NRS 465 Topic 6 Benchmark – Literature Review

Literature Review

Asthma among school-aged children is one of the most common chronic illnesses, leading to school absenteeism, hospitalizations, ER visits, and an undesirable quality of life (Zhou & Tang, 2025). Effective asthma management and outcomes are highly dependent on the patient and their caregivers’ knowledge of the condition, medication adherence, triggers, preventing exacerbations, and self-management skills. However, most exacerbations and ER visits are associated with inadequate knowledge of the disease and its management (Samady et al., 2022). This paper presents a literature review on the issue, including a summary of the purpose of the selected studies, their samples and populations comparison, a synthesis of the studies’ conclusions, a summary of the limitations, and recommendations for further research based on the studies.

The PICOT question that guided the literature review is as follows: In school-aged asthmatic patients (P), how does the implementation of a structured caregiver and patient Education Program (I), compared to routine patient education (C) affect emergency Room (ER) visits (O) within 12 Weeks (T)?

Purpose of the Studies

The review entails eight studies that explored different aspects of pediatric asthma management and education. Zhou and Tang (2025) examined the global prevalence and risk factors associated with childhood asthma, highlighting the growing burden of the disease and the importance of preventive interventions. Lin et al. (2024) evaluated the effectiveness of multifaceted health education strategies in improving medication adherence and disease management among children with asthma. Similarly, Omara et al. (2023) investigated the impact of asthma education on asthma severity, ER visits, lung function, and quality of life.

The study by Kassa et al. (2022), however, focused on understanding perceptions and barriers related to asthma management among children, caregivers, and healthcare providers. Samady et al. (2022) evaluated whether interactive inpatient asthma education reduced hospitalizations and emergency department utilization compared to standard education, while Yang et al. (2024) investigated caregiver burden among parents of school-aged children with asthma and identified factors contributing to increased stress and emotional strain. Additionally, Silva-Lavigne et al. (2022) examined the use of serious games as a pediatric asthma education tool, while O’Connor et al. (2023) developed and evaluated an augmented reality educational intervention aimed at improving inhaler technique and asthma knowledge among children.

Sample Populations Comparison

The selected studies varied considerably in sample sizes, population characteristics, and settings. Zhou and Tang (2025) included the largest sample, analyzing data from over 1.5 million children across 164 studies. Yang et al. (2024) also used a relatively large sample of 366 caregivers recruited from pediatric outpatient departments. In contrast, smaller studies such as Silva-Lavigne et al.(2022)  and O’Connor et al. (2023) included only 11 and 16 participants, respectively.

However, most studies targeted school-aged children with asthma and their caregivers, although participant ages differed slightly across studies. For instance, Samady et al. (2022) included children aged 2–16 years hospitalized for asthma exacerbations, while Silva-Lavigne et al. (2022) focused specifically on children aged 8–12 years. Some studies, including Omara et al. (2023) and Lin et al. (2024), recruited participants from outpatient clinics and tertiary pediatric hospitals. These diverse populations provided a comprehensive understanding of pediatric asthma education and management.

Synthesis of the Studies Conclusions

There were four major themes that emerged from analyzing the studies’ conclusions. The first theme was the justification of asthma as a significant public health concern. Zhou and Tang (2025), highlighted the high global prevalence of childhood asthma and identified multiple contributing risk factors, including obesity, parental smoking, family history, and premature birth, reinforcing the importance of ongoing asthma education programs. Additionally, a consistent finding across multiple studies was that structured educational interventions improve asthma management outcomes. Lin et al. (2024), found that multifaceted education strategies significantly improved medication knowledge and disease management compared to standard education. Omara et al. (2023) similarly reported reduced asthma exacerbations, fewer ER visits, improved lung function, and better quality of life following structured asthma education sessions.

Samady et al. (2022) further demonstrated that interactive education reduced hospitalizations and improved inhaler technique and symptom control. Other studies also emphasized the important role caregivers play in asthma management. For instance, studies found that caregivers frequently experience moderate to high emotional, social and practical challenges when managing asthma and physical burden, particularly when children have frequent ER visits or miss school (Kassa et al., 2022; Yang et al., 2024).

Another major theme involved the effectiveness of innovative and interactive educational approaches. Silva-Lavigne et al. (2022) found that serious games improved children’s engagement and reinforced asthma self-management concepts such as medication use and trigger recognition. O’Connor et al. (2023) demonstrated that augmented reality educational tools were highly engaging, easy to use, and effective for teaching inhaler techniques. Similarly, Samady et al. (2022) emphasized that education becomes more effective when it is interactive rather than purely didactic, indicating that technology-based and interactive educational methods may improve learning retention and patient participation.

Limitations

Although the reviewed studies provided valuable insights, several limitations were identified. Many studies used relatively small sample sizes, particularly the qualitative and pilot studies, which limited generalizability. Silva-Lavigne et al. (2022) and O’Connor et al. (2023), for instance, had fewer than 20 participants, making it difficult to apply findings broadly. Some studies lacked control groups or randomization. For example, Omara et al. (2023) used a single-arm prospective design without a comparison group, which may reduce the strength of causal conclusions. Additionally, several studies relied on self-reported questionnaires and participant feedback, increasing the risk of response bias.

Conclusion

The reviewed literature strongly supports the effectiveness of structured asthma education programs for school-aged children and their caregivers. Educational interventions consistently improved asthma knowledge, medication adherence, symptom control, inhaler technique, and quality of life while reducing ER visits and hospitalizations. The findings also highlight the importance of caregiver involvement and interactive/technology-based educational approaches. However, additional research is needed to examine the long-term effectiveness of structured asthma education programs across larger and more diverse populations. Future studies should therefore focus on standardized intervention protocols, long-term follow-up periods, and the integration of culturally sensitive educational approaches.

References

Kassa, E., Kebede, R. A., & Habte, B. M. (2022). Perceptions towards childhood asthma and barriers to its management among patients, caregivers, and healthcare providers: A qualitative study from Ethiopia. BMC Pulmonary Medicine, 22(1), 184. https://doi.org/10.1186/s12890-022-01984-2

Lin, G. Q., Ye, Z. Q., Song, E. L., & Lin, Y. N. (2024). Enhancing pediatric asthma management through multifaceted health education. World Journal of Clinical Cases, 12(19), 3708–3716. https://doi.org/10.12998/wjcc.v12.i19.3708

O’Connor, A., Tai, A., Brinn, M., Hoang, A. N. T. H., Cataldi, D., & Carson-Chahhoud, K. (2023). Co-design of an augmented reality asthma inhaler educational intervention for children: Development and usability study. JMIR Pediatrics and Parenting, 6, e40219. https://doi.org/10.2196/40219

Omara, H. A., Mansour, M. G., & Badr, R. M. (2023). Asthma education and its impact on pediatric asthma severity: A prospective cohort study. The Journal of Asthma, 60(3), 588–599. https://doi.org/10.1080/02770903.2022.2082306

Samady, W., Rodriguez, V. A., Gupta, R., Palac, H., Pongracic, J. A., & Press, V. G. (2022). Interactive inpatient asthma education: A randomized controlled trial. Hospital Pediatrics, 12(3), 239–247. https://doi.org/10.1542/hpeds.2021-006259

Silva-Lavigne, N., Valderrama, A., Pelaez, S., Bransi, M., Balli, F., Gervais, Y., Gaudy, T., & Tse, S. M. (2022). Acceptability of serious games in pediatric asthma education and self-management: Pilot study. JMIR Pediatrics and Parenting, 5(2), e33389. https://doi.org/10.2196/33389

Yang, F., Zhou, J., Xiao, H., Wu, X., Cui, Y., Huang, H., Zheng, S., & Li, H. (2024). Caregiver burden among parents of school-age children with asthma: A cross-sectional study. Frontiers in Public Health, 12, 1368519. https://doi.org/10.3389/fpubh.2024.1368519

Zhou, W., & Tang, J. (2025). Prevalence and risk factors for childhood asthma: A systematic review and meta-analysis. BMC Pediatrics, 25(1), 50. https://link.springer.com/article/10.1186/s12887-025-05409-x

CLICK HERE TO ORDER A PLAGIARISM-FREE PAPER

NRS 465 Topic 6 Benchmark – Literature Review

While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone project change proposal, the literature review enables students to map out and move into the active planning and development stages of the project.

A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the PICOT question from the earlier “PICOT Question” template and information from the “Literature Evaluation Table” assignment to develop a review.

Using eight peer-reviewed articles, write 750-1,000-word review that includes the following sections:

• Introduction section (including PICOT Question)
• A summary of the purpose of the studies
• A comparison of sample populations
• A synthesis of the studies’ conclusions (when looking at all of the studies together, group the conclusions by themes )
• A summary of the limitations of the studies
• A conclusion section, incorporating recommendations for further research

You are required to cite a minimum of eight peer-reviewed articles to complete this assignment. Sources must be published within the past 5 years, appropriate for the assignment criteria, and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

RN-BSN

4.1: Advance the scholarship of nursing.

American Association of Colleges of Nursing Core Competencies for Professional Nursing Education

This assignment aligns to AACN Core Competencies 4.1