Álbum seriado para promoção da autoeficácia de pais e/ou cuidadores no manejo e controle da asma infantil: ensaio clínico randomizado

Abstract

Asthma is a common chronic condition in children, characterized by inflammation and narrowing of the airways, responsible for high childhood morbidity and mortality. Parents and/or caregivers play an important role in the control and management of this

disease, which reveals the need to develop educational technologies based on self- efficacy that allow parents to promote children's health. Thus, the objective was to

evaluate the effectiveness of using the flipchart: “Childhood asthma: you are able to control it!” to promote the self-efficacy of parents and/or caregivers in the management and control of childhood asthma. It is a Randomized Clinical Trial (RCT) developed in two Primary Health Care Units (UAPS) in Fortaleza, Ceará, with 84 parents and/or caregivers of children between two and 12 years of age, divided into two groups: Intervention Group (IG), which received the educational intervention with the flipchart application; and Control Group (CG), which did not receive intervention from the researcher. Data collection occurred in three phases: 1st phase - at the UAPS, with application of the sociodemographic form and the Self-Efficacy and Their Child’s Level of Asthma Control scale: Brazilian Version (STCLA-VB) for the IG and CG and application of the flipchart for the IG; 2nd phase - 30 days after the application of the scale, by telephone contact, the reduced form of investigation of childhood asthma control and the STCLA-VB scale were applied to both groups; 3rd phase - 60 days after the application of the scale, the reduced form of investigation of childhood asthma control and the STCLA-VB scale were applied again to both groups. Data were compiled and analyzed in the Statistical Package for the Social Sciences version 20.0.

Statistical tests were used for data analysis, such as the Chi-square test, Student’s t- test, Friedman test and Odds Ratio. The project was approved by the Research Ethics

Committee of the Federal University of Ceará and by the Brazilian Registry of Clinical Trials. The groups were homogeneous at baseline, except for the variable “family income”. After the intervention, the self-efficacy scores in the IG were significantly higher than in the CG, with a statistically significant difference for the total scale (p<0.0001), efficacy expectations (p<0.0001) and outcome expectations (p<0.0001).

After 30 days of intervention, the CG was 6.3 times more likely to have moderate self- efficacy (p=0.001), and 14 times more likely after 60 days (p<0.001), compared to the

IG. Regarding asthma control parameters, the CG, compared to the IG, was more likely to have: daytime symptoms after 30 and 60 days (RC=4 and RC=1.5); nocturnal

symptoms after 30 and 60 days (OR=1.4 and OR=1.6); limitation of physical activity after 30 and 60 days (OR=1.4 and OR=4.2); emergency room visits after XX days (OR=11.2); asthma attacks after 30 and 60 days (OR=2.7 and OR=1.2). It is concluded that the educational intervention, that is, the application of the flipchart “Childhood asthma: you are capable of controlling it!”, based on the concept of self-efficacy, was able to increase the self-efficacy scores of parents and/or caregivers in the control and management of childhood asthma, in addition to reducing the chance of their children having asthma attacks and the occurrence of asthma attacks in children, as well as improving asthma control parameters (lower probability of daytime and nighttime symptoms, lower limitation of physical activity, lower chance of visiting the emergency room, lower chance of asthma attacks).