title: Evaluation of animated cartoon-aided teaching of intranasal corticosteroid administration technique among Thai children with allergic rhinitis.
abstract: BACKGROUND
  Correct use of intranasal corticosteroid (INCS) and compliance with treatment is very important for the treatment of allergic rhinitis (AR). An animated cartoon-aided teaching method for INCS administration was created to decrease the workload of health care professionals. The aim of this study was to compare the performance of children with AR in using INCS between a group who were instructed using animated cartoon-aided teaching and those receiving only an oral presentation without demonstration.
  
  
  METHODS
  The study was a prospective randomized controlled trial in children aged 5-16 years with moderate to severe intermittent or persistent AR who had never used INCS. The patients were randomly divided into 2 groups; 1) those receiving teaching about how to use INCS by an oral presentation without demonstration and 2) by animated cartoon-aided teaching. The performance of the children was recorded after the initial training using a five-point checklist. If they were unable to use the INCS correctly after the first teaching session, the same instructions were repeated and a second assessment was performed.
  
  
  RESULTS
  A total of 80 patients, 40 each group, underwent randomization. The rate of achieving competency for the patients after the first instruction using the animated cartoon-aided teaching group was significantly higher than that for the oral presentation group (57.5% VS 27.5%; P = 0.007). The cumulative success rate for the second assessment of the animated cartoon-aided group was also significantly higher than for those receiving only an oral presentation (95% VS 60%, P = 0.004).
  
  
  CONCLUSIONS
  With regard to mastering the correct method for INCS usage, instruction using animated cartoon-aided teaching is better than oral presentation without demonstration. However, the best method for teaching patients how to use INCS is a combination of oral explanation and demonstration by cartoon-aided teaching. The teaching should be repeated periodically to remind patients of the correct method for INCS usage.
authors.affiliation: Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand 10700.
authors.forename: Somying
authors.initials: S
authors.lastname: Indradat
authors.forename: Orathai
authors.initials: O
authors.lastname: Jirapongsananuruk
authors.forename: Nualanong
authors.initials: N
authors.lastname: Visitsunthorn
mesh_terms: D000281:Administration, Intranasal; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D009040:Motion Pictures; D010353:Patient Education as Topic / Q000379:methods*; D011446:Prospective Studies; D065631:Rhinitis, Allergic; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy*; D013785:Thailand
chemical_list: D000305:Adrenal Cortex Hormones