Evidence Based Practice

Executive Summary of Self-Management of Asthma

The report has described the change in practice that is required to improve the self-management practise of asthma. The improved educational plan is utilized to improve the self-management practise by utilizing attractive learning technique. The increased advantage of education in self-management intervention increases the need to improve the educational strategy as it directly improves the health status of the patient. The educational program helps to improve the patient health and skills to manage the health-related complication by coping technique. Certain barriers can directly decrease the chances of accurate implementation of the intervention. Certain barriers include the different belief of patient, decreased health literacy, decreased communication skill of the health professional and less of resources. These barriers can be overcome by improving cultural competency, assisting the patient to improve his/her understating, training to health care professional and improving health care setting.

Introduction to Self-Management of Asthma

The self-management technique for asthma is considered to be an important method to reduce complication and increase the quality of life. The self-management plan should be following the patient current health status that aims to reduce the gap in health (Pinnock, 2015). The report is going to discuss the change that is required to improve the self-management technique of asthma. The next two sections of the report will discuss the barrier and management technique to implement the changes in practice.

Practise Change

The change in patient educational method is required to improve the individual understanding concerning the correct self-management technique. The attractive education technique is the innovative method that included different aspect that can be utilized to change the education pattern in the self-management technique for asthma (Carvalho Coelho et al., 2017). Moreover, Plaza et al (2015) conducted the randomized controlled trials to identify the impact of the asthma educational program related to the repeated short intervention. The educational intervention includes basic information related to asthma that helps to improve the knowledge of the participants concerning the disorder. The second aspect includes personalized action plan that can help to improve the patient accessibility toward the self-management method. The last aspect includes teaching the patient with accurate use of the inhaler device to improve the skill of the individual to manage the exacerbation incidents.

Tseng et al. (2017) have conducted the randomized controlled trial to understand the effect of new self-management that has a better educational method concerning the conventional self-management technique. The researchers have utilized the expert panel report-3 (EPR-3) to improve the educational pattern of the patient that help to improve the self-management. The educational method utilized for the study was modified with the different factor that can help the patient to improve quality of life. The first part was to educate them about peak flow monitoring that can help them to assess the level of symptoms. The written action plan is another method that can be useful for the patient that can include long term control and some quick medication that can be used for relief. Education should also include the correct inhalation technique.

The education method should be tailored according to the literacy level of the patient to improve the understanding. The education program should include members from health care to provide holistic care to the patient and improve knowledge about different aspect related to self-management. The study proposed by Kohler et al. (2020) discussed the structured asthma education program that should be included in the self-management intervention. The educational program includes a different aspect that can be used to improve the knowledge of the asthma patient concerning asthma and related aspect. The educational program included and the first aspect includes anatomy and physiology of the airways concerning asthma and its complication. The second aspect of the educational pattern includes information about drug treatment and its side effects. The third aspect includes a different measure that can be utilized for the disease control that can help to improve the quality of life of the patient. The last step includes a different coping technique that can be utilized for the self-management.

Moreover, the article presented by Olivera et al. (2016) have utilized the study to understand the impact of the new self-management program that can utilize different learning strategy to improve the learning outcome of the patient. The main aim of the study was to improve the knowledge and understanding regarding the medication in asthma patient that can help to improve the self-management skill of the individual. The learning methodology for the educational perspective of the patient was by Dr. Bruce Wilkinson. The learning methodology was based on seven law of learning that is going to utilized in the educational session with the patient. The first law is the law of learner that includes educator way to teaching directly impacts the learning outcome of the patient. The second is the law of expectation that includes expecting high from the patient help to motivate them to improve learning. The third aspect is the law of application that include learner should utilize the knowledge in practice and this is ensured by the educator. The law of retention includes education should utilize all the senses to educate the patient that includes the use of engaging content. The next law is laws of need that include stimulating felt needs that help to satisfy the real need of the learner. The law of equipping include educator with lesson should improve the skill of the leaner. The last law includes the law of revival that includes educational session should transform the individual skill.

On the other hand, article prosed by the Bäuerle et al. (2017) has analyzed the impact of the modified patient education program to improve patient understanding concerning the self-management technique. The educational program in the study has utilized for the three criteria to improve the educational aspect of the individual and the first aspect include the utilization of the better learning technique that include learning sequences to improve understanding. The second aspect includes understanding participation orientation by utilization problem-oriented situation to improve the educational program. The third criteria include trainer action that includes increase engagement of the learner by intensive thinking process. The study has compared the traditional learning problem with the modified educational learning process and the result indicates that the modified educational learning process is better due to improved learning strategies.

Need to Change the Practice

The educational program in the self-management intervention is considered to be one of the methods that directly help to improve the understanding of the individual concerning a different aspect of the self-management skills. The accurate educational program is considered to be one of the strategies that can be utilized to improve patient behaviour, motivation and shared decision in the care. The increased understanding regarding the disease and management technique helps to improve the adherence to the therapy and better patient outcome (Boulet, 2015). Moreover, this was supported by another study presented by Mishra et al. (2017) the educational program in the self-management intervention considered to be associated with multiple advantages that include improve outcome due to decreased hospital visit, reduced day off from work and reduce complication. Currently, the lack of education concerning asthma and different coping technique directly leads to poor control of asthma that can cause serious complication. The improvement in practice which include educational program will help to improve the symptoms control by using coping technique and better health outcome of the patient.

Currently, one of the major barriers which have been identified with the increased complication of the patient with asthma is the lack of education concerning asthma and its associated complication. The lack of education is directly associated with decreased adherence to the medicine that can lead to increased symptoms with lead to complication. There is a need to improve the educational pattern of the patient to improve the health outcome of the patient and the better educational program should follow the integral comprehensive program that will improve patient’s comprehensive and confidence concerning self-management. The traditional education program utilizes in self-management intervention limits the understanding of the individual concerning different technique. The improved educational program is considered to empower the skills and knowledge of the patient that lead to better self-confidence to utile self-management strategy for better health outcome (Murphy et al., 2016). The education strategy is considered to be the key aspect that is required to achieve the improved health outcome and mental wellbeing in the patient.

There is a need to improve the educational program that can assist the patient to improve the patient understanding and managing skills. The educational plan should include an action plan that can help the patient to recall all the necessary information required to deal with symptoms and manage the complication. The educational plan helps the patient and health care professional to form a rapport that can be utilized to improve the understanding regarding self-management technique (Murray & O'Neill, 2018).

Barriers in Implementing Change

Many barriers can directly decrease the chances to accurately implement the change in practice. One of the barriers that can decrease the implementation of the practice includes the different belief of the individual that can directly affect the acceptance of the changed practise. The different belief of the patient concerning the coping technique and medication can directly decrease the chances to accept the change. Low health literacy is one of the major issues faced by the health care professional during the conversation with the patient that can hamper the understanding of the patient and implementation of change (Miles et al., 2017). Some other barriers that are associated with the implementation of the change include lack of communication skills of the health care professional directly hinder the educational session. The decrease in communication skill directly decreases the understanding of the patient. The deteriorated clinical setting can also decrease the implementation of the change due to decrease resources, less-skilled health care professional and decreased clinical premises (Holley et al., 2018).

Management of The Barriers

One of the methods that can be utilized to improve the patient experience includes cultural competency that can help to maintain the compatibility between the different cultural belief of the patient and self-management program (McElfish et al., 2017). Individual health literacy program can be utilized to assist the patient to understand the different aspect that is related to the health and associated factors. The health literacy can be improved by improving the understanding of the patient reading different health-related aspect and document (Visscher et al., 2018). Interpersonal communication training can be utilized to improve the communication skill of the health care professional that will improve communication. The training will include verbal and non-verbal communication that can be used to improve the communication skill of the individual (Chichirez & Purcărea, 2018). The improvement in the health care setting can be done by reviewing the health care setting to identify the gap in the resources. The gap identification can be utilized to improve health care setting and provide accurate resources to the patient (Salmond, & Echevarria, 2017). These methods can be applied to improve the accurate implementation of the intervention that will help to improve the change in the self-management practise.

References for Self-Management of Asthma

Bäuerle, K., Feicke, J., Scherer, W., Spörhase, U. & Bitzer, E. M. (2017). Evaluation of a standardized patient education program for inpatient asthma rehabilitation: Impact on patient-reported health outcomes for up to one year. Patient Education and Counseling, 100(5), 957–960.

Boulet, L. (2015). Asthma education: An essential component in asthma management. European Respiratory Journal, 46(5), 1262–1264.

Carvalho Coelho, A. C., Barretto Cardoso, L. S., de Souza-Machado, C.& Souza-Machado, A. (2016). The impacts of educational asthma interventions in schools: A systematic review of the literature. Canadian Respiratory Journal, 2016, 1-14. https://doi.org/10.1155/2016/8476206

Chichirez, C. M.& Purcărea, V. L. (2018). Interpersonal communication in healthcare. Journal of medicine and life, 11(2), 119–122.

Holley, S., Walker, D., Knibb, R., Latter, S., Liossi, C., Mitchell, F. & Roberts, G. (2018). Barriers and facilitators to self-management of asthma in adolescents: An interview study to inform the development of a novel intervention. Clinical & Experimental Allergy, 48(8), 944–956. DOI:10.1111/cea.13141

Kohler, B., Kellerer, C., Schultz, K., Wittman, M., Atmann, O., Linde, K., Hapfelmeier, A. & Schneider, A. (2020). An internet-based asthma self-management program increases knowledge about asthma. Dtsch Arztebl Int, 117(5), 64–71.

McElfish, P. A., Long, C. R., Rowland, B., Moore, S., Wilmoth, R.& Ayers, B. (2017). Improving culturally appropriate care using a community-based participatory research approach: Evaluation of a multicomponent cultural competency training program, arkansas, 2015-2016. Preventing chronic disease, 14, 1-11. https://doi.org/10.5888/pcd14.170014

Miles, C., Arden-Close, E., Thomas, M., Bruton, A., Yardley, L., Hankins, M.& Kirby, S. E. (2017). Barriers and facilitators of effective self-management in asthma: Systematic review and thematic synthesis of patient and healthcare professional views. Npj Primary Care Respiratory Medicine, 27(1), 1-21. DOI:10.1038/s41533-017-

Mishra, R., Kashif, M., Venkatram, S., George, T., Luo, K. & Diaz-Fuentes, G. (2017). Role of Adult asthma education in improving asthma control and reducing emergency room utilization and hospital admissions in an inner city hospital. Canadian Respiratory Journal, 2017, 1-6. https://doi.org/10.1155/2017/5681962

Murphy, H., Wolverton, J.& Dinakar, C. (2016). Building a targeted asthma education and management program. Missouri Medicine, 113(5), 409–414.

Murray, B. & O'Neill, M. (2018). Supporting self-management of asthma through patient education. British Journal of Nursing (Mark Allen Publishing). 27. 396-401. 10.12968/bjon.2018.27.7.396.

Olivera, C. M. X., Vianna, E. O., Bonizio, R. C., de Menezes, M. B., Ferraz, E., Cetlin, A. A. &de Freitas, O. (2016). Asthma self-management model: Randomized controlled trial. Health Education Research, 31(5), 639–652.

Pinnock, H. (2015). Supported self-management for asthma. Breathe (Sheff), 11(2), 98‐109. DOI:10.1183/20734735.015614

Plaza, V., Peiró, M., Torrejón, M., Fletcher, M., López-Viña, A., Ignacio, J. M. & Gich, I. (2015). Repeated short educational intervention improves asthma control and quality of life. European Respiratory Journal, 46(5), 1298–1307.

Salmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopedic nursing, 36(1), 12–25. https://doi.org/10.1097/NOR.0000000000000308

Tseng, T. J., Chang, A. M., & Wu, C. J. (2017). A randomized control trial of an asthma self-management program for adolescents in Taiwan: A study protocol. Contemporary Clinical Trials Communications, 8, 122–126. https://doi.org/10.1016/j.conctc.2017.09.005

Visscher, B. B., Steunenberg, B. &Heijmans, M. (2018). . Evidence on the effectiveness of health literacy interventions in the EU: A systematic review. BMC Public Health 18(1414), 1-12.

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