor analysis and multi factor analysis.2.Literature review and expert group meeting:construct inhalation technology intervention program based on forgetting curve.3.Experimental study:82 children with asthma in a children’s Hospital of Chongqing from March to September 2020 were selected as the research objects.According to the order of outpatient visits,41 children from March to June were selected as the experimental group,and 41 children from July to September were selected as the control group.The control group was given routine health education,and the experimental group was given follow-up education based on forgetting curve.Three months after the intervention,data were collected by wechat,questionnaire and telephone.Independent sample t-test,rank sum test,x2 test and repeated measurement ANOVA were used to compare the inhalation technology,disease cognition,medication compliance,family self-management and asthma control test between the two groups.Result:1.(1)four kinds of drug inhalation devices were involved in 428 cases,including 344 cases(80.4%)of PMDI+spacer,26 cases(6.1%)of PMDI and accuhaler(?))28 cases(6.5%)were treated with Turbuhaler(?))30 cases(7.0%).There were 274 cases(64.0%)who didn’t master the inhalation technique completely,and 141 cases(38.1%)who didn’t shake the drugs of PMDI+spacer and PMDI before inhalation;PMDI class,accuhaler(?)And turbohaler(?)49 cases(11.5%)did not exhale before inhalation,37 cases(8.6%)did not inhale deeply and slowly,and 36 cases(8.4%)did not hold their breath after inhalation;112 cases(26.2%)did not gargle after using four kinds of suction devices(2)Multivariate logistic regression analysis showed that the duration of using inhalation device,the number of medical staff guidance,the attitude of children or their parents to inhalation technology all affected the level of inhalation technology.2.According to the literature review and the discussion of one off-line and two on-line expert group meetings,the final follow-up education program of inhalation technology based on forgetting curve was formed.The program contents include:intervention objects:children with asthma who were diagnosed for the first time and planned to use ICs treatment and their parents;Intervention form:in the control group and intervention group,the outpatient service was face-to-face intervention for the first time,and the home service was wechat online intervention;Intervention content:asthma monitoring method,inhalation device use method,guidance of disease-related knowledge,simple laboratory examination index,daily life management knowledge,emotional cognitive management knowledge six education topics,intervention frequency:the experimental group was intervened in 8-9 hours,1 day,2 days,6 days and 1 month of the most easily forgotten memory;Offline intervention location:offline health education consultation room of asthma outpatient department;Interveners:trained child respiratory specialist nurses.3.Comparison of inhalation technique scores at different time points between the two groups:there was no significant difference in inhalation technique scores between the two groups in the first intervention and the night after the first consultation(P>0.05);After the first and third months of intervention,the score of inhalation technique in the experimental group was significantly higher than that in the control group(P<0.05);After the intervention,the scores of inhalation technology in the first month of the two groups were increased by 0.91 and 3.56 points respectively(P<0.05),but the scores of inhalation technology in the third month of the experimental group were significantly higher than those of the first intervention,The score of inhalation technology in the third month of the control group was significantly lower than that of the first intervention in the outpatient department,and the difference was statistically significant(P<0.05).Conclusion:1.Similar to the foreign investigation,the inhalation technology level of asthmatic children is not optimistic.The medical staff can take countermeasures from the structural characteristics of the inhalation device,the way of guidance,the attitude of children and their parents towards the treatment of the disease,so as to improve the level of inhalation technology.2.The inhalation technology follow-up education program based on forgetting curve can improve the inhalation technology of preschool children with asthma,especially in the evening of the first day,or in the second or third day after the first diagnosis.