Date of Award
2024
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Program
Nursing Science
Research Advisor
Mona Wicks
Committee
Amal Shokri Haji Assa; Elizabeth Tolley; J. Carolyn Graff; Michael Carter
Keywords
asthma, Imogene King, pediatric asthma
Abstract
Asthma is among the most prevalent chronic illnesses found in the United States, affecting millions of people under the age of 18 each year. The disease burden for affected children, adolescents, their families, and the healthcare system is immense. Finding ways to mitigate its impact is critical to improving the lives of affected children, adolescents, and their families. The three chapters included in this dissertation aimed to document the asthma triggers that children and adolescents are exposed to and strategies for reducing them and to demonstrate using Imogene King’s conceptual framework to guide nursing practice to care for and nursing research focused on children and adolescents with the disease. Chapter Two describes the physical environment within public schools in the United States and other countries, how environmental triggers affect children with asthma, and the potential interventions to reduce their effects. Findings indicated that additional information is needed regarding the cost-effectiveness and efficient implementation of available interventions to mitigate asthma-trigger effects. Chapter Three presents a case study about a young child with severe and persistent asthma, hospitalized in a Pediatric Intensive Care Unit, demonstrating how his nurses unconsciously used concepts from King’s Open Systems Framework as part of their routine care practices. The chapter conclusions recommend the framework’s intentional use and the need for teaching clinicians to use theory to guide practice. Chapter Four is a secondary analysis of a multi-site data-based study exploring the interactions between personal, interpersonal, and social factors extracted from King’s framework in adolescents with asthma. The study examined adolescents’ baseline perceived self-efficacy (PSE), perceived family support (PFS), family history of asthma, the asthma healthcare provider utilized, and demographic characteristics and their relationship to the adolescents’ asthma self-management assessed using two outcomes—asthma prevention and asthma management behaviors. The study findings revealed that PSE and asthma healthcare provider type were highly associated with asthma prevention behaviors and PSE and PFS were highly associated with asthma management behaviors. Future research is warranted to explore better how adolescents can be educated and aided in self-managing their asthma, potentially reducing exacerbations and hospitalizations. Asthma in children and adolescents is a critical public health challenge requiring high-quality care guided by evidence and theory. Two of the three pediatric-related projects demonstrated the utility of King’s conceptual framework for guiding nursing practice and research, and one project presented evidence informing nursing care in this population.
ORCID
0009-0005-4502-5847
DOI
10.21007/etd.cghs.2024.0680
Recommended Citation
Moore, Elizabeth Kate Coffey (0009-0005-4502-5847), "Improving Health Outcomes in Children and Adolescents with Asthma" (2024). Theses and Dissertations (ETD). Paper 700. http://dx.doi.org/10.21007/etd.cghs.2024.0680.
https://dc.uthsc.edu/dissertations/700
Declaration of Authorship
Included in
Family Medicine Commons, Family Practice Nursing Commons, Nursing Administration Commons, Pediatric Nursing Commons, Pediatrics Commons, Pulmonology Commons, Quality Improvement Commons, Respiratory Tract Diseases Commons
