VALIDATION OF HINDI CLASSIFICATION OF ASTHMA SEVERITY FOR HOME BASED SEVERITY ASSESSMENT BY PARENTS

INTRODUCTION

Asthma is a serious global problem affecting 300 million people worldwide with rising prevalence in developing countries. It poses an unacceptable burden on the healthcare systems, and the society due to the decreasing productivity of the patient and especially in paediatric asthma causing disruption of families. ^[1]

The Global Initiative for Asthma (GINA 1993) was established to create awareness among the health professionals, patients and the community in order to improve prevention and management of asthma. ^[2]

In January 2004, the GINA Executive Committee recommended that the Global Strategy for Asthma Management and Prevention be revised to emphasize asthma classification based on clinical control, rather than classification of the patient’s severity based on symptoms. ^[3] Whatever might be the criterion for classification of asthma severity, it must be feasible and easily implementable.

The GINA Report 2006 has stated that the recommendations in the report must be adapted to fit local practices. ^[3] This study takes a step forward in that direction as we aim to validate a locally prepared Hindi classification of asthma severity by teaching the procedure of charting the symptom diary to the parents and ask them to classify the severity of asthma of prefilled symptom diaries to assess them.

The GINA Report 2016 for adults and children insist that parents should be taught understanding of severity so that the home management of asthma by them becomes easier to a certain extent; though it does not specify the exact way to go about it. ^[1]

We could not find any published literature in this regard; making the understanding of asthma and its management simpler for parents by classifying severity based on symptoms or control.

By validating the Hindi classification of the asthma severity based on GINA guidelines, we feel that if successful, we may be able to provide a way of feasible understanding of asthma severity at home, which is instrumental in providing fast relief to patients and reducing the work load of the hospitals.

This study goes with the very principles of GINA as it teaches the parents to judge the severity of their child’s condition and take appropriate decisions which saves time, money and effort of both the family and the hospitals.

TITLE

Validation of Hindi classification of asthma severity for home based monitoring OF CHILDHOOD ASTHMA SEVERITY

TYPE

iNTERVENTIONAL pilot study

OBJECTIVE

Validation of the locally prepared Hindi classification of asthma severity based on symptom diary by parents of asthmatic children

METHODOLOGY

STUDY AREA

Paediatric Respiratory Clinic, B.Y.L NAIR CHARITABLE HOSPITAL,

MUMBAI CENTRAL 400 008 

[TERTIARY CARE HOSPITAL] 

STUDY SAMPLE

Study population consists of 1 parent/guardian of each of the asthmatic child aged 4 to 12 years 

INCLUSION CRITERIA

·         Parents of children aged 4 to 12 years  who have a diagnosis of asthma

EXCLUSION CRITERIA

·         

Parents who are unable to understand, read and write Hindi language

 

RESEARCH DESIGN                                                   

Interventional pilot study aimed to validate a classification system by means of face and formative validity by conducting a post training assessment of parents of asthmatic children

Methods:

Preparatory Phase

·         Conceptualisation and rationalisation of study design

·         Preparation of the hindi classification and its validation

·         Approval from ECARP

·         Preparing a 5 min training PPT module for symptom diary charting procedure and severity classification training

    

       After  E CARP approval, written informed consent of parents to be trained, and of parents of the cases whose symptom diaries are used for "training and tests"; assent is taken for appropriate age groups.

·         Training the parents of the asthmatic children with the help of prepared modules

·         Post training assessment of parentson same day and after 30 days

     comparing the severity assessment by parents with assessment by Dr, on 10 precharted symptom diaries of real patients.

·      statistical analysis:

  Pre and post test scores of parents are analysed descriptively and in percentage and demography to study its accuracy with severity assessment by a Dr.