Indoor Allergens Assessing and Controlling Adverse Health Effects (1993) / Chapter Skim
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8 The Role of Education
8 The Role of Education
Pages 233-245
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From page 233... ...
Education that improves awareness of health risks is basic to disease prevention and health promotion; by disseminating information to health care providers and to patients, prevention of diseases associated with indoor allergens becomes not only realistic but may offer a cost-effective means of reducing morbidity. Many questions remain unanswered, however, as to the best way or ways to disseminate information and provide such education.
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From page 234... ...
Investigators also found increases in peak flow rates; improved attitudes toward asthma, including the perceived ability of patients that they could help control it; and improved selfesteem. The investigators who conducted these studies included both medical and behavioral scientists who had worked together for a number of years on the problems of asthma.
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From page 235... ...
For example, in an educational program consisting of classes conducted in group settings, only 38 percent of a group of Chicago inner-city children with asthma and their families attended one or more of four scheduled classes (Shields et al., 19901. The median household income of these families was 6 percent below the overall city median of Chicago.
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From page 236... ...
Thus, it was unclear if regular assessment of peak flow, adequate inhaled corticosteroids, education of the patient, prevention of acute episodes, regular clinic attendance, or improved adherence to prescribed regimens had separately or collectively contributed to the overall improvement that was noted. Allergen Avoidance and Environmental Control The role of allergen avoidance is a primary method of promoting good health and controlling diseases that are initiated or exacerbated by exposure to indoor allergens.
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From page 237... ...
In general, dust mite allergens will take about 20 minutes to fall after cleaning. MEDIUM TERM OBJECTIVES · Removing carpets from bedrooms makes it much easier to control , .
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From page 238... ...
, there was substantial reduction in bronchial hyperreactivity and medication requirements in 10 children who employed dust mite avoidance measures. The regimen was stringent and included removing carpets and sealing heating ducts, as well as removing from the home animals to which the child had positive allergy skin tests.
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From page 239... ...
Central to the hypothesis that education about allergen avoidance reduces morbidity of respiratory diseases such as asthma is the demonstration of threshold levels of exposure to common indoor allergens in individuals at risk. Recent progress in the immunochemical detection of common indoor allergens such as those associated with cats, dust mites, and cockroaches makes it possible to estimate exposure to these allergens and to begin to define threshold levels of exposure that will cause sensitization and increased symptoms.
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From page 240... ...
A strong experimental foundation underlies self-management methods that have been applied to change a number of health-related behaviors, including substance abuse, smoking, and overeating, and to treat chronic disorders, including diabetes, hypertension, recurrent headache, and chronic pain (Holroyd and Creer, 1986~. With few exceptions, asthma education and self-management programs emphasized instruction provided to patients and assessed the output or outcome measures.
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From page 241... ...
This partnership can be instrumental in helping patients understand asthma, as well as in learning and practicing the skills necessary to manage asthma. Evaluation of the effects of this national education program for physicians and health care professionals awaits its widespread dissemination and acceptance in the medical community.
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From page 242... ...
The basis for early recognition of allergic disease and development of a plan for therapeutic management depends on the appropriate education of the physician. The majority of health care of the allergic patient will be delivered by primary care providers who are also pediatricians, internists, or family practitioners.
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From page 243... ...
As noted, Guidelines for the Diagnosis and Management of Asthma (NHLBI, 1991) presents not only detailed recommendations to diagnose and manage asthma but also emphasizes the importance of education and of identifying causative agents, such as indoor allergens, that may initiate and exacerbate asthma symptoms.
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From page 244... ...
Recommendation: Encourage scientific societies with expertise in allergy, pulmonary medicine, public health, and occupational and environmental medicine to continue to assess and promote the development of primary prevention strategies for allergic disease. Engineers, Architects, and Building Maintenance Personnel As discussed in chapter 7, concerns about the design and operation of heating, ventilation, and air conditioning systems have focussed traditionally on the comfort of the building occupants and the efficiency of the
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From page 245... ...
Improved education in these areas is important to reducing the incidence, prevalence, and severity of adverse health effects associated with indoor environmental exposures. Recommendation: Develop educational processes and accountability procedures for architects, engineers, contractors, and building maintenance personnel with respect to the health implications of the design, construction, and operation of buildings.
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