Feasibility of a worksheet for facilitating self-management in children with asthma.
BACKGROUND
Few tools exist to facilitate recommended self-management support for children with asthma. We sought to examine the feasibility, acceptance and preliminary results of a novel worksheet designed to provide such support for children and their caregivers presenting for asthma care.


METHODS
A 12-topic asthma worksheet was modeled on currently available self-management tools and based on the behavior change theory and motivational interviewing techniques. Children 1-18 years old with asthma and their caregivers were recruited from an allergy clinic and an inpatient ward to pilot test the worksheet by choosing three topics, generating self-management goals for each topic and assessing their self-efficacy for behavior change. Physician documentation of the visit was reviewed for comparison. Telephone follow up of self-management goals occurred 1 week after the visit.


RESULTS
Forty-one of 46 eligible subjects agreed to participate (89%). Average completion time was 5:47 min (range 3:30-13:00). Most of them (98%) found the worksheet easy to understand, with minor modifications suggested. Topics most commonly selected were distinct from topics documented by physicians in the subsequent encounter (p < 0.01). Subjects generated 121 total self-management goals; 93% were at least "moderately confident" they could meet the goals. All 15 subjects reached by phone (37%) had achieved at least one goal at follow-up.


CONCLUSIONS
A worksheet designed for self-management support of children is brief, feasible and acceptable in the clinical environment. This tool captures unique patient-centered preferences for behavior change, and shows promise for facilitating goal-setting and self-management education in the routine clinical care of pediatric asthma.
a Eastern Virginia Medical School and The Children's Hospital of The King's Daughters , Norfolk , VA , USA.
Kyrie L
KL
Shomaker
a Eastern Virginia Medical School and The Children's Hospital of The King's Daughters , Norfolk , VA , USA.
Stephanie H
SH
DeVeau-Rosen
D000293:Adolescent; D001249:Asthma / Q000628:therapy*; D017028:Caregivers / Q000193:education*; D002648:Child; D002675:Child, Preschool; D005240:Feasibility Studies; D006801:Humans; D007223:Infant; D010353:Patient Education as Topic; D012648:Self Care; D011795:Surveys and Questionnaires
Education; health behavior; motivational interviewing; patient-centered care; pediatric