Objective

Proper use of respiratory inhalers is crucial to asthma self-management and associated with improved outcomes. Previous studies conducted in outpatient and community settings show parents and children are overconfident in children's ability to use inhalers properly, which may lead healthcare providers to not teach or review inhaler technique. This study examined whether children and parents' confidence were associated with proper inhaler technique among children hospitalized with asthma.

Methods

Children between 5 and 10 years old hospitalized with asthma at an urban academic medical center demonstrated inhaler technique using metered dose inhalers and spacers. Technique was scored based on a validated 12-step scale. Confidence was measured using three items assessing 1. Knowledge to use inhaler, 2. Skills to use inhaler, and 3. Ability to independently use inhaler. These items were five-point scales and analyzed as binary variables. Independent t-tests were used to measure associations between confidence and number of steps performed correctly.

Results

None of the confidence items, when asked to parents or children (n = 70), were associated with the number of steps performed correctly. Further, while the majority of children and parents (59–70%) were confident based on each item, the mean number of steps correctly completed was 6.4 out of 12.

Conclusions

Children and parents' confidence in children's knowledge, skills, and ability to independently use an inhaler were all poor proxies for proper inhaler technique. Inpatient healthcare professionals should objectively evaluate technique and teach proper inhaler use to all children with asthma to optimize outcomes.

中文翻译：

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哮喘住院患儿吸入技术与信心的关系

客观的

正确使用呼吸吸入器对于哮喘自我管理至关重要，并与改善结果相关。以前在门诊和社区环境中进行的研究表明，父母和孩子对孩子正确使用吸入器的能力过于自信，这可能导致医疗保健提供者不教授或审查吸入器技术。这项研究检查了儿童和父母的信心是否与哮喘住院儿童的正确吸入技术有关。

方法

在城市学术医疗中心因哮喘住院的 5 至 10 岁儿童展示了使用计量吸入器和垫片的吸入器技术。根据经过验证的 12 步量表对技术进行评分。信心是通过三个评估项目来衡量的：1. 使用吸入器的知识，2. 使用吸入器的技能，以及 3. 独立使用吸入器的能力。这些项目是五点量表，并作为二元变量进行分析。独立 t 检验用于测量置信度与正确执行的步骤数之间的关联。

结果

当询问父母或孩子（n = 70）时，没有一个置信项与正确执行的步骤数相关。此外，虽然大多数儿童和家长 (59-70%) 对每个项目都充满信心，但正确完成的平均步骤数为 12 步中的 6.4 步。

结论

儿童和父母对儿童知识、技能和独立使用吸入器的能力的信心都不能代表正确的吸入器技术。住院医疗保健专业人员应客观地评估技术并向所有哮喘儿童教授正确使用吸入器以优化结果。