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Master Thesis

Connaissances parentales et effets d’une intervention éducative précoce dans l’asthme aux urgences pédiatriques du CHU de Bordeaux

Abstract : Background: Asthma is the most frequent chronic condition for children in France, causing an increasing number of hospitalizations and visits in emergency departments. Lack of medical follow-up and insufficient patient education are frequent reasons why asthma remains poorly controlled. Visits in the emergency department represent an opportunity to include asthmatic children and their families in a healthcare circuit preventing future exacerbations and visits in hospital. Considering this, we conducted a study which objectives were to assess parental knowledge about childhood asthma after a visit in the emergency department and to examine the effects of an early telephonic educational intervention on the readmission rates in the emergency department. Methods: Population was recruited in the pediatric emergency department of the University Hospital of Bordeaux. We included patients aged from 6 months to 18 years, consulting for asthma between 10/21/2015 and 01/11/2016 and going home after the consult. Data about diagnosis, treatment and childhood asthma-related parental knowledge was collected through a first standardized telephone interview within the 8 days following the visit in the emergency department. At the end of it, oral and written educational information about asthma was delivered. Parents were contacted again 4 months later in order to collect data regarding asthma control, treatment, follow-up and parental knowledge. Hospitalizations and visits to the emergency department were considered during the 6 months following the first visit for both included patients and patients who met the inclusion criteria during the recruitment phase but could not be included. Results: Among the 313 patients who consulted in the emergency department for asthma during the recruitment phase, 40 patients were included. There was an increase in hospitalization (p = 0,04) and reconsultation (p < 0,001) rates for non-included patients during the 6 months following the first visit in the emergency department whereas those rates remained stable for included patients. Yet, there were no statistically significant difference in hospitalization rates (12,5% for included patients and 8,8% for non-included patients) and in reconsultation rates (respectively 17,5% and 17,6%) between the 2 groups during the 6 months period. And in both groups, parents were significantly less ready to face an asthma attack 4 months after the visit in the emergency departments than in the first 8 days, except for those who participated in patient education in individual or collective sessions. Conclusion: An early educational intervention permits to stabilize readmission rates for children consulting in an emergency department for asthma. Further studies are needed to increase educational dimension of asthma management and to offer a standardized healthcare circuit for every asthmatic children visiting the emergency department.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01398116
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Wednesday, November 16, 2016 - 4:56:09 PM
Last modification on : Wednesday, August 23, 2017 - 4:41:25 PM
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Mélanie Joseph. Connaissances parentales et effets d’une intervention éducative précoce dans l’asthme aux urgences pédiatriques du CHU de Bordeaux. Médecine humaine et pathologie. 2016. ⟨dumas-01398116⟩

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