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Caregivers’ education vs rhinopharyngeal clearance in children with upper respiratory infections: impact on children’s health outcomes

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Abstract

Upper Respiratory Tract Infections (URTI) are very common in children having no effective pharmacological treatment. This study aimed to compare the effect of caregivers’ health education regarding children’s respiratory infections and the effect of a rhinopharyngeal clearance protocol in children with URTI. A factorial trial was conducted in 138 children up to 3 years, attending day-care centres. Children were distributed into four groups: control group (CG) (n = 38); education group (EG) (n = 34); intervention group (IG) (n = 35); and education and intervention group (E + IG) (n = 31). A Diary of Records was kept by caregivers during 1 month. There were significant differences between groups concerning: Lower Respiratory Tract Infections (CG = 29.4%; EG = 10.7%; IG = 3.8%; E + IG = 0.0%; p = 0.014); acute otitis media (CG = 32.4%; EG = 7.1%; IG = 11.5%; E + IG = 7.7%; p = 0.014); medical consultations (CG = 70.6%; EG = 42.9%; IG = 38.5%; E + IG = 30.8%; p = 0.021); antibiotics (CG = 44.1%; EG = 7.1%; IG = 23.1%; E + IG = 15.4%; p = 0.006); days missed from day-care (CG = 55 days; EG = 22 days; IG = 14 days; E + IG = 6 days; p = 0.020); days missed from employment (CG = 31 days; EG = 20 days; IG = 5 days; E + IG = 1 day; p = 0.021); and nasal clearance techniques (CG = 41.4%; EG = 78.6%; IG = 57.7%; E + IG = 84.6%; p = 0.011).

Conclusion: This study showed that the most positive impact on children’s health outcomes occurred when combining health education of caregivers, regarding children’s respiratory infections, with a rhinopharyngeal clearance protocol in children with URTI.

What is Known:

• Upper Respiratory Tract Infections are very common in children but still do not have an effective pharmacological treatment.

• This generates a great burden of disease for the child and families, increasing the use of antibiotics.

What is New:

• This study is the first one that aims to analyze the effects of caregivers’ health education in comparison to non-pharmacological intervention in acute respiratory infections in children.

• It shows a positive impact on children’s health outcomes, empowering caregivers regarding their child’s health and reducing the burden of disease, medical consultations and the use of antibiotics.

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Abbreviations

AOM:

Acute otitis media

CG:

Control group

DRR:

Désobstruction Rhinopharyngée Rétrograde

E + IG:

Education and intervention group

ED:

Education group

HES:

Health Education Session

IG:

Intervention group

LRTI:

Lower Respiratory Tract Infections

PRSS:

Paediatric Respiratory Severity Score

URTI:

Upper Respiratory Tract Infections

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Acknowledgements

The authors would like to thank all the caregivers and educators from the day-care centres who accepted to participate in this study. A special thanks to Veronica Parreiro, Inês Azevedo and Daniel Costa for their help in the early stages of this project.

Funding

The authors declare that they received no funding.

Author information

Authors and Affiliations

  1. Department of Physiotherapy, School of Health, P.Porto, Porto, Portugal

    Ana Silva Alexandrino, Rita Santos & Cristina Melo

  2. Department of Health Sciences, University of Aveiro, Aveiro, Portugal

    Ana Silva Alexandrino

  3. Baixo Vouga Hospital Centre, Aveiro, Portugal

    José Mesquita Bastos

  4. Department of Intensive Care and Pediatric Service, Grand Hôpital de Charleroi—GHDC, Charleroi, Belgium

    Guy Postiaux

Authors
  1. Ana Silva Alexandrino
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  2. Rita Santos
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  3. Cristina Melo
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  4. José Mesquita Bastos
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  5. Guy Postiaux
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Contributions

Alexandrino, AS was responsible for the conception and the design of the study, acquisition of data, analysis and interpretation of data and drafting the article; Santos, R took part in the design of the study, acquisition of data, analysis and interpretation of data and revised the paper; Melo, C took part in the design of the study, reviewed the findings and revised the paper; Bastos, JM assured the medical supervision of the study and revised the paper; Postiaux, G developed the intervention procedures and revised the paper. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ana Silva Alexandrino.

Ethics declarations

Conflict of interests

The authors declare that they have no conflict of interest.

Ethical approval and consent to participate

All procedures performed in this study were in accordance with the ethical standards of the Ethics Committee of the School of Allied Health Technologies, Polytechnic Institute of Porto (CE_1744/2014) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in this study.

This study is registered at ClinicalTrials.gov with the identifier: NCT02588963.

Availability of data and material

The dataset supporting the conclusions of this article is available from the authors.

Additional information

Communicated by Nicole Ritz

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Alexandrino, A.S., Santos, R., Melo, C. et al. Caregivers’ education vs rhinopharyngeal clearance in children with upper respiratory infections: impact on children’s health outcomes. Eur J Pediatr 176, 1375–1383 (2017). https://doi.org/10.1007/s00431-017-3003-z

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  • DOI: https://doi.org/10.1007/s00431-017-3003-z

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