الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 302 |  |  |
| | | from | 302 | | |
Abstract
Summary
B
ronchial asthma is one of the most common causes of intensive care unit visits and admission for medical seeking each year. One important part of the treatment of bronchial asthma is the control of the disease which needs to be assessed at its baseline and routine intervals, particularly in primary care centers (Abo El-Fadl & Sheta, 2019).
Research design
A quasi-experimental research design with (one group pretest, post-test & follow-up test) was used in the study.
Research setting
The study was conducted at (the chest department & outpatient clinics) for bronchial asthma affiliated El- Fayoum University hospital, Egypt.
Research subject
A purposive sample of 100 adult patients with bronchial asthma was selected from the previous setting according to inclusion and exclusion criteria. The sample size was calculated based on the previous year’s census report of admission in outpatient clinics (Fayoum Teaching Hospital Census, 2019).
Inclusion criteria:
1. Adult Patients from both gender > 20 years old.
2. Conscious, diagnosed with bronchial asthma with previous attacks.
3. Willing to participate, and able to communicate with others.
4. Patients diagnosed with bronchial asthma for more than six months.
Exclusion criteria:
1. Patients with physical or mental handicapped.
2. Patients who had previously taken part in any asthma educational program.
3. Subjects who refuse participation in the program.
Tools of data collection and techniques:
Three tools were used in the current study as the following:
Tool I- Patients’ interview questionnaire form: (Appendix I):
Part 1: Socio-demographic data:
This part was concerned with the socio-demographic characteristics of patients under study.
Part 2: Patient’s clinical data and medical health history:
It was used to assess patients’ medical health history
Part 3: Asthma control test (ACT):
It was used to assess asthma control.
Asthma control scoring system was categorized into:
Level of Control Score
• Uncontrolled <16
• Partially controlled 16–19
• Controlled ≥20
Tool II- Patients’ level of knowledge regarding asthma and self-care management: (Appendix II):
It was used to assess patients’ knowledge regarding bronchial asthma and self-care management.
Scoring system:
The scoring system for this part was as follows: one grade was given for the correct answer and zero for the incorrect answer, with a total grade = 52 grades, for a total of 52 questions.
The total level of the patient’s knowledge score was categorized as follows:
≥70% was considered satisfactory (≥ 36.4 grades).
<70% was considered unsatisfactory (< 36.4 grades).
Tool III: Patients’ observational checklist: (Appendix III):
It was used to assess patients’ level of practice regarding bronchial asthma and self - care management.
Scoring system: For each step, the score was graded as (1) = done, and (zero) = not done. The total score for whole seven procedures of the patients’ practice observational checklist (82 steps) is as follows:
≥70% was considered a satisfactory level of practice (≥ 57.4 grades).
<70% was considered an unsatisfactory level of practice (< 57.4 grades).
Preparatory phase:
It included reviewing the current and more recent relevant national and international literature reviews and theoretical knowledge of the various related aspects using books, articles, periodicals, magazines, and the internet to develop the data collection tools.
Field work:
The aim of the study was explained to the patients who agreed to participate in the study before data collection. The actual work of this study took more than six months, from the beginning of August 2021 till the end of January 2022. The data were collected by the researcher over four days/week (Saturday, Sunday, Tuesday, and Thursday) during the morning shift in the previously mentioned setting.
The researcher started by identification of bronchial asthma patients who were included in the study. Data were collected using a written questionnaire for each patient that was interviewed individually to fill in the questionnaire.
The current study was conducted through four phases; pre-implementation of the educational program (initial assessment), planning, educational program implementation, and evaluation phase.
*Self-care management educational booklet:
Consisted of two parts, theoretical and practical part:
A- Theoretical part covered: an introduction to the disease, anatomy, and physiology of the respiratory system, a definition of bronchial asthma, asthma triggers, signs and symptoms, complications, prevention, medication, and actions during asthma attacks.
B-Practical part covered: using inhalers or nebulizers, breathing and coughing exercises.
The findings of the study can be summarized in the followings:
• According to the level of knowledge among studied patients, the present study revealed that 31% of the studied patients had a satisfactory level of total knowledge regarding bronchial asthma and self-care management pre-program implementation, while 85% of them had a satisfactory level of total knowledge post-program implementation with highly statistically significant at p<0.001 and a slightly marked decline at follow-up phase but not reach to a pre-program phase.
• According to the level of practice among studied nurses, the present study revealed that 28% of the studied patients had a satisfactory level of total practice regarding bronchial asthma and self-care management pre-program implementation, while 86% of them had a satisfactory level of total practice post-program implementation with highly statistically significant at p<0.001 and a slightly marked decline at follow-up phase but not reach to a pre-program phase.
Conclusion
Based on the result of the current study; it can be concluded that. The results revealed that there were improvements in studied patients’ knowledge, practices and self-care management post-program implementation compared to preprogram implementation. The results of the study indicated that the implementation of the educational program for patients with bronchial asthma improves all aspects of self-management. Finally, the present study concluded that the application of educational program had a positive effect on studied patients’ knowledge, practice, and asthma control test, and this support the research hypothesis.
Recommendations
Based on the results of the present study the following recommendations can be suggested:
• The periodic educational program should be provided for patients and their family members to prevent the occurrence of complications and improve patients’ knowledge, practice, and self-care strategies.
• Nursing educators and clinical facilitators must incorporate strategies regarding asthma self-care management into the ICUs, and chest departments and use learning opportunities.
• Developing a simplified and comprehensive booklet including basic information about asthma self-care management for patients.
• Replication of the current study on a larger sample is recommended to achieve generalization of the results and wider utilization of the designed program.
• Future research should be conducted to examine patients’ perceptions, knowledge, and practices before and after the implementation of an educational program regarding asthma self-care management.