Evaluation of the effect of an education program using cartoons and comics on disease management in children with asthma: a randomized controlled study

Abstract

Objective

The aim of this study was to determine the effect of an education program, the Health Promotion Program for Children with Asthma (HPPCA), on disease control and quality of life in children aged between 7 and 11 and diagnosed with asthma. The program was developed using cartoons and color-in materials and was based on the health promotion model developed by Nola J. Pender and brain-based learning theories.

Materials and methods

The sample of the study consisted of 74 children between the ages of 7 and 11 who presented to the respiratory diseases’ unit of a university hospital in Istanbul. All participants were given basic asthma education by their physicians, and were then randomly assigned to a group that received the HPPCA program or a control group that received no further education. After the HPPCA education was applied to the experimental group alone, both groups were administered two post-tests as a follow-up and retest at the end of the first and fourth month after the intervention. The standardized Sociodemographic Question Form, the Childhood Asthma Control Test (C-ACT) and the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) were used for the follow-up.

Results

The asthma control and quality of life scores of the children included in the experimental group were found to be significantly higher compared to the control group at the first- and fourth-month follow-ups (p<.001). The rate of school absenteeism decreased significantly in children who received HPPCA education at the first follow-up compared to the children who did not receive the education (p<.05).

Practice implications

The present study found that the HPPCA education, whose design was based on the health promotion model, and which was supported by cartoons in order to attract the attention of the children, was effective. The HPPCA was proven to create a sense of control over asthma and to improve the quality of life in the children. It is recommended that there be an asthma nurse in pediatric allergy and immunology outpatient clinics who can specifically provide an HPPCA. Further studies should be conducted to demonstrate the effectiveness of this program, which was examined in the present study for the first time with a randomized controlled method.

Highlights

• Asthma control is extremely important for the quality of life in children with asthma.

• Asthma education provided to school-age children yields the best results when new teaching techniques and multimedia content are used.

• Asthma education for children must be based on a good theoretical methodology.

• Children can best manage asthma when they learn about it directly.

• Asthma education conducted according to the guidelines is of great importance during the COVID-19 pandemic.

Keywords:

• Pediatric asthma
• quality of life in children with asthma
• cartoon education in asthma
• control education in pediatric asthma

Acknowledgements

This study was a PhD thesis. I would like to thank Koc University, and my esteemed advisor, who guided my work throughout the process of my doctoral dissertation. In addition, I would like to thank Alex Thomas MD and Gary Ashwal MA of Booster Shot Media, Inc. for providing Turkish-language versions of their Iggy and the Inhalers (https://iggyandtheinhalers.com) asthma education animations and handouts, which was the important part of the study. We’d like to thank the pediatric asthma specialist doctor Dr. Şebnem Özdoğan, chief of the department Doc Dr Ihsan Kafadar and assistant chief of the hospital Dr Savaş Özdemir for giving their permission.

Funding

The author(s) reported there is no funding associated with the work featured in this article.