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 Patricia
Burkhart, Ph.D., R.N., a pediatric nurse and an assistant
professor at the College of Nursing, has used her own
experience as one of those parents to launch her research
program related to promoting children’s asthma
self-management.
According to the Centers for Disease Control and
Prevention (CDC), asthma is the most prevalent chronic
condition among children in the United States, affecting
8.6 million children. Recent statistics tell of an
alarming increase in asthma morbidity and mortality. While
death rates for many diseases are falling, the mortality
rates for children 19 and younger with asthma increased by
78% between 1980 and 1993.
Blame for the increased rates in morbidity and
mortality can be placed on children’s lack of knowledge
regarding self-management, lack of early intervention, and
non-adherence to prescribed treatment regimens.
Practitioners and researchers like Burkhart are directing
their efforts toward resolving these issues.
With health care reform, responsibility for asthma
management has shifted to the patient and the family.
 So
Burkhart’s studies focus on home management of childhood
asthma. Self-management decreases the patient’s
dependence on the health care system, while at the same
time increasing his/her control over the severity and
number of asthmatic episodes. As Burkhart notes, “Even
small improvements in adherence to asthma treatment may be
clinically significant.”
Burkhart examines the efficacy of behavioral
interventions to enhance school-age children’s daily
adherence to peak flow monitoring. Peak flow monitoring is
essential to asthma self-management in order to assess the
existence and severity of airflow obstruction for patients
with persistent asthma. In a randomized, controlled
clinical trial, funded by Glaxo Wellcome, Burkhart
measured adherence to peak flow monitoring using
cutting-edge microprocessor-based technology. The
electronic peak flow meter records the date, time, and
peak flow value.
 As
Burkhart, the first nurse researcher to use a
microprocessor-based peak flow measurement instrument
said, “This is a huge advance over the less accurate
self-report asthma diaries that are generally used. Now
objective data about children’s adherence behaviors can
be gathered electronically.”
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