Bridging Disciplinary Boundaries (January 11 - 14, 2007)

Purpose: The paper aims to evaluation a parallel group for parents and children with asthma in Hong Kong by adopting an integrated approach. While literature showed that having asthma not only affected physical and psychosocial conditions of the child, but also the family as a whole (the mother in particular), the We Together – We Success (WTWS) Parallel Group for Children with Asthma and their Parents program integrated the psycho-educational approach with the systematic approach. Methods: A randomized waiting list control design was used to evaluate the group effectiveness. Children with stable asthma and their parents were recruited from a pediatric chest clinic in Hong Kong. In this study asthma stable was defined as no asthmatic exacerbation for the preceding four weeks necessitating oral prednisolone or an increased use of inhaled corticosteroids; the use of rescue treatment no more than three times a week; and with no clinical indication for change in treatment medication. Approval from the Ethics Committee of the Chinese University of Hong Kong had been obtained for this study. Written informed consents were obtained from the parents or guardians of subjects before the study. Recruited patients and their parents were randomly assigned to the experimental or control group. Baseline (pretest) measures of the children and their parents from the two groups were obtained before commencement of the intervention. The scheduled intervention lasted for 11 weeks and during this time the control group did not receive any form of active psychosocial intervention or therapy. The two groups underwent repeated assessments once the experimental group had completed the intervention. The process then repeated itself whereby the initial control group underwent intervention and the original experimental group did not receive further intervention, which provided chances for assessing the maintenance effects of the intervention. The outcome measures included, for the children: exhaled nitric oxide (eNO); and for the parents: perceived efficacy in asthma management (self-constructed scale), Hospital Anxiety and Depression Scale anxiety subscale, Body Mind Spirit Well-being Inventory emotion subscale, and Short Form 12 (SF-12) health-related quality of life scale. Due to the limited size of each group (capacity of each group was up to 10-12 participants), the procedure described above was repeated five times to achieve a larger sample size. Hence, forty-six patients participated in the study. Attrition rates were 13.0% and 26.0% for the experimental and control groups respectively. Results: Repeated-measures ANOVA revealed significant effects on eNO, patient's adjustment to asthma, and parents' perceived efficacy in asthma management. Serial trend analysis revealed that most psychosocial measures continued to progress steadily after intervention. Significant improvements in both symptom-related measures, and mental health and relationship measures were observed. Implications for practice: Results showed that WTWS was effective in enhancing parents and children's perceived self-efficacy and parents' well-being, which supports the initial effort to integrate systematic and psycho-education intervention in future practice. Implications for practice were future discussed regarding cultural sensitive practice.