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Effectiveness of Buteyko Method in Asthma Control and Quality of Life of School-age Children | 1 Effectiveness of Buteyko Method in Asthma Control and Quality of Life of School-age Children Romella C. Lina, Matthew Daniel V. Leysa, Zarah DF. Libozada, Maria Francesca I. Lirio, Angelo A. Liwag, Gabriel D. Ramos, Margaret M. Natividad, RN, M.Ed. College of Nursing, University of Santo Tomas, España, Manila, Philippines 1015 ______________________________________________________________________________ ABSTRACT Background: Asthma affects not only the physiological status of school-age children but also their over- all functional capacity. This may eventually impede personality development if not managed promptly and adequately. Objective: This study aimed to determine the effectiveness of Buteyko Method in improving asthma control and quality of life of school-age children. Methods: This study utilized a pre-test – post test design to measure the changes in asthma control and quality of life after the administration of Buteyko Method. Fourteen (14) subjects diagnosed with bronchial asthma, age 7 - 11 years old participated in the study. They were equally divided into two groups: the control group received no intervention while the experimental group was asked to attend sessions of Buteyko Method lecture and demonstration. The experimental group was visited for three (3) consecutive weeks to monitor their progress and compliance. Moreover, each group was asked to answer ACQ pre- and post-intervention and PAQLQ before the start of the intervention phase and every week during the follow-up visits. Results: In comparing the asthma control pre-test and post-test mean scores of the control group, no significant difference was noted (p=0.177) while the experimental group showed a significant difference after the administration of Buteyko Method (p=0.002). On the contrary, the quality of life pre-test and post-test mean scores of the control group showed no significant difference in any week within one month of follow-up (p=0.736, 0.604, 0.689). On the other hand, the experimental group showed a significant difference on the third visit (p = 0.035) and fourth visit (p=0.002) but no significant difference on the second visit (p=0.111). Conclusion: The use of Buteyko Method within 3-4 weeks as an adjunct to conventional management of asthma helps in improving asthma control and quality of life of school-age children. Keywords: Buteyko Method, Asthma, School-age children, Asthma Control, Quality of life ______________________________________________________________________________ Introduction (Centers for Disease Control and Prevention, Asthma is defined as an 2012). It is considered as a chronic illness inflammatory disease of the airways which affects not only the physiological manifested by coughing, wheezing, status of the patient but also his over-all shortness of breath and chest tightness functional capacity and productivity. In fact, Effectiveness of Buteyko Method in Asthma Control and Quality of Life of School-age Children | 2 approximately 235 million people suffer illness is a punishment for his or his parent’s from asthma and it is the most common sins. They may also view their condition as chronic disease among children (World permanent and may fear that it would Health Organization, 2011). progressively worsen. As a result, their In a recent study on the prevalence misconception about their illness can of asthma in 12 Asia Pacific Countries, de possibly lead to inability to deal with the Guia states that 10.7 million Filipinos are symptoms and to cope on a physical and suffering from asthma and 49% of them psychological level (Theofanidis, 2007). have uncontrolled symptoms. In the In connection to this, it is necessary Philippines, limited reports showed a to give prompt management to adequately prevalence rate of 12% in children aged 13- control asthmatic symptoms and minimize 14 years old and 12-22% in older age groups the occurrence of acute exacerbation; thus, (Mendoza, De la Cruz, Banzon, Ayuyao & preventing its drastic effects from restricting De Guia, 2007). Furthermore, according to the child’s development. This can be American Academy of Allergy Asthma & achieved through pharmacological Immunology (AAAAI), asthma accounts for management and other complementary approximately 500,000 hospitalizations each alternative medicine (CAM) therapy as an year and it is the third-ranking cause of adjunct. An example of CAM therapy is hospitalization among children under 15 Buteyko Method which was developed in years old (United States Environmental Russia in the year 1952 by Dr. Konstantin Protection Agency, 2012). Buteyko who postulated that asthma is The possible effects of asthma to caused by hyperventilation. This technique school-age children are often attributed to aims to train asthmatic clients to reduce restrictions in activity. Considering the fact ventilation by educating them about the that these children are in the phase of proper way of holding their breath at Industry vs. Inferiority according to Erik functional residual capacity and about the Erikson’s Psychosocial Theory, this chronic importance of mouth-taping at night to illness in its acute exacerbation can hinder a increase alveolar and arterial carbon dioxide child’s development as it limits his tension (Cooper, Oborne, Harrison & opportunity to perform his role not only in Tattersfield, 2009). school and at home but also in the With the aforementioned problems, community. Thus, failure to feel a sense of this research study is geared towards accomplishment can result to the determining the effectiveness of Buteyko development of inferiority (Cherry, 2011). Method as a safe nonpharmacotherapeutic Through this stage, the child is also method of alleviating symptoms of asthma expected to acquire and master new skills to decrease treatment costs and to prevent and to assume responsibilities. Occurrence the aggravation of the client’s condition. It of situations such as physical and mental also aims to educate asthmatic clients limitations may lead to the development of a regarding adequate asthma control through sense of inadequacy or failure to feel a sense proper breathing to maximize their of accomplishment (Hockenberry & Wilson, functional capacity and ability to perform 2007). physical activities. In connection to this, the At their young age, children may not researchers aim to determine the be able to comprehend the complexities of effectiveness of Buteyko Method in asthma the diagnosis and treatment. Thus, confusion control and quality of life of school-age may arise and children may think that their children. Effectiveness of Buteyko Method in Asthma Control and Quality of Life of School-age Children | 3 Literature Review 4. Is there a significant difference between the asthma control pre-test Theoretical Framework and post-test scores of the: 4.1. control group? The study utilized Myra Levine’s 4.2. experimental group? Conservation theory as it focuses on 5. What are the quality of life pre-test promoting adaptation and wholeness using mean scores of the control and the principle of conservation of structural, experimental group? personal and social integrity. Conservation 6. Is there a significant difference in the of structural integrity refers to the quality of life pre-test mean scores maintenance and restoration of the body between the control and experimental structure to prevent physical breakdown and to promote group? healing. On the other hand, the conservation 7. What are the quality of life post-test of personal integrity addresses each mean scores of the control and individual as someone who strives for experimental group? recognition, respect, self awareness and self 8. Is there a significant difference determination while the conservation of between the quality of life pre-test and social integrity refers to the preservation of post-test scores of the: human interaction (Fandino, et. al., 2009). In 8.1. control group? connection to this, the research study is 8.2. experimental group? geared towards controlling symptoms of 9. Is there a significant difference asthma to help these school-age children between the asthma control post-test continue performing their role in home, scores of the control and experimental school and community for them to achieve a group? sense of accomplishment despite the 10. Is there a significant difference physical limitations due to their chronic between the quality of life post test- condition. scores of the control and experimental group? Research Questions Research Hypotheses This research study aimed to determine the effectiveness of Buteyko Null hypothesis 1 (H 1): There is no 0 Method in asthma control and in improving significant difference in asthma control pre- the quality of life of school-age children. It test mean scores between the control and sought to answer the following questions: experimental group. 1. What are the asthma control pre-test mean scores of the control and Null hypothesis 2 (H 2): There is no 0 experimental group? significant difference between the asthma 2. Is there a significant difference in the control pre-test and post-test scores of the asthma control pre-test mean scores control group. between the control and experimental group? Null Hypothesis 3 (H 3): There is no 0 3. What are the asthma control post-test significant difference between the asthma mean scores of the control and control pre-test and post-test scores of the experimental group? experimental group. Effectiveness of Buteyko Method in Asthma Control and Quality of Life of School-age Children | 4 Null Hypothesis 4 (H 4): There is no breathlessness, inflammation of airways and 0 significant difference in quality of life pre- increased mucus production. test mean scores between the control and The four cardinal rules of Buteyko experimental group. Method are as follows: (1) keeping the mouth closed; (2) keeping the back straight; Null Hypothesis 5 (H 5): There is no (3) breathing softly and quietly; and, (4) 0 significant difference between the quality of eating only when hungry. life pre-test and post-test scores of the control group. Asthma Null Hypothesis 6 (H 6): There is no Asthma is defined as an 0 significant difference between the quality of inflammatory disease of the airways life pre-test and post-test scores of the manifested by coughing, wheezing, experimental group. shortness of breath and chest tightness (Center for Disease and Control Prevention, Null Hypothesis 7 (H 7): There is no 2012). It is considered as a chronic illness 0 significant difference between the asthma which affects not only the physiological control post-test scores of the control and status of the patient but also his over-all experimental group. functional capacity and productivity. In fact, approximately 235 million people suffer Null Hypothesis 8 (H 8): There is no from asthma and it is the most common 0 significant difference between the quality of chronic disease among children. In the life post test-scores of the control and Philippines, limited reports showed a experimental group. prevalence rate of 12% in children aged 13- 14 years old and 12-22% in older age groups Review of Related Literature (Mendoza, De la Cruz, Banzon, Ayuyao & De Guia, 2007). Asthma affects 235 million Buteyko Method people today and the prevalence is rising (The Global Asthma Report 2011. Paris, Buteyko Method is an alternative France: The International Union Against breathing exercise that can help patients Tuberculosis and Lung Disease, 2011). control the symptoms of asthma (Godfrey, According to asthma statistics compiled by 2010). Buteyko Method was developed by a the American Academy of Allergy Asthma Ukrainian physician named Dr. Konstantin & Immunology (AAAAI), there are about Buteyko in the year 1950. He postulated the 23 million people, including almost 7 "Hyperventilation Theory" which considers million children, having asthma; an average hyperventilation as the primary cause of the of 1 out of every 10 school-aged children disruption in homeostasis. This disruption is has asthma. characterized by an imbalance in the level of When the breathing passages become carbon dioxide in the blood. Carbon dioxide irritated or infected, an attack is triggered. is known to be a smooth muscle relaxant of The attack may occur suddenly or develop both bronchial and arterial walls. Decreased slowly over several days or hours. The main levels of carbon dioxide may lead to a symptoms that signal an attack are myriad of symptoms and conditions wheezing, breathlessness, chest tightness, including exacerbation of asthma such as coughing and difficulty of speaking. bronchial spasm, chest tightness,
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