A Study of Printed Pediatric Asthma Education Material for Caregivers with Limited Literacy Skills

• Main Authors: Mei-Chuan Chang, 張美娟
• Other Authors: 陳月枝
• Format: Others
• Language: zh-TW
• Published: 2012
• Online Access: http://ndltd.ncl.edu.tw/handle/15845034199735144389

博士 === 國立臺灣大學 === 護理學研究所 === 100 === Background Patient education is an important aspect of asthma care. Printed health education materials are vital teaching tools for health professionals to educate asthmatic children and their caregivers. However, these materials are effective only if their intended audiences can read, understand, and accept the information. Nurses have an important responsibility to provide easy-to-read and appropriate printed asthma education materials to caregivers, particularly those with limited literacy. Purpose This study explores the suitability of existing printed pediatric asthma education materials, develops new pediatric asthma education materials, and verifies their effectiveness for caregivers with limited literacy skills. Methods The study comprised two phases. A method with data source triangulation was conducted during Phase 1 to explore the suitability of existing printed pediatric asthma education materials. The data included assessment scores for the suitability of the existing materials and caregivers’ and asthma educators’ experiences of using the materials. Various data were integrated to determine the suitability of existing materials and provide suggestions for developing new asthma education materials. The Suitability Assessment of Materials (SAM) Chinese Version was used to analyze the suitability of existing materials. The experiences of caregivers and asthma educators were recorded through interviews. The structure of Phase 2 was a quasi-experimental nonequivalent group design. This study included an experimental group and a control group. The participants were legal caregivers of asthmatic children. Through purposive sampling, the participants were assigned to the experimental group, who received new printed pediatric suitable education materials (NSPPAEM), and the control group, who received existing printed pediatric asthma education materials (EPPAEM). Each group contained 2 subgroups, that is, caregivers with adequate literacy and caregivers with limited literacy. A Chinese graded word recognition inventory was used to assess the participants’ literacy. The outcome indicators were the participants’ comprehension and satisfaction of the printed material, which were measured using self-designed questionnaires. Data analysis methods included content analysis of qualitative data and statistical analysis of quantitative data, such as calculating the frequency, percentage, mean, and standard deviation and conducting one-way analysis of covariance (ANCOVA), two-way ANCOVA, and independent sample t-tests. Results During Phase 1 of this study, 20 existing printed asthma education materials were examined and 5 caregivers of asthmatic children and 5 asthma educators were recruited. The suitability scores of SAM showed that the materials lacked summary and review of content, the cover graphics did not convey the topic, the graphics did not have titles, and the majority of the materials did not contain any section for audience interaction. The SAM scores and data from interviews with the caregivers and asthma educators all suggested that the existing materials did not motivate caregivers to read, lacked common vocabulary, and were difficult to read. Furthermore, the caregivers and asthma educators expressed that the information was not integrated, the advice on asthma care was insufficient, and the layout and typology of the materials was inappropriate. During Phase 2, a total of 76 legal caregivers were enrolled in this study. For the caregivers’ comprehension of asthma information and satisfaction of the materials, regardless of their literacy level, the experimental group (NSPPAEM) scored higher than the control group (EPPAEM) did. For the control group, who received the EPPAEM, the comprehension scores of the caregivers with limited literacy (15.25 ± 4.52) were lower than those of the caregivers with adequate literacy (24.55 ± 4.25). For the experimental group, who received the NSPPAEM, the comprehension scores of the caregivers with limited literacy (30.06 ± 5.07) were lower than those of the caregivers with adequate literacy (34.52 ± 2.39). However, by analyzing the interaction between the two variables material and literacy we found that the caregivers who received the NSPPAEM were better able to comprehend the asthma information than those who received the EPPAEM. Additionally, the comprehension gap between the caregivers with limited literacy and those with adequate literacy decreased. For the caregivers’ satisfaction of the materials, regardless of their literacy level, the experimental group scored higher than the control group scored. Conclusion The NSPPAEM was designed based on the SAM criteria, integrating asthma care information. The results of this study verify the effectiveness of the NSPPAEM. The caregivers’ comprehension and satisfaction of the NSPPAEM was higher than that of the EPPAEM, particularly caregivers with limited literacy. This study indicates that health care professionals developing asthma education materials according to the criteria of suitability and integrating information will enhance caregivers’ comprehension and satisfaction of written information. The results of this study provides practical knowledge and skills for health care professionals on developing suitable education materials for the caregivers of asthmatic children, especially for caregivers with limited literacy.