The knowledge, attitudes and practices of parents of children with asthma in 29 cities of China: a multi-center study

BMC Pediatrics

Qiyi Chen¹  Juan Bai¹  Meng Xie¹  Guoqing Zhang¹  Li Xiang²  Kunling Shen²  Jing Zhao¹ 

[1] Capital Institute of Pediatrics, Beijing, China;Beijing Children’s Hospital, Beijing, China

关键词: China;    Parents;    Practices;    Attitudes;    Knowledge;    Asthma;   

Others  :  1164260
DOI  :  10.1186/1471-2431-13-20

 received in 2012-06-01, accepted in 2013-01-31,  发布年份 2013

【 摘 要 】

Background

Asthma is becoming increasingly prevalent among children in China. Poor parent knowledge and attitudes often contribute to inappropriate management practices, leading to deficiencies in the care process. We aimed to document the knowledge, attitudes and practices (KAP) of parents of children with asthma and analyze how knowledge and attitudes relate to practices. Our secondary objective was to identify the factors associated with parent KAP scores.

Methods

A KAP questionnaire was distributed to parents caring for 2960 children (0–14 years) diagnosed with asthma for at least 3 months from China’s 29 provinces. A 50-item questionnaire was devised for this cross-sectional survey based on a comprehensive review of the subject. Questionnaires were scored on 30 items regarding parent asthma-related KAP, with one point for every correct response and a possible range of 0–13 for knowledge, 0–7 for attitudes and 0–10 for practices. Higher scores indicated better KAP. Chi-squared tests and logistic regression were used to identify factors associated with practices and combined KAP scores.

Results

The response rate was 83.95% (2485/2960). Only 18.31% (455/2485) of parents correctly answered ≥ 60% of the knowledge questions (mean = 5.69). Most (89.85%; 2226/2485) gave positive responses to ≥ 60% of the attitude questions (mean = 5.23) while 67.89% (1687/2485) correctly answered ≥ 60% of the practices questions (mean = 6.19). Knowledge and attitudes were positively associated with pulmonary function testing, regular physician visits, monitoring with a peak flow meter and the Children’s Asthma Control Test questionnaire, avoidance of asthma triggers, using an inhaled β2 receptor agonist and adherence to medication regimen (p ≤ 0.05). Attitudes were also associated with allergen testing. In logistic regression analysis, high KAP scores (dichotomized by a cut-off score of 18) were positively associated with food allergy, rhinitis, physician visits, frequency of visits and parent education (p < 0.05, OR > 1).

Conclusions

Generally, the parents’ KAP were poor. A gap between recommended and actual practice was observed, which may be related to inadequate knowledge about and poor attitudes toward childhood asthma. Improving knowledge and attitudes may encourage better practices among parents of children with asthma.

【 授权许可】

   
2013 Zhao et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]The Global Initiative for Asthma. Pocket guide for asthma management and prevention, Global Initiative for Asthma (GINA) 2011 [EB/OL]. (2011-12) [2012-07-01]. http://www.ginasthma.org/guidelines-pocket-guide-for-asthma-management.html webcite
• [2]Cao L, Chen Y, Zhao J, et al.: Comparative study on the current status of treatment with 10 years before in children with asthma living in the Chinese cities. J Clin Pediatrics 2003, 11:704-706.
• [3]National cooperation group on childhood asthma: A nationwide survey in China on prevalence of asthma in urban children. Chinese J Pediatr 2003, 2:123-127.
• [4]McIvor RA, Chapman KR: The coming of age of asthma guidelines. Lancet 2008, 20:1021-1022.
• [5]Pinnock H, Fletcher M, Holmes S, Keeley D, Leyshon J, Price D, Russell R, Versnel J, Wagstaff B: Setting the standard for routine asthma consultations: a discussion of the aims, process and outcomes of reviewing people with asthma in primary care. Prim Care Respir J 2010, 19:75-83.
• [6]Joe KG, Yanhui S, Roni G, Lynn BG: Asthma morbidity among children evaluated by asthma case detection. Pediatrics 2009, 11:e927-e933.
• [7]Clatworthy J, Price D, Ryan D, Haughney J, Horne R: The value of self-report assessment of adherence, rhinitis and smoking in relation to asthma control. Prim Care Respir J 2009, 18:300-305.
• [8]The Global Initiative for Asthma. Global Strategy for the Diagnosis and Management of Asthma in Children 5 Years and Younger, Global Initiative for Asthma (GINA). 2009. [EB/OL]. 2009 [2012-07-01]. http://www.ginasthma.org/guidelines-global-strategy-for-the-diagnosis.html webcite
• [9]Zahradnik A: Asthma education information source preferences and their relationship to asthma knowledge. J Health Hum Serv Adm 2011, 34:325-351.
• [10]Yilmaz O, Eroglu N, Ozalp D, Yuksel H: Beliefs about medications in asthmatic children presenting to emergency department and their parents. J Asthma 2012, 49:282-287.
• [11]McArthur R: A practical approach to managing asthma and rhinitis. Prim Care Respir J 2012, 21:230-232.
• [12]Rabe KF, Vermeire PA, Soriano JB, et al.: Clinical management of asthma in 1999:the Asthma Insight and Reality in Europe(AIRE)study. Eur Respir J 2000, 16:802-807.
• [13]Zainudin BM, Lai CK, Soriano JB, et al.: Asthma control in adult in Asia-Pacific. Respirology 2005, 10(5):586-597.
• [14]Nathan RA, Sorkness CA, Kosinski M, et al.: Development of the asthma control test: a survey for assessing asthma control. Allergy Clin Immunol 2004, 113:59-65.
• [15]National Asthma Education and Prevention Program: Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma-Summary Report 2007. J Allergy Clin Immunol 2007, 120:S94-S138.
• [16]Rea H, Sears M, Beaglehole R, Fenwick J: Lessons from the national asthma mortality study: deaths in hospital. NZ med J 1987, 100(821):199-202.
• [17]Bryant-Stephens T, Li Y: Community asthma education program for parents of urban asthmatic children. J Natl Med Assoc 2004, 96(7):954-960.
• [18]Guo-qing Z, Zhao J, Kun-ling S, et al.: Survey on knowledge, attitude and practices in asthmatic children’s parents in Beijing. Chinese J Pediatr 2009, 47(12):942-945.
• [19]Shivbalan S, Balasubramanian S, Anandnathan K: What do parents of asthmatic children know about asthma? An Indian perspective. Indian J Chest Dis Allied Sci 2005, 47(2):81-87.
• [20]Matsumoto H, Niimi A, Takemura M, et al.: Prognosis of cough variant asthma:a retrospective analysis. J Asthma 2006, 43:131-135.
• [21]Fujimura M, Ogawa H, Nishizawa Y, et al.: Comparison of atopic cough with cough variant asthma:is atopic cough a precursor of asthma ? Thorax 2003, 58:14-18.
• [22]Respiratory Medicine Branch of Chinese Pediatric Studies Group Editorial Board: Diagnosis and treatment of children with chronic cough Guide (trial). J Pediatr 2008, 46:104-107.
• [23]Chinese Medical Association credits will be asthma respiratory disease: Diagnosis and treatment of cough Guide (draft). Chin J Tuberculosis Respir Dis 2005, 28:738-744.
• [24]Mancuso CA, Sayles W, Allegrante JP: Knowledge, attitude, and self-efficacy in asthma self-management and quality of life. J Asthma 2010, 47(8):883-888.
• [25]Mancuso CA, Sayles W, Allegrante JP: Development and testing of an asthma self-management questionnaire. Ann Allergy Asthma Immunol 2009, 102:294-302.
• [26]Carrillo Zuniga G, Kirk S, Mier N, Garza NI, Lucio RL, Zuniga MA: The impact of asthma health education for parents of children attending head start centers. J Community Health 2012. [Epub ahead of print]
• [27]Welsh L, Kemp JG, Roberts RGD: Effects of physical conditioning on children and adolescents with asthma. Sports Med 2005, 35:127-141.
• [28]Chay OM, Goh A, Lim WH, Leong KH, Lou J: Effects of inhaled corticosteroid on bone turnover in children with bronchial asthma. Respirology 1999, 4(1):463-467.
• [29]Le Bourgeois M, Cormier C, Kindermans C, et al.: Inhaled beclomethasone and bone metabolism in young asthmatic children: a six2 month study. Allergy Clin Immunol 1995, 96(4):565-567.
• [30]Ring N, Jepson R, Hoskins G, Wilson C, Pinnock H, Sheikh A, Wyke S: Understanding what helps or hinders asthma action plan use: a systematic review and synthesis of the qualitative literature. Patient Educ Couns 2011, 85(2):e131-e143.
• [31]Deis JN, Spiro DM, Jenkins CA, Buckles TL, Arnold DH: Parental knowledge and use of preventive asthma care measures in two pediatric emergency departments. J Asthma 2010, 47(5):551-556.
• [32]Suissa S, Ernst P: Bias in observational study of the effectiveness of nasal corticosteroids in asthma. Allergy Clin Immunol 2005, 115:714-719.
• [33]Zhao J: Relationship of allergic asthma and allergic rhinitis. J Appl Clin Pediatirics 2004, 19(4):1020-1022.
• [34]Rosenthal MP: Childhood asthma: considerations for primary care practice and chronic disease management in the village of care. Prim Care 2012, 39(2):381-391.