Researchers have found that a programme of cognitive behaviour therapy delivered by nurses to children who had asthma and anxiety improved the children's quality of life scores and reduced the risk of escalation of treatment.
Levels of anxiety and hyperventilation in children with asthma fell and their quality of life improved after a course of behaviour therapy from a nurse-led clinic, research has found.
The therapy included techniques such as mindfulness, where children were encouraged to concentrate on the present moment, rather than worry about what might happen or what has happened before.
Basic cognitive restructuring was also used, which involved looking at recurring detrimental thoughts or anxieties experienced by the children and encouraging them to replace them with more positive thoughts. Some of the thoughts children said might increase their anxiety were: 'I don't like people watching me take my inhaler' and 'the ambulance might not come in time'.
Writing in the journal Nursing Children and Young People, the researchers said early identification of the role of anxiety in asthma could prevent unnecessary escalation of treatment, for example overuse of oral steroids, which has side effects.
'The programme seems to be a cost-effective, rapid access service providing a psychological intervention for all children showing a clinical need,' the researchers said. 'The study also highlights the need for all nursing staff to be aware of the detrimental effects of anxiety on asthma control, so early symptoms can be identified and addressed quickly,' they added.
Sessions also included education about anxiety, for example, an explanation of dysfunctional breathing and the physiological effects it can produce, such as symptoms of hyperventilation. Children were subsequently taught rescue breathing exercises and a variety of general relaxation exercises.
The intervention was conducted by a clinical nurse specialist with basic training in behaviour therapy techniques.
The study was a prospective cohort pilot study and included children between seven and 16 years of age with confirmed asthma who had been diagnosed with health-related anxiety by a treating doctor.
- Marriage D, Henderson J. Cognitive behaviour therapy for anxiety in children with asthma. Nursing Children and Young People, 2012
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