Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

11-3-2014

Graduate Advisor

Susann Farberman,DNP

Committee

Magnuson, Nancy

Yakimo, Rick

Strunk, Robert

Abstract

Asthma and overweight are two of the most common chronic health problems in children. Data support a relationship between the two health issues. Although asthma is one of the top reasons for hospital admission for children, little is known about the prevalence of overweight and obesity or clinical practice related to weight in children hospitalized for asthma. The purpose of this project was to assess weight characteristics of children admitted with asthma, as well as the current practices of monitoring and management of overweight and obesity in children hospitalized with asthma. A retrospective review of medical records was conducted. The sample consisted of 510 subjects aged 3 to 17 who were admitted to a pediatric hospital in the Midwest with a primary diagnosis of asthma in 2012. ANOVA, Chi-Square and Fisher’s Exact Test were used for analysis. The results showed the weight distribution for the sample to be similar to that of the general population. Age differed statistically by weight group (p < 0.001). Healthy weight participants were younger than overweight participants (p = 0.008) and obese participants (p < 0.001). The relationship of chronic asthma severity and weight group was significant in the older age category (p = 0.033). Comparison of acute severity and weight group was not statistically significant. Documentation of Body Mass Index (BMI) percentile was missing in 493 (96.7%) of the records. Providers documented BMI percentile for 11% of the subjects with obesity but it was not documented for any of the 68 subjects with overweight (0%). Only 5.4% of the subjects with overweight or obesity were given a discharge diagnosis indicating overweight or obesity and only 8.3% received counseling or treatment for weight management. In conclusion, there was significant lack of recognition, diagnosis and treatment of overweight and obesity in children hospitalized with asthma. Asthma severity increased as BMI percentile increased, but only in the older subjects. This study supports the importance of weight recognition and management in the care of children with asthma. The results will be the basis for planning and implementing practice change to improve the care of children hospitalized with asthma who are overweight or obese.

OCLC Number

949680315

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