NURBN2009 Essay: Asthma Management, Health Promotion, and Nursing Role

This essay examines the Community Asthma Program in the context of the Ottawa Charter for Health Promotion. It analyzes the program's strategies, focusing on health literacy, health education, and the six action areas of the Ottawa Charter. The essay assesses how the program addresses these areas, highlighting strengths and weaknesses in its approach to asthma management for children. Furthermore, it explores the crucial role of nurses in this program, emphasizing their responsibilities in educating patients, facilitating self-management, and providing care interventions. The analysis includes a discussion of health disparities, parental involvement, and the importance of trigger identification in asthma control. The essay concludes by evaluating the program's comprehensiveness and suggesting areas for improvement to enhance the effectiveness of asthma management strategies, particularly in the context of pediatric care. It also emphasizes the need for health promotion and education within the community.

Running Head: NURSING ESSAY
NURSING ESSAY
Name of the student
Name of the University
Author Note

1
NURSING ESSAY
Introduction
The Ottawa Charter for health promotion was introduced in 1986, which acts as the
governing guidelines directing the base of any health program development. It helps in
devising, planning, and implementing a sound and strategic public health management
program. By application of the key strategies of the Ottawa Charter and the six action areas
identified in it, a health promotion plan can be effectively built with enhanced features and
implemented productively. The necessary strategies for the successful establishment and
operation of a health promotion program are health literacy and health education in which the
nurse practitioner plays an integral part (Lee, 2015). The purpose of this essay is to illustrate
the strategies of a health promotional activity ‘Asthma Management’, and investigate the
program based o the six action areas. The essay will also outline the role of a nurse in this
promotional program.
Community Asthma Program
Asthma is a substantial health problem pervasive in the community, which happens to
be one of the primary reasons for children being admitted to the hospital. When asthma is
well managed in these children, they can actively take part in daily activities and enjoy a
normal childhood. The mechanism of an asthma attack involves the narrowing of bronchi in
the lungs caused by muscle tightening and inflammation inside the walls of the bronchial
tubes. Frequent wheezing, coughing and breathing difficulties make it difficult for asthmatics
to take in air which often leads to shortness of breath and respiratory distress. Prevalence of
childhood asthma reveals that about one in 10 children in the Australian communities gets
diagnosed with asthma, and some of them suffer from wheezing at some point in their life.
However, it is crucial to understand that wheezing in childhood does not necessarily signify
asthma, therefore, making it challenging to detect asthma in children. Hence, there was an

2
NURSING ESSAY
emerging need for a community program addressing the asthma prevalence in Australian
children between the ages of 0-18 years (Otim et al., 2015). The ‘Community Asthma
Program’ was developed for the people living in regions of the north or western Melbourne,
including the suburbs of Wyndham (cohealth - Community Health Service, 2020). To be
eligible for this program, the children who require enhanced education and backing from their
paediatric asthma educator are considered and encouraged to take part. The program is
personalised to fulfil specific family needs and is delivered at both Community Health
Centre, or outreach centres. The primary goal of this asthma management program is to assist
the clients in understanding asthma /wheeze and providing them with a sound care plan or
intervention. The specific services of this program include-
 Drug management
 Training for device usage
 Facilitating a documented action plan for asthma management
 Recognising the asthma triggers
 Ascertaining the need for medical or emergency assistance
 Encouraging self-management
The priority action areas of health promotion acknowledged in the Ottawa Charter are
relevant to ascertain the efficacy of a health promotion program (Thompson et al., 2018).
These are:
1. Building public health policy – to build a health promotion policy, diverse
approaches must be combined to achieve the best results. Health promotion policy
involves the detection of possible barriers in the adoption of those policies in various
settings and developing ways to mitigate the obstacles. The community asthma

3
NURSING ESSAY
program partially addresses this action area by providing the patients with an
identification of the trigger factors during the management or treatment of asthma,
which could act as potential barriers.
2. Constructing supportive surroundings – sustainable use of resources and ways to
prevent depletion of natural and ecological systems must be addressed by any health
program. The community asthma program provides a supportive framework for the
clients who receive it by promoting education on their disease conditions.
3. Supporting community actions – with the help of community participation, a health
program can be enriched with the assistance received from human and material
resources which aid in the growth of flexible systems for strengthening the public
health problems. This involves complete and constant information access and
educational health opportunities, along with funding support. Participation from all
health practitioners and caregivers are encouraged throughout the community asthma
program to create a collaborative environment for care delivery.
4. Improving individual skills – it is essential to empower people in lifelong learning
helps them to organise themselves for all life stages and to manage chronic illness and
injuries. This has to be facilitated in school, home, work and community settings.
Building self-management of the patients is a vital aspect identified in the community
program.
5. Reorientation of health amenities – the health services must transition increasingly
towards the direction of health promotion, apart from only providing clinical and
curative services. Reorienting health services also requires more vigorous attention to
health research, as well as changes in professional education and training. The
community program partially addresses this action area through the facilitation of
education and training for adequate management of asthma in children.

4
NURSING ESSAY
6. Assessing future needs – while developing strategies for health promotion issues
concerning holistic care and ecological sustenance must be adequately considered. A
guiding principle should be that women and men should become equal partners in
each phase of planning, implementation and evaluation of health promotion activities.
The community asthma program does not include and address this action area, as
there is not enough information involved in developing the plan where the future
activities are incorporated.
By examining the asthma management program for the Australian community level, it can be
said that the plan does not address all the key action areas substantially, and there is ample
room for improvement so that the specific areas can be effectively tackled and included while
enhancing the program.
Health literacy, health education, and health promotion
Health disparities have been associated with affecting the health literacy of children’s
asthma and disease outcomes. Since parents are the primary caregivers of the children in
most cases, they must have sound healthcare knowledge. Therefore, health literacy of the
parents has a significant influence on the outcomes and concerns of the health of the child,
especially in asthma control (Brigham et al., 2016). Higher health literacy in parents is related
to improved asthma knowledge and better asthma control in their child. Pediatric asthma
caregivers, therefore, should consider adopting strategies for educating the parents regarding
the treatment plans (Harrington et al., 2015).
Patient’s education is a critical component in asthma management. For pediatric
asthma, the parents must have sound knowledge about their child’s condition and care
process. Asthma trigger identification should be the focal point of the education systems as it
aids as a longstanding control strategy for sudden asthma attacks with or without

5
NURSING ESSAY
medications, and avoid any exacerbation, which further leads to complications (Boulet et al.,
2015).
An adequate asthma health promotion mediates an affirmative effect on health
outcomes when it incorporates community activities, engage the participation of community-
based organisations, provide program mechanisms in a clinical site, arrange for asthma
training to healthcare providers, collaborate with several agencies and government
organisations, design a program for a specific group, customise the health or educational
needs, and establish interventions based on these areas (Guarnaccia et al., 2016).
The scope of specialist nurses has broadened in the area of chronic disease
management, which is why they are now considered to be an invaluable part of the
multidisciplinary team. The adept skills and clinical practice knowledge of the nurses help to
achieve high-quality patient care. Primary and secondary care nurses are employed as
autonomous experts in the management of asthmatics and formulating treatment plans for
them. The expansion of advanced nursing responsibilities has created a prospect to widen
multiple areas were proficient skills of nursing deem to be highly significant in respiratory
management (Konstantaki et al., 2014). Nurses play the chief role by helping children and
their families to keep the asthma attacks under control and sustain minimal medication to
maintain drug independence for the children. Through this, the affected children and their
family gains an improved baseline control, averts any chance of asthma exacerbation via
effective trigger detection, enhanced adherence to control measures and ultimately increased
quality of life (Klok et al., 2015). Additionally, nurses can carry out home visits for special
purposes when resources are ample. Home visits aids in ascertaining the patients who might
be facing severe therapy-resistant asthma, effectively identifying remediable areas fr them
and developing nursing care plans.

6
NURSING ESSAY
Conclusion
Having evaluated the community asthma management program, it can be deduced that
the plan of the program is not sufficient to be a comprehensive management plan for pediatric
asthma care. All the action areas of the Ottawa Charter are also not addressed through this
health program. Hence, there is a need for implementing effective health plans to achieve
higher success in asthma management. The role of health literacy, promotion, and education
highlights the necessity of considering these key strategies while developing and establishing
any health program. Childhood asthma is a complex disease which may be resistant to
treatment and varies in its clinical presentation. Nurses can play a vital part in mediation and
provision of enhanced care interventions for the difficulties and challenges that are faced in
the course of asthma in children.

7
NURSING ESSAY
References
Boulet, L. P., Boulay, M. È., Gauthier, G., Battisti, L., Chabot, V., Beauchesne, M. F., ... &
Côté, P. (2015). Benefits of an asthma education program provided at primary care
sites on asthma outcomes. Respiratory Medicine, 109(8), 991-1000.
https://doi.org/10.1016/j.rmed.2015.05.004
Brigham, E. L., Goldenberg, L., Stolfi, A., Mueller, G. A., & Forbis, S. G. (2016).
Associations between parental health literacy, use of asthma management plans, and
child’s asthma control. Clinical pediatrics, 55(2), 111-117.
https://www.researchgate.net/profile/Gary_Mueller3/publication/277079034_Associat
ions_Between_Parental_Health_Literacy_Use_of_Asthma_Management_Plans_and_
Child’s_Asthma_Control/links/588b628a92851c02fa5f91f3/Associations-Between-
Parental-Health-Literacy-Use-of-Asthma-Management-Plans-and-Childs-Asthma-
Control.pdf
cohealth - Community Health Service. (2020). Community asthma program (CAP) - cohealth
- Community Health Service. cohealth - Community Health Service. Retrieved 19
April 2020, from https://www.cohealth.org.au/health-services/child-and-family-
health/community-asthma-program-cap/.
Guarnaccia, S., Holliday, C. N., D’Agata, E., Pluda, A., Pecorelli, G., Gretter, V., ... & Ricci,
E. (2016, July). Clinical and health promotion asthma management: an intervention
for children and adolescents. In Allergy & Asthma Proceedings (Vol. 37, No. 4).
https://doi.org/10.2500/aap.2016.37.3967
Harrington, K. F., Zhang, B., Magruder, T., Bailey, W. C., & Gerald, L. B. (2015). The
impact of Parent’s health literacy on pediatric asthma outcomes. Pediatric allergy,

8
NURSING ESSAY
immunology, and pulmonology, 28(1), 20-26.
https://dx.doi.org/10.1089%2Fped.2014.0379
Klok, T., Kaptein, A. A., & Brand, P. L. (2015). Non‐adherence in children with asthma
reviewed: The need for improvement of asthma care and medical education. Pediatric
Allergy and Immunology, 26(3), 197-205. https://doi.org/10.1111/pai.12362
Konstantaki, E., Priftis, K. N., Antonogeorgos, G., Papoutsakis, C., Drakouli, M., & Matziou,
V. (2014). The association of sedentary lifestyle with childhood asthma. The role of
nurse as educator. Allergologia et immunopathologia, 42(6), 609-615.
http://dx.doi.org/10.1016/j.aller.2013.05.008
Lee, M. S. (2015). The principles and values of health promotion: building upon the Ottawa
charter and related WHO documents. Korean Journal of Health Education and
Promotion, 32(4), 1-11. https://doi.org/10.14367/kjhep.2015.32.4.1
Otim, M. E., Jayasinha, R., Forbes, H., & Shah, S. (2015). Building evidence for peer-led
interventions: assessing the cost of the Adolescent Asthma Action program in
Australia. Australian journal of primary health, 21(4), 438-443.
http://dx.doi.org/10.1071/PY14066
Thompson, S. R., Watson, M. C., & Tilford, S. (2018). The Ottawa Charter 30 years on: still
an important standard for health promotion. International Journal of Health
Promotion and Education, 56(2), 73-84.
https://doi.org/10.1080/14635240.2017.1415765

9
NURSING ESSAY