Shanghai Jiaotong Daxue xuebao. Yixue ban (Feb 2024)
Application of continuous nursing based on EMS management mode in preschool children with wheezing diseases
Abstract
Objective·To explore the effect of continuous nursing based on EMS [environment management (E), medicine direction (M) and self monitoring (S)] management mode on the preschool children with asthmatic diseases.Methods·A total of 67 children aged 0 to 6 years with asthmatic diseases admitted to the Department of Respiratory Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine from December 2019 to November 2020 were selected and divided into observation group (33 cases) and control group (34 cases) according to the random number table method, with 3 cases lost, and finally 32 cases in each group. The observation group received continuous nursing care based on EMS management mode, while the control group received routine care and discharge follow-up through the telephone. The children in the two groups were followed up at 1, 3, and 6 months after discharge to evaluate the results of Test for Respiratory and Asthma Control in Kids (TRACK) and wheezing recurrence; Medication Adherence Report Scale for Asthma (MARS-A) and Nursing Job Satisfaction Questionnaire were used to evaluate medication adherence and nursing job satisfaction 6 months after discharge.Results·There was no significant difference in demographic characteristics and clinical baseline characteristics between the two groups. Repeated measures analysis of variance showed that effects of time, groups and the interaction of groups×time on the total score of TRACK were statistically significant. The total scores of TRACK in the observation group were significantly higher than those in the control group at 1, 3, and 6 months after discharge (P=0.000). The total scores of TRACK in the two groups gradually increased with time (P=0.000). The recurrence rates of wheezing in the observation group were 25.0%, 18.7%, and 9.4% at 1, 3, and 6 months after discharge, which were significantly lower than those in the control group (50.0%, 43.7%, and 31.3%, respectively, P<0.05). Generalized estimating equation analysis showed that there was a statistically significant difference between the two groups (P=0.013), and the intervention effect of the observation group was better than that of the control group (OR=0.292). The MARS-A score of the observation group was 4.519±0.395 at 6 months after discharge, which was significantly higher than that of the control group (3.994±0.739, P=0.001). The nursing job satisfaction of the observation group was significantly higher than that of the control group (P=0.000). There was a moderate positive correlation between the MARS-A score and the nursing job satisfaction (r=0.389, P=0.001).Conclusion·Continuous nursing based on EMS management mode can significantly improve the medication compliance and wheezing control level of the preschool children with asthmatic diseases, significantly reduce the recurrence rate of wheezing, and improve the nursing satisfaction.
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