To the best of our knowledge, this study is the first randomized controlled trial to examine the effectiveness of nursing educational intervention on asthma control in children. In Pakistan, the prevalence of asthma is higher than in India and Iran, on the other hand, lower than in Saudi Arabia and Afghanistan. Previously, asthma was prevalent in developed countries; inversely, it has decreased considerably in recent times[13].
Asthma control plays a substantial role in asthma management. The causes of failure to control asthma might be linked to a lack of knowledge of triggers and the inability to avoid them. Therefore, this study was conducted to identify the impact of nursing educational intervention on asthma control among children.
The current study findings showed that nursing educational intervention improved asthma control in children. A significant difference between the scores in the two groups was found in favor of the experimental group. These results align with a study conducted to determine the effect of educational and modifying intervention on asthma control among adolescents with a before-after design and control group in Iran[11].
Such nursing education can increase patients' and caregivers' knowledge about the disease and causes of asthma to control the disease. The most important issues of primary principles of asthma control exist in civilization. The essential concerns are training of health care providers, conducting training sessions for asthma (for health care workers and patients), usage of outpatient follow-up care, and longstanding control of the disease rather than of rarely acute care. Nurses play an indispensable role in achieving these goals. To avoid severe asthma attacks, nurses working in clinics and hospitals must provide updated information to educate patients depending on the diagnosis, age, influential factors, education status, and culture.
Identifying triggers that lead to the onset of asthma symptoms among children is vital for diagnosing and controlling the disease[14]. Factors such as triggers cause the onset of disease symptoms. Every individual who has asthma may have distinct triggers. Furthermore, behavior modification to minimize the individual's exposure to these triggers is crucial in controlling asthma[15].
A review was accomplished by Boyd et al.[16] on 38 research studies with 7843 children and different subjects of educational interventions through nurses and health caregivers. The review showed that many studies, due to educational intervention, observed a decreasing number of hospital admissions, a decrease in emergency room visits in children, and a one-quarter reduction in the total number of emergency room visits and hospitalizations. Our study results are consistent with the findings of Boyd et al.
A study was accomplished by Shah et al.[17] on the impact of peer asthma education programs among adolescents in grades 7 and 10, which established an increase in average pulmonary function scores of both control and intervention groups. However, that was not because of the intervention. However, in our study, the score variation was precisely due to the nursing educational intervention.
Another research study was carried out by Watson et al., who determined the impact of the interactive education of children in small groups on asthma control after a year of follow-up. The study findings showed a decrease in emergency room visits, the use of oral steroids, and a reduction in earlier treatments. These results were parallel with our study findings, as we found a decrease in the number of visits to the emergency department due to asthma in the last month in the intervention group.
Our study showed that children in the experimental group exhibited fewer days of asthma symptoms. This finding agrees with the study performed by Butz et al. on the impact of an educational plan through parents among children from rural areas, which exhibited a reduction in daily asthma symptoms for the experimental group[5].
A study conducted by Clark et al. on the effect of a school-based educational plan on symptoms, school absences, and academic performance among children exhibited a reduction in night-time and daily asthma symptoms. These findings were similar to our study findings.
Another study conducted by Joseph et al. to determine the performance of internet-based self-management plans for asthma in school revealed a reduction in each day and night asthma symptoms and absenteeism from school[18].
Our findings are also parallel with another study by Magzamen et al. on a school-based asthma educational program among adolescents that found a significant reduction in hospitalization and the number of visits to the emergency department after the intervention[19].
Empirical studies are scarce, with pre and post-design and control groups, on nursing educational interventions for asthma control by the Asthma Control Questionnaire. Therefore, comparing the current findings with those of other studies takes work.