Effect of Case Management vs. Internet-based Case Management Program on the Caregivers of Children with Asthma

• Main Authors: Hui-mei Tsao, 曹慧美
• Other Authors: Mei-Chih Hwang
• Format: Others
• Language: zh-TW
• Published: 2008
• Online Access: http://ndltd.ncl.edu.tw/handle/40050510836407447091

碩士 === 國立成功大學 === 護理學系碩博士班 === 96 === Because asthma is the most common and costly chronic disease of childhood in Taiwan, manage and control asthma in childhood has become a major public health problem. An efficient, continuous and cost–effective asthma managing model can be designed to improve the quality of asthma care in childhood. The purpose of this study were to：1. assess the effectiveness of internet-based case management program on caregiver’s asthma knowledge, skill, self-management behavior and children’s health condition; 2. evaluate the comparative effect of two different asthma case management program which was based on the PRECEDE/PROCEED model. Forty-one caregivers of children with asthma visiting pediatric allergy-immunology clinic were randomly assigned to experimental and comparison group (19 participants were in experimental group and 22 participants were in comparison group). Both group received an asthma education and experimental group participants received additional internet-based case management program in which researcher provided instant and closer care through an interactive internet device. The comparison group also received a case management program in which researcher provided a traditional case management care. The outcomes measurement including: Pediatric asthma caregiver’s knowledge and skill questionnaire, Pediatric asthma caregiver’s self-management behavior, Childhood Asthma Control Test (ACAT), and the visiting number in previous three months collected on the time before intervention and 12 weeks later. Results showed that the scores of caregiver’s asthma knowledge and skill in experimental group was significant increased (9.40 vs. 11.84, p＜.001), caregiver’s self-management behavior significant improved (89.84 vs. 99.63, p＜.002). Also, the scores of CACT increased (20.32 vs. 23.00, p＜.02) and the visiting number decreased (1.74 vs. 0.74, p＜.01) in experimental group. Besides, the similar effect were shown in comparison group, which were the significant increased in caregiver’s asthma knowledge and skill (9.73 vs. 12.27, p＜.001), caregiver’s self-management behavior (83.64 vs. 94.77, p＜.09), scores of CACT (19.32 vs. 22.27, p＜.002), and slightly decreased on the number of visiting (1.00 vs. 0.45). Compare to the differences in caregiver’s asthma knowledge and skill, self-management behavior and children’s health condition in both group after receiving different case management program, results indicated that there was no significant difference in scores of caregiver’s asthma knowledge and skill, caregiver’s self-management behavior, CACT and the number of visiting in both of experimental group and comparison group. In conclusion, both traditional case management and internet-based case management program can provide the effective outcome to asthmatic children and their caregivers, however,internet-based case management demonstrated more advantages, which included immediate monitoring, alert reporting and advises for symptom management. Further study would focus on the applications for pediatric asthma control and managed care.