**3. Results**

#### **3.1 Selection of the studies**

After removing duplicates, 81 articles were screened. Forty-two articles were removed since they were published before 2010. After the analysis of the full-text articles, 17 articles were excluded since they did not meet the inclusion criteria. Finally, 22 articles were included in this literature review.

#### **3.2 Characteristics of the included studies**

**Table 1** shows that 9 studies were randomized controlled trials (RCT). The sample sizes of the reviewed studies ranged from 14 to 167 children with asthma, with a total of 1087 participants. The major target group of the educational interventions was asthmatic school-aged children and their families [13, 15–25]. Some studies included teachers [13], and asthma physicians [20]. Most of the educational sessions were conducted in groups. The duration of sessions varied between 30 and 120 minutes. The assessment time ranged from 2 weeks to 12 months.

The topics discussed in almost 90% of the educational sessions were asthma pathophysiology, triggers identification, symptoms recognition, effective response during exacerbations, asthma action plan, types of asthma medications and their correct use, and communication with care providers [16–25].

Five interventions were conducted by the research team of the trial [16–18, 22, 25]. Other interventions were carried out by a multidisciplinary team [24], and certified educators of asthma [15, 20].

**Table 2** shows the outcomes assessed in each study and their assessment tools. The Pediatric Asthma Quality of Life Questionnaire and the Pediatric Asthma Caregiver Quality of Life Questionnaire were used to assess the QOL of children and their parents in all studies respectively. Different tools were used for symptoms control assessment. The Asthma Control Test (ACT) was commonly used.

#### **3.3 Impact of educational interventions on asthma-related health outcomes**

#### *3.3.1 Quality of life*

As shown in **Table 2**, five studies assessed the QOL of children with asthma, and three studies assessed the QOL of parents. One RCT [25] and two quasiexperimental studies [16, 17] referred to family empowerment in school-age children with asthma and their parents. Improved QOL scores were observed after implementing family empowerment interventions in Tunisia, Egypt, and Iran. Furthermore, the "Healthy Breathing Program" implemented by Grover and colleagues in children with asthma aged 7–12 years and their parents in India led to a significant improvement in the QOL scores of parents at six-month follow-up in the intervention group (p < .001) [18]. Similarly, the self-care education program contributed to improved QOL scores of children in Iran [23]. Montalbano et al. conducted a therapeutic asthma education that combines a multidisciplinary education with a smartphone application in school-age children with asthma and their parents in Italy. The program contributed to higher scores of QOL in the intervention and the control group at the three-month follow-up (Intervention group, p = .014; Control group, p = .046) [24].


### *Effect of Family Education on Clinical Outcomes in Children with Asthma: A Review DOI: http://dx.doi.org/10.5772/intechopen.105205*

*New Perspectives on Asthma*


*Effect of Family Education on Clinical Outcomes in Children with Asthma: A Review DOI: http://dx.doi.org/10.5772/intechopen.105205*


*New Perspectives on Asthma*


*Effect of Family Education on Clinical Outcomes in Children with Asthma: A Review DOI: http://dx.doi.org/10.5772/intechopen.105205*

**Table 1.**

 *Description of the characteristics of family asthma educational interventions.*


#### *New Perspectives on Asthma*

