Effectiveness of a Mastery Learning Education Program for Parents of Children Using Inhaler Therapy in an Emergency Unit

Overview

Respiratory diseases account for a significant proportion of pediatric emergency department admissions, and effective management of respiratory conditions in children is crucial. Inhaler therapy is commonly used due to its rapid action, non-invasive nature, and ease of administration. However, the effectiveness of inhaler therapy largely depends on correct technique and adherence, particularly among children and their parents. Incorrect inhaler use may worsen clinical outcomes and increase respiratory complications. Educational interventions, including structured and technology-based training, have been shown to improve inhaler technique and treatment effectiveness. The aim of this study is to evaluate the effectiveness of a mastery learning-based educational program provided to children receiving inhaler therapy and their parents in a pediatric emergency department.

Study Procedure Phase 1 In the first phase, a validity and reliability study of the Inhaler Therapy Application Checklist, developed to evaluate parents' inhaler administration skills, will be conducted. Validity and reliability data will be collected. After generating the checklist items, the form will be submitted to 10 expert faculty members to evaluate the scientific appropriateness of each item. The Davis technique will be used for expert evaluation. Each item will be rated on a four-point scale as "appropriate," "needs minor revision," "needs major revision," and "not appropriate." Revisions will be made in line with expert feedback, and once all items are considered appropriate, the checklist will be finalized. To determine construct validity, Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) will be performed. Phase 2 In the second phase, data will be collected by the researcher between October 2025 and October 2026 from children and parents who meet the study criteria. Parents and children will be informed about the study, and their participation will be requested. Mothers who agree to participate will complete the Informed Consent Form and the Introductory Information Form. Mothers' initial inhaler administration skills in the emergency department will be evaluated by the researcher using the Inhaler Therapy Application Checklist. In routine hospital education, the placement of the medication into the chamber, positioning of the mask on the face, and operation of the system are explained. Mothers' application skills will be evaluated by the researcher using the Inhaler Therapy Application Checklist during the second inhaler administration following routine nursing education (during the second nebulizer medication administration). Mothers' application skills will be reassessed by the researcher at the 4th-6th hour of hospitalization. Mothers in the intervention group will receive face-to-face practical training before the procedure using a brochure and the inhaler masks used in the hospital. The brochure will be used as a visual educational material to enhance learning effectiveness. Each step of the procedure will be explained using a return-demonstration method, and mothers will be asked to perform all steps practically. The training sessions are planned to last approximately 15-20 minutes. Mothers will be given the opportunity to ask questions, unclear points will be re-explained, and their deficiencies and mistakes will be discussed based on the provided information. Mothers' inhaler administration skills will be evaluated again by the researcher using the Inhaler Therapy Application Checklist during the subsequent inhaler therapy (during the second inhaled medication administration after training). Anxiety levels of mothers in both groups will be assessed by the researcher after the procedure.