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Objective: The difficulties adults have using inhaler devices is well documented but much less is known about how parents administer inhaler devices to young children and the difficulties experienced. The purpose of this article is to explore the underlying concepts and practical issues that parents encounter in administering inhaled asthma medications to their young children. Methods: This is a qualitative study using applied thematic analysis on parental written discourses from asynchronous online discussion forums on the topic of administration and use of asthma inhaler devices to young children. Results: "At a loss of what to do" summarizes the experiences parents described when administering inhaler devices to their young children. Parents describe the problems, the situations, the emotions, the decisions, and the confusion they face. They struggle with their child's resistance and the associated conflict, describing their own and their child's distress. Results highlight the coping strategies used in administration, how parents decide whether to use coercive measures or not, their help-seeking endeavors, together with the assurance they give to themselves and others after administration. Conclusion: The online discussions highlight parents' distress, lack of preparedness, and understanding of administering inhaler devices to young children. While the prevalence of the problem cannot be estimated from our data, it illustrates a need for some healthcare professionals to review their own knowledge and skills in administration of inhaled medication to younger patients, and their provision of patient and family centered care. [ABSTRACT FROM AUTHOR]

Objective: Patient education materials (PEMs) are commonly used for patient education. This study assessed readability, format quality, accuracy, understandability and actionability of printed asthma PEMs available in primary care in Singapore. Methods: Primary care in Singapore is provided by island-wide polyclinics and private general practices. We invited the three polyclinic healthcare groups and private general practices via the Primary Care Research Network to submit asthma-related PEMs. Readability was assessed using Simple Measure of Gobbledegook (SMOG) and Flesch–Kincaid (FK) score. Format quality was assessed using "Clear-print and large-print golden rules" from UK Association for Accessible Formats (UKAAF). Understandability and actionability were evaluated using Patient Education Materials Assessment Tool – Printed. Three pulmonologists assessed content accuracy. Results: Thirty leaflets were assessed. SMOG and FK estimated 93% (mean 9.3, range 5–14, SD 1.8) and 47% (mean 6.8, range 2.4–9.9, SD 2.0) exceeded the recommended sixth-grade reading level, respectively. About a third (37%) were fully concordant with UKAAF guidelines, with poor format quality contributed by small font size, poor text emphasis methods, and not using left-aligned text. Leaflets generally scored well in both understandability (mean 84%) and actionability (mean 72%). Thirteen leaflets were inaccurate, 92% of which contained at least one inaccuracy judged to have potentially harmful consequences to patients, including wrong emergency advice. Conclusion: While understandability and actionability are adequate, current asthma PEMs are limited by inappropriately high reading levels, poor format quality and inaccuracies. Healthcare professionals need to assess patients' reading abilities and ensure PEMs are accurate and suitable for their patients. [ABSTRACT FROM AUTHOR]

Objective: To conduct a comprehensive review and meta-analysis of the effectiveness of meditation on a variety of asthma outcomes. Methods: We searched MEDLINE, EMBASE, CINAHL, PsycINFO and AMED in June 2016 to identify randomized controlled trials (RCTs) investigating the effectiveness of meditation in adults with asthma. No restriction was put on language or year of publication. Study quality was assessed using The Cochrane Risk of Bias Assessment Tool. Meta-analysis was carried out using RevMan 5.3. Results: Four RCTs involving 201 patients met the inclusion criteria. Quality of studies was inconsistent with only one study reporting adequate allocation concealment. Disease-specific quality of life was assessed in two trials; a pooled result involving 62 intervention and 65 control participants indicated a significant improvement in quality of life in the meditation group compared to the control group (SMD 0.40, 95% CI 0.05-0.76). A pooled result from all four studies indicated the uncertain effect of meditation in forced expiratory volume in 1 s (FEV1) (SMD −0.67, 95% CI −2.17 to 0.82). Results from the individual trials suggest that meditation may be helpful in reducing perceived stress and the use of short-term rescue medication. Conclusion: Our review suggests that there is some evidence that meditation is beneficial in improving quality of life in asthma patients. As two out of four studies in our review were of poor quality, further trials with better methodological quality are needed to support or refute this finding. [ABSTRACT FROM AUTHOR]

Objective: In epidemiological studies that aim to investigate the relationship between pet exposure and allergy/asthma, pet exposure is often ascertained by means of a questionnaire, but it is unclear which questionnaire items are used. The objective of this study was to systematically review self-reported pet exposure assessment in questionnaires used in epidemiological studies which explore the associations between pets and allergy/asthma.Methods: A systematic literature search was conducted in PubMed and papers were selected according to pre-specified eligibility criteria. The pet exposure questions used were classified within a framework including direct pet contact, indirect pet contact (e.g. through carers or grandparents) and avoidance behaviour. Authors were contacted when the questions used were not reported in detail.Results: Ninety-six full text papers were systematically reviewed. All studies assessed direct pet contact, but less than half (45%) explicitly assessed whether pets were allowed indoors. The vast majority of studies assessed both pet exposures during the first year of life and after the first year of life. The minority (13%) assessed whether pet(s) were kept at places regularly visited by the child and pet exposurein utero(15%). Even fewer studies assessed indirect contact to pets (n = 8) and avoidance behaviour (n = 10).Conclusions: In epidemiological studies, the ascertainment of pet exposure through questionnaires appears to vary greatly. This variation might partly explain the inconsistent and contradictory results of the effects of pet exposure on the development of allergy and asthma. [ABSTRACT FROM PUBLISHER]

Objective. It is unclear which of the commonly used asthma-specific quality of life (QoL) questionnaires best capture the lived experience of people with asthma. The objective of this study was to explore patients' views on three asthma-specific QoL questionnaires. Methods. Ten adult individuals with asthma were asked to complete three asthma-specific QoL questionnaires (Standardized Juniper Asthma Quality of Life Questionnaire (AQLQ-J-s), Sydney Asthma Quality of Life Questionnaire (AQLQ-S), and Fragebogen zur Lebensqualität bei Asthma (FLA)). Interviews were conducted to elicit patients' views on the questionnaires. Interviews were transcribed verbatim and thematic content analysis was performed. Results. Participants spoke about response format and options, missing and redundant/similar content as well as content that was perceived to be irrelevant. A lack of specificity was named for some items, and issues concerning layout were raised. Despite the diversity of views expressed, participants mostly agreed on the ranking of the questionnaires and, overall, favored the AQLQ-S. Conclusions. Patient involvement highlights shortcomings and strengths of various asthma-specific questionnaires in terms of both format and content. The AQLQ-S was the most positively perceived questionnaire. Future research will need to explore other settings and potentially involve a larger and more diverse sample. [ABSTRACT FROM AUTHOR]