Diagnosis and Treatment of Asthma in Saudi Arabia

Diagnosis and Treatment of bronchial bronchial bronchial asthma attack attack attack attack in Saudi-Arabian-Arabian-Arabian-Arabian ArabiaMore than 300 million people currently suffer from bronchial bronchial bronchial asthma worldwide. It is the most common chronic disease among children (WHO, 2008). In Saudi Arabia, on that point is a lack of statistics nearly the asthma, however, an estimated number can be untrue through Abou Zaid et al study. consort to Abou Zaid et al (2009), thither atomic number 18 most 7 percent of the children and adolescents in the s byh region but ugly from bronchial asthma. That percentage was ground in one city (AlTaif) from the Saudi Arabia regions (s surfaceh region). Moreover, that study was based on a city that does not hand polluted environment much(prenominal) as the capital city and the touch beas. That city AlTaif, this city is hunch forwardn with the high altitude city and fresh environment collect to the staggering d istance from the polluted industries. From that point, it can be seen that the percentage of the children who dumbfound asthma for let down be higher in the capital cities or in the industrial environments referable to the excessive position of the pollution and the asthma triggers (Abou Zaid et alone, 2009).BackgroundAsthma is a chronic insurgent disease of the airways that a recurrent symptoms. Its declarationing from the interaction between the inflammatory cells and the create from raw stuff cell that cover the airways. The inflammatory process during asthma is fart-ining to the asthma pattern such as the difficulty of breathing, wheezing, coughing and chest denseness (Henson Johnston. 2002).The enhancements of pediatric asthma have clearly conjugate to the esthesia of airways. This sensitivity can lead to the asthma onset. The allergic inflammation of the airways can be stimulated by the allergens (Henson Johnston. 2002).asthma in children can be ca subroutined by numerous factors. Several factors that qualification add-on the gamble of development of asthma such as genetic, gender, environment and prematurity when delivery (Henson Johnston. 2002). Smoking for women during pregnancy has been linked strongly to asthma in children (Henson Johnston. 2002). This exit be an bed with the women who lot in Saudi Arabia.Primary Health C ar Centers in Saudi Arabia have been lacking in asthma perplexity knowledge structures (equipment and practice of medicine) (Alhaddad et al. 1997). In addition, in that respect were a large number of asthma prescriptions from the primary wellness care centers that had no resist of the dosage for the asthma inhalers and this showed how silly the documentation has been from the asthma medicines prescribers. Moreover patients who were ordered asthma steroids have shown a poor conformity with the prescriptions. All of that has led to to a greater extent primary wellness care centers visits and more than infi rmaryizations. The studies withal showed there were only 35% of the prescriptions were in the deterrent therapy. That means the other prescription were either higher than the preventive therapy or abjecter than the recommended preventive therapy (Aldashash, Almukhtar. 2003).The significance of the proposalThe knobs who have poor conformance and with no studyal tools, the hospital visits and hospitalization by them leave alone append and remain in the high level. However, if the nodes have been given pamphlets which teach them how to wrap up the asthma bangs and how to prevent them, the hospital visits whitethorn be decreased with the worthy motivation and direction.Aims and objectives for the declare oneself-importanceThis proposal is targeting the children with asthma to decrease the hospital visits by them. It lead also improve the sensory faculty for the childrens guardians and what is an asthma leaflet for children may promote the quality of the childrens live s and it also may decrease the hospitalization. That brochure are also receiveing to maintain the self focusing for children with asthma it result increase the public apprisedness in what to do if roun do had an asthma attack by providing the children and their guardians the qualified rearing.The strategies of the projectMaking the cusp.This strategy is the main archetype to start the execution process. In addition, this brochure should start with giving the clients multi designing cultivation related to their guide. The ways to realize the client satisfy with this booklet, all the information are in penury to be simple to understand. Up to date information compulsory to fill out this booklet to derive the client equal to relate it to the young self management approaches. The booklet go forth be very handy to the client who cannot or do not have the ability to check the information via online. All the updated and pauperizationed data imparting be avail su fficient at the booklet for the commentator to read it and to ask about anything that they want or they need to know about the booklet.Process of death penalty.Asthma self management booklet postulate to be implemented in strong apply methods to be adapted to gain the fruits of successes. Knox (2000) has suggested that the implementation process need to be based on many theories to give it the ability to conciliate on the various changes in the clients needfully or barriers such as eye sight problems and literacy. The elect speculation leave alone be adapting Lewins theory. Lewins theory has been choose because of it is the easiest theory to be overtopled and monitored. In addition, Lewins theory is capable to be adjusted to suit the wanted changes more than the other theories (Knox, 2000).Literature reviewThis publications review has only focused on the recent articles that only done in 2009 and 2010. These articles are not about the Kingdom of Saudi Arabia due to th e lack of the recent imagerys that have mentioned the asthma pedagogy in Saudi Arabia. These articles were taken from the re see engine CINHAL based on key words asthma and education. The search was limited on the articles that have been published in years 2009 and 2010. scarce 32 hits were found 13 of them were in English but those articles were based on the church communities. Thus, those articles have been excluded due to the inconvenient to the topic to mount it in Saudi Arabia. In addition, 6 of the articles were compose by a foreign language Portuguese language so these articles have been excluded too. That allow leave only 13 recent articles to use in this literature review. The literatures allow be mentioned under the following sub headingsAsthma in connection with communitiesAsthma self care management is more upright for the client when it is connected with the community (Otsuki et al 2009 Millard et al 2009 Krieger et al 2009). The purpose of connecting the asthma self management image is to get the supreme support to the clients and to the proposal itself. This entrust give the wanted plan with the upper limit validatedity. When public lecture about victimisation the communities to give a great aid to the asthma self management plan from allowing a large informatics resource to be focused on that plan (Clark et al 2010). The management needs to be supported by giving guardians need to be include in that education to allow them to be a good instrumentalist in the asthma self management plan for the children (Tolomeo 2009 Zhao et al 2009).When the asthma self management plan has been separated from the community. The wanted education plans allow be disrupted by the invalid information and testament be lacking of resources such as clients and trainers. This go away lead to failing in that education plans (Farber, 2009).Asthma in connection with wellness check facilitiesAsthma is a medical exam problem. This medical problem go out require a medical attention. When a clients education have been provided without any connection to any medical facilities, then the asthma education will obligates a lot of faker information. From that point, asthma self care management plan should have whatever connection with the medical facilities to be able to be capable to be carried out with attention from the medical staffs. In addition, the medical facilities will lubricate the educational process to the client by allowing them to feel the difference sooner and after using the suggested self management education plan (Praeger 2009 Farber, 2009).Asthma education for undergraduate nursesThe way to make the educator nurse able to deliver a good education to the clients is to allow the nurses to get more methods to civilize the clients when they are taking their degrees. In another words, allow the asthma self management methods to be taught in the tertiary schools to the nurses to increase the flexibilities to the nurse s to adapt the methods to teach the clients more effectively and to create the realism in the education plan (Richard, 2009).Reducing clients with asthma hospitalizationWhen the clients are getting an stingy education, the indispensability visits by the clients will be increased (Flores et al 2009). vice versa, if the wellness education have become more effective to the clients, that will lead to promote their health. When their health side has been promoted, the visit to the emergency way of life will be reduced (Zhao et al 2009)Clients with asthma in schoolsWhen the clients who diagnosed with asthma are having an episode of asthma, then the absence of school will go across and the emergency visits will increase (Murdock et al 2010). Increasing the community sureness and the asthma self management education will promote the clients health circumstance and that will decrease the absence from schools (Otsuki et al 2009). Moreover, when using an education techniques to the ch ildren clients, an appropriate technique should be used to avoid the incompliance from the children such as ignorant or depression (Murdock et al 2010). One study done by Tolomeo has describe that only 15 % of children who diagnosed with asthma that have veritable a complete asthma education (2009). That is less percentage than what has been reported by Apter et al (2001). However, another study done by Millard et al has argued that the affect of asthma absence in schools were highly over estimated (2009). However, there still gaps between the recommended asthma care plan and the current plan that has been used in the schools (Frankowski, 2009). In addition, Frankowski recommended Physician Asthma Care fosterage (PACE) to increase the effort in communication while providing the client the asthma self management plans (2009).The content of the booklet with the rationaleThe content of the booklet will use the simple English to make it easy to be understood by the client and the cli ent guardian if any. In addition, it will be indite as a dot point to make it easy to be absorbed by the clients mind. The booklet will keep back rough of the pictures to make it easy to rationalize the contents to the clients. The booklet will contain hexad characters those sections will be clearly identified below. first of all sectionThis section is talking about the asthma disease and includes sufficient information about the asthma. It is also include the sign and symptoms of asthma.The intention of this section is to give the client enough information about the asthma to assign the reality of the disease and how to identify the sign and symptoms. This will be usable to the client and their guardian to be able to identify the initial information about what is asthma and what is it doing to the client health status. In addition, this section is including some information about how to control the asthma. In peculiar(prenominal) this booklet is aiming to displace the se lf management for the clients to promote their health by promoting their self control for the asthma. Moreover, if the booklet has engaged the client and their guardians by acknowledging them to the sign and symptoms of asthma on sets, then the booklet has allowed the client to be more confident in managing his health condition and that will reduce the depression to the client (Murdock et al 2010).The aim is achieved by including an explanation on what are the asthma and the pathology for the asthma. This description is to make it clear to the client in what is exactly going on in the clients lungs. The booklet did also include some of the sign and symptoms for asthma and some definitions for the difficult words such as wheezing. Wheezing is the sound or squeaky sound thats appears when the asthmatic person are breaths (LBI 2007). Moreover, the booklet has identified when the clients need to contact their doctors and when they need their medications. In addition, the booklet has shown some information about how to control the child asthma. All the information that has been written in the booklet was from up to date references.The second sectionThe aim of this section is acknowledging the client about the different kind of asthma medication and the purpose for them. This page will allow the client to gain the decent knowledge about what is the medication and why those medications have been prescribed for the client. This also will allow the medical team to educate the client about the medication. By engaging the clients and their guarding in the asthma self management plan and provide them with sufficient education then the booklet is actually insuring that the clients are getting the sufficient asthma education (Tolomeo, 2009). In addition, if the clients are aware of the asthma onset sign and symptoms then the client also aware about how to use the supplied medication to solve the onset, then the pressure to the client from the sickness itself will be re duced and the client will not be more depressed about their medical conditions (Murdock et al 2010).This aim is achieved by explaining that there are cardinal kind of asthma medication the reliever one puffer and the preventive medication (LBI 2007). The medication will be varying from each client. That is why there were no specific brand name to the inhalers has been mentioned in details. All the details that have been written in the booklet were general due to the avoidance of getting sloped or malfunctioned. plane section threeThis section contains some useful pictures that explain to the client how to use the different kind of inhalers. This will promote the client knowledge about the proper way to use the inhalers to check out the maximum benefits from the medication.Section fourThis section was established in this booklet to educate the client about what are the asthma triggers and how to solve or annihilate them to be more in control for their asthma situations.Section q uintetteThis section is mainly about the asthma management plan during emergency action plan. This section can be filled by the doctor to make the client able to handle emergency situations and when to know when their health status are dropping down or getting better. This section is essential to the booklet due to the highly urgent need to the client to know their emergency action plan. In addition, this section is giving the clients and the reviewer more information on how to scale the clients with asthma health status regarding the asthma point of view. When the client is able to measure the peak run and know what the vital variance to determine their asthma status, then they will know when to seek help or when they are in the risk free zone. That will allow them to take in charge for their health and will give them an advance notice when to be worried and need to seek attention or help for the medical staff. This also will allow the client to know when they need to book themse lves an appointment in the medical facilities in advance. This issue may lead to less time lag hours in the primary health care clinics from the asthma perspective. That will lead to less hospitalization and might reduce the mortality rate for the clients.Section sixThis section is about the useful community services in Saudi Arabia. This will help he client to seek the adequate sufficient information about asthma when needed. It is also including some of the valid web site links for those community services to be able to locate them in their areas or have the contact numbers for them. According to Knox (2000), explained that the clients are reading about their condition more than what they used to, in particular when they are looking for a solution to a problem that they have. When the clients are suffering from a specific problem, they would require looking for the solution and lacking a valid resource for them to be able to find the solution.The implementation processEvery imp lementation process would require a leading or changing agent. While there is no leadership or no change agent the implementation will eventually fails due to there will be no control for the outcomes. In addition, the leadership or the change agent needs to be armed with skills to be able to control the implementation process and need to have adequate expertise about what is the change and what the favor from the implementation. The leadership shall identify the changes and how it will affect the organization. In addition, the leadership will have the leading skills to lead the other staffs to be able to reduce or eliminate the fears from the changes and the suspense while making the changes. Moreover, this leadership will visualize the recent valid change process to be able to implement them to the changes that the leadership will require (Swanburgs, 2005). The leaders ship should be honest responsible and have the flexibility to admit their own mistakes. Moreover, the leader ships need to be qualifies persons whom can create a business on a trust and can cut into to important goals (Swanburgs, 2005).The process of making the implementation more flexible and effective is to make it based on more than one change theory (Knox. 2000). The implementation of the booklet will basically base on Lewins force-out field model of change. Lewins model is consisting of three shows unfreeze stage, moving stage and freeze stage (Swanburgs, 2005). However, other change process theories might be included in this project.Ethical issueThe implementation process will consider that there will be no harm that will occur to the clients and there will be no harm for the distributers or the medical staffs (Swanburgs, 2005). If any harm was noted to any of the parts the implementation process will immediately terminated and that incidence will get investigated to see where the implementation process were deviated from the track and to discuss whether or not that harm will aff ect the future of the implementation process. The harm might happen when the clients or their guardian are not understanding the booklet and might misuse it.Unfreezing stageThis stage will include the crowd of all the recent asthma brochures and investigate what are the brochures that are out dated. All the out dated brochures need to be collected and inform to the client to not use them. later on that, an introduction for this booklet needs to be done in small community such as rural area. The supposed area in Kingdom of Saudi Arabia is AlMajmaah due to it contains only three Primary Health Clinics and two hospitals. The introduction for the booklet will be started on the asthma yardbirds in one of the hospital and for this trail the elected hospital will be King Khalid infirmary because of there is special department for asthma patients in there and there is Special Ward for clients with asthma there. That ward consists of 12 beds especially for children whom diagnosed with as thma so the trial can be easily controlled. Prior to distributing the booklet, the project leadership will collect the sufficient data about the status of those children and what they have received from the education point of view. The culture habits such as raising sheeps or camels should be considered and investigated whether or not it triggers the asthma attacks. That will need to be investigated by the physicians. The other educational elements should be considered such as literacy, education level, any cultural befooling such as lack of transportation or lack of guardians, any physical impairment such as eye sight or deafness. After compendium and analyzing the data, the leadership will establish basic team to assist the leadership in applying the changes. This team will be armed with experience and it will contain trustable persons that are accountable for the palmy of the supposed change aims. After the investigation has been collected and analyzed, some of the inpatient c lients will be elected for the first trial. The election will be based on the children whom with low complications to decrease the chance for the failure of this trail. Those selected subjects and the selected team will receive an intensifier course for the use of the booklet and the benefits for the booklet. That course will not be established unless a formal consent has been gained from the hospital administration and from the guardians of the children. The intensive course will be held for one week and it will contain the needed educational material such as the booklet, some posters and brochures to maximize the knowledge that will be gained by the mentioned subjects. This trial was inspired by Roger s theory (Swanburgs, 2005). After the intensive course the booklet will be handed on to the clients and observation for the real benefits that gained after handing the booklet will be monitored.Moving stageIn this stage the leadership and the nominated team will start distributing t he booklet among the whole AlMajmaah inpatient children whom are suffering from asthma especially the recent diagnosed children. When introducing and distributing for the booklet a classes will be held in all the inpatients wards that contains children whom diagnosed with asthma to brief them of the benefits of using the booklet and how to use them. The mentioned classes will run for a period of a month. After the mentioned month, an evaluation process will run for the whole two hospital and investigation about the actual benefits that been gained from that booklet. The booklet may need modification or alteration to make the booklet more suitable for the use by the clients. When there is any alteration for the booklet the preceding implementation steps will be carried out again to insure the smoothness of the changing process. After finishing the alteration for the booklet and the successful of the trails, the booklet will be recommended to the Ministry of Health to implement it fo r the whole Saudi Arabia medical facilities and that the aim of this project.Freeze stageWhen completing the booklet trials and insuring the maximum validity of the booklet contents, then the booklet should get the official anatomy and recommended to the Ministry of Health to be able to make it the primary distributed booklet for children with asthma in Saudi Arabia.Discussion and limitationThe most significant barrier for this booklet would be adapting the medical team and the public about the beaver safe way to use the booklet, this can be covered by established a educational facilities or teams to keep educating the public how to use the booklet and an intensive program to teach the medical teams as well. In addition, some of the information might be not valid or useless after a while, that can be cover by creating an evaluation teams to keep this booklet up to date. Moreover, the booklet maybe in need for more information or more sections and that can be dealt with by the eval uation teams. The booklet may suffer from the lack of compliance from the patients, that can be dealt with educate the patient of the importance of following the steering that been given by the medical team. Moreover, some patient may curb the informations in the booklet or adding more information that might deviate the booklet that might be solved by educating the patient in how dangerous it would be if they done so and how inappropriate treatments might result from that. However, some of the departments in Saudi Arabia have adopted some of the asthma education techniques such as King Fahd National Guard Hospital. KFNGH has created a link via web site to allow the clients to calculate the severity of their asthma if they have it.Future recommendationThis booklet may be used as a data base style so the clients will require a USB device to carry their entire case filing cabinet and their required information. The booklet can be as well a digital booklet so the client can check it out via online or using the new devices such as i aggrandize or iPod. The booklet will include in the future more sections to get the booklet further in the way to reach to the holistic approach.ConclusionIn conclusion, asthma is a chronic health issue that affects many people from all around the world. Many asthma self management education method has been used around the globe. Moreover, the asthma education is one of the essentials to reduce the clients emergency room visits and hospitalization. Education will require connecting it with the community and medical facilities to get the maximum benefits to the plan. In addition, one of the education methods that can be used to educate the clients is the asthma self management booklet. This booklet need to have up to date information to be able to assist the clients to promote their health.th booklet will contain six section that have been detailed above. The implementation of the booklet will go via three stages unfreeze, move then freeze. All the implementation stages should be monitored thoroughly to maintain the success. This booklet may reach to preferred destination and may not. If it reached to the final hoped destination then the booklet will require prize and frequent update.