Construction Of An Evidence-based Pulmonary Rehabilitation Program For Children With Asthm

Objective: To explore the feasibility,safety,and effectiveness of an evidence-based pulmonary rehabilitation program for children with asthma,to improve their health behavior and provide a reference and basis for clinical pulmonary rehabilitation.Methods:(1)Under the guidance of evidence-based nursing,we searched and evaluated the literature about pulmonary rehabilitation of asthmatic children in various databases to find the best relevant evidence,and after discussion by the task group,we initially formed a pulmonary rehabilitation plan for asthmatic children;(2)Through the qualitative research on the main caregivers of asthmatic children,understand and analyze their cognition of pulmonary rehabilitation,independent influencing factors,and guidance needs for pulmonary rehabilitation,and supplement and improve the contents of the plan drawn up in the early stage;(3)Inviting experts in related fields to evaluate this scheme through Delphi expert correspondence method,and finally forming a pulmonary rehabilitation scheme for asthmatic children in line with clinical practice;(4)The feasibility,safety,and effectiveness of the scheme are tested through clinical pre-experiments.Results:(1)A total of 2139 articles were initially searched,screened,and evaluated according to the standards of literature acceptance,and finally,24 articles were included,including 4articles of evidence-based guidelines,1 article of clinical practice,5 articles of systematic evaluation,4 articles of expert consensus and 10 articles of randomized controlled trials.After discussion by the subject group,the pulmonary rehabilitation plan for asthmatic children was initially drawn up.A total of 8 first-level items and 37 specific items were extracted from pre-rehabilitation preparation,exercise training,respiratory training,nutritional support,psychological care,health education,follow-up management,and effect evaluation;(2)A total of 15 caregivers of asthmatic children were interviewed qualitatively,and three first-level themes were extracted,namely,the benefits of participating in pulmonary rehabilitation,the independent factors that hinder the development of pulmonary rehabilitation,and the expectation of getting guidance on pulmonary rehabilitation.Five second-level themes,namely,the lack of knowledge about pulmonary rehabilitation,there lative lack of motivation for pulmonary rehabilitation,the limited environment for pulmonary rehabilitation,the professional guidance of medical staff,and the remote rehabilitation guidance of internet plus,provided a reference for the formulation of pulmonary rehabilitation programs for asthmatic children;(3)A total of 18 inquiry experts and inquiry experts were included.The effective recovery rate of the first round of inquiry papers was 82%,and the suggestion rate was 56%.The effective recovery rate of the second round of inquiry papers was 100%,and the suggestion rate was 39%.The authoritative coefficient Cr of the two rounds of expert inquiry was 0.84.After two rounds of expert inquiry,the Kendall coefficient(W)of the first,second,and third level items were 0.195,0.162,and 0.153 respectively,with statistical significance(P < 0.05).A total of 1 first-level item was revised,4second-level items were added,12 third-level items were revised and 1 third-level item was deleted.Finally,the pulmonary rehabilitation program for asthmatic children with 8 first-level items,24 second-level items,and 41 third-level items was determined;(4)A total of 15 children with asthma were included.Through the self-control test,the research results show that the pulmonary rehabilitation program can effectively improve children’s compliance,reduce the incidence of adverse events,and improve the asthma control level and six-minute walking distance.The difference is statistically significant(P < 0.05),and the feasibility,safety,and effectiveness of the program are good.Conclusion: Based on evidence summary,qualitative interview,Delphi method,and clinical pre-experiment,this study constructs a pulmonary rehabilitation program for asthmatic children,which is scientific and practical,and can provide evidence-based guidance and reference for clinical medical staff to carry out pulmonary rehabilitation treatment for asthmatic children in the future.