Enhancing pediatric asthma management through multifaceted health education

Author contributions: Lin GQ and Ye ZQ designed the research study; Lin GQ, Ye ZQ and Song EL performed the research; Lin GQ, Ye ZQ and Lin YN analyzed the data and wrote the manuscript; Guang-Qun Lin and Zu-Qiong Ye contributed equally to the study; and all authors have read and approve the final manuscript.

Supported by Self-raised project of Health and Health Commission of Guangxi Zhuang Autonomous Region, NO. Z-A20220429, Guangxi Natural Science Foundation, NO. 2020JJA140193.

Corresponding author: Yu-Nan Lin, MD, Chief Doctor, Doctor, Anesthesia & Operation Center, First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangzhong Road, Qingxiu District, Nanning 530021, Guangxi Zhuang Autonomous Region, China. moc.361@nnnanuynil

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Associated Data

All data can be requested by contacting the corresponding author.

Abstract

BACKGROUND

Pediatric asthma is a significant public health issue that impacts the quality of life of children globally. Traditional management approaches focus on symptom control and medication adherence but often overlook the comprehensive educational needs of patients and their families. A multifaceted health education approach may offer a more holistic strategy in managing pediatric asthma, especially in outpatient settings.

AIM

To evaluate the efficacy of a comprehensive health education strategy in improving disease management, medication adherence, and quality of life among children with asthma in outpatient settings.

METHODS

In total, 100 pediatric patients with severe asthma were enrolled from January 2021 to November 2022 and randomly allocated to a control group (n = 50) or an observation group (n = 50). The control group received standard nursing care, including basic nursing interventions and health education upon admission. In contrast, the observation group was exposed to a broad spectrum of health education methodologies, including internet-based hospital systems, social media channels, one-on-one verbal education, informational brochures, slide presentations, telephone check-ins, animated videos, and illustrated health education manuals. Data on asthma management knowledge, symptom control, quality of life [St. George’s Respiratory Questionnaire (SGRQ)], treatment adherence, and nursing satisfaction were collected and analyzed.

RESULTS

CONCLUSION

Implementing a diversified health education approach in pediatric asthma management significantly enhances disease understanding, symptom management, and treatment adherence, leading to improved quality of life for affected children. These findings underscore the importance of multifaceted clinical health education in augmenting disease awareness and facilitating continuous improvements in asthma control rates, highlighting the potential benefits of incorporating comprehensive educational strategies into pediatric asthma care protocols.

Core Tip: This study highlights the benefits of a multifaceted health education approach in pediatric asthma management in outpatient settings. By integrating digital and traditional educational tools, significant improvements in disease knowledge, symptom control, and treatment adherence were observed. The involvement of patients and families is crucial for effective management. Increased nursing satisfaction indicates the acceptability of this comprehensive strategy, suggesting that such educational methods should be integrated into standard care protocols to enhance holistic asthma management.

INTRODUCTION

Asthma is a chronic respiratory disease affecting 8.4% of children. Despite treatment with high-dose inhaled corticosteroids or oral corticosteroids, symptoms persist in 5% of pediatric cases[1]. Asthma is a common pulmonary disorder among children, characterized by symptoms like coughing, wheezing, and dyspnea, which frequently recur. This condition significantly contributes to the morbidity associated with respiratory diseases in children, markedly impairing their physiological health[2]. The occurrence of asthma symptoms during the academic year can severely affect the educational and daily activities of these children[3]. Without proper management, the condition may continue into adulthood, leading to lifelong implications and possibly causing irreversible lung damage[4]. Effective management of pediatric asthma requires continuous and meticulous efforts, based on active engagement from both the affected children and their families, supported by vigilant familial care. Research indicates that the effectiveness of family-centered intervention strategies exceeds that of traditional nursing practices[5]. Within this intervention framework, the role of family support not only supplements professional healthcare but also underscores the importance of a nurturing family environment and a thorough understanding of asthma[6]. This approach includes acquiring essential skills for managing asthma exacerbations and regulating the child’s lifestyle and dietary habits. Therefore, implementing a comprehensive health education model is crucial in the treatment plan for pediatric asthma, highlighting the focus of this study on evaluating the efficacy and outcomes of such an educational approach in managing pediatric outpatient bronchial asthma[5,6].

MATERIALS AND METHODS

General information

A cohort of 100 pediatric patients, presenting with severe asthma and concurrent respiratory failure, were enrolled from the Outpatient Department of First Affiliated Hospital of Guangxi Medical University during the period from January 2021 to November 2022. These participants were randomly allocated into two groups: a control group and an observation group, with each group comprising 50 individuals. The inclusion criteria for this study were as follows: (1) Diagnosis of severe asthma as per established criteria; (2) absence of glucocorticoid hormone therapy within the preceding two months; (3) demonstrated adherence to treatment protocols by the children; (4) established tolerance to the medications used within this study by the children; and (5) respiratory parameters indicating severe respiratory distress, characterized by a partial pressure of carbon dioxide (PaCO₂) exceeding 50 mmHg and an oxygen partial pressure (PaO₂) falling below 60 mmHg. The exclusion criteria were delineated to omit participants with: (1) Any concurrent malignant neoplasms; (2) hematological disorders; (3) immunological diseases; (4) any form of consciousness impairment; and (5) significant organ dysfunction involving the heart, liver, or kidneys. Preliminary analysis revealed no statistically significant disparities between the two groups in terms of demographic and clinical baseline characteristics, including gender distribution, age, duration of asthma, and familial educational background (P > 0.05), as detailed in Table ​ Table1 1 .

Table 1

Comparison of clinical data between the two groups

Methods

The control group underwent standard nursing care, encompassing basic nursing interventions and health education upon admission. Upon discharge, this cohort was provided with verbal guidance regarding medication adherence, lifestyle adjustments, and dietary considerations, followed by scheduled outpatient follow-up appointments.

The observation group was engaged in a multifaceted health education strategy utilizing various platforms and modalities. This included digital platforms such as an internet-based hospital system, social media groups on WeChat, QQ, and Douyin, alongside more traditional methods such as individual oral instruction, informational displays, slide presentations, telephonic follow-ups, animated educational content, and illustrated health education guides.

The process of implementing this comprehensive health education approach for pediatric asthma patients encompassed several key steps. Initially, it involved a thorough review of existing literature on pediatric asthma and consultations with clinicians to understand the pathophysiology of asthma, pharmacodynamics of treatment medications, post-discharge care, and preventive strategies for asthma exacerbation. Nursing staff were engaged from the onset of the patient's admission, undertaking a detailed assessment of the child's condition and ensuring hands-on involvement throughout the entire continuum of care from admission to discharge. This also included collaboration with physicians to optimize the treatment plan and offering nursing insights where appropriate.

Moreover, the development and distribution of educational materials tailored to a lay audience, such as brochures and cartoons explaining asthma management, and the broadcasting of educational short films within hospital premises were emphasized. This strategy aimed to demystify asthma's mechanisms and its management for both the patients and their families, making the information accessible and comprehensible.

A patient and family-centered approach was pivotal, with a focus on understanding and respecting the needs and preferences of the children and their families, acknowledging the significant role of the family in managing pediatric asthma, and addressing any concerns or anxieties they might have. Given China's status as a developing country with generally lower family incomes compared to Western nations, the economic burden on the patients' families was also a critical consideration, emphasizing the need for empathy, respect, and support for their choices.

Post-treatment, the discharge of a patient did not signify the end of care. Nursing staff conducted telephonic follow-ups at suitable intervals post-discharge to monitor the patient's condition, offer support in addressing any challenges, and ensure continued disease management until full recovery. Recognizing that the caregiving role transitions to the parents post-discharge, it was imperative that family members were equipped with essential nursing knowledge, with the nursing staff providing comprehensive education to empower the parents in their new role.

Observation indicators

(1) To ascertain the level of disease comprehension among the family members of the participants, a bespoke asthma health knowledge questionnaire, developed by our institution, was administered both pre- and post-intervention. This assessment covered a spectrum of topics including pharmacological understanding, home-based care, pathology insights, symptom management, preventative strategies, and nutritional guidelines. Each domain was scored on a scale from 0 to 10, where a higher score denoted a more profound awareness of asthma management; (2) The assessment of the pediatric patients' quality of life was conducted using the St. George’s Respiratory Questionnaire (SGRQ)[7] at two junctures: Before and after the intervention. This instrument evaluated three dimensions of health-related quality of life: Symptomatic relief, the impact of the disease on daily activities, and physical mobility, with scores ranging from 0 to 100. A lower score indicated a superior quality of life, reflecting lesser symptom burden and reduced disease impact; (3) Post-intervention, the efficacy of symptom management was quantified in both groups, encompassing the absence of diurnal and nocturnal symptoms, unrestricted activities, and the non-necessity for symptomatic medication. Additionally, adherence to the treatment regimen, including compliance with medication as per physician directives and routine medical follow-ups, was systematically recorded; and (4) Following the intervention, a nursing satisfaction survey, crafted by our hospital, was disseminated to gauge the satisfaction levels of the patients' families regarding various aspects of the nursing care provided. This encompassed the breadth of nursing knowledge imparted, the quality of care delivered, and the extent of professional responsibility demonstrated. The evaluation scale ranged from 0 to 100 for each parameter, with higher scores indicating greater satisfaction. Preliminary validation of this questionnaire yielded a consistency reliability score of 0.89 and a validity coefficient of 0.84, attesting to its robustness and applicability in measuring nursing satisfaction.

Statistical analysis

Data analysis was conducted using SPSS version 23.0. Given that all quantitative variables in this study adhered to a normal distribution, these were presented as mean ± SD. Comparative analyses between groups were performed utilizing either independent sample t-tests or paired t-tests for continuous data. Categorical variables were expressed as frequencies and percentages [n (%)], with inter-group comparisons being facilitated through the application of the Chi-square test or Fisher's exact test, as appropriate. A P-value of less than 0.05 was considered indicative of statistical significance.

RESULTS

Cognition of disease knowledge

Initially, a comparative analysis was conducted focusing on disease awareness. Prior to the intervention, there were no significant differences between the two groups in terms of medication knowledge, home management, disease understanding, symptom management, prophylaxis, healthy diet, and overall scores (P > 0.05). Following the intervention, the observation group exhibited a significantly higher proficiency in medication knowledge compared to the control group, with scores of 8.26 ± 1.47 and 7.62 ± 1.34 respectively (P < 0.05). Furthermore, post-intervention, the observation group demonstrated superior outcomes in home management, disease knowledge, symptom management, prophylaxis, healthy diet, and overall scores, markedly outperforming the control group in these aspects (P < 0.05; Table ​ Table2 2 ).

Table 2

Comparison of disease knowledge cognition between the two groups (mean ± SD, point)

Symptom control

Subsequently, we conducted a detailed investigation into the proportion of symptom control at different times. Following the intervention, the observation group had 39 asymptomatic patients, and the number of patients experiencing no daytime symptoms and no nighttime symptoms being 37 and 36, respectively. The number of patients without movement limitations was 36, and those not requiring palliative medication amounted to 38. These instances of effective symptom control were significantly higher in the observation group compared to the control group (P < 0.05; Table ​ Table3 3 ).

Table 3

compares symptom control between the two groups [n (%)]

SGRQ Score

Regarding the SGRQ scores, before the intervention, there were no statistically significant differences between the two groups in terms of symptom scores, impact scores, activity capability scores, and total scores on the SGRQ scale (P > 0.05). After the intervention, the observation group reported a symptom score of 46.54 ± 8.04, an impact score of 43.74 ± 9.68, and a mobility score of 24.67 ± 5.07. The composite score was 38.32 ± 7.52, all of which were significantly higher than those in the control group (P < 0.05; Table ​ Table4 4 ).

Table 4

Comparison of St. George’s Respiratory Questionnaire scores between the two groups (mean ± SD, point)

Treatment compliance

Subsequently, treatment compliance between the two groups was compared using two indicators: adherence to taking the medicine as directed and undergoing timely reviews. In the observation group, 38 cases complied with taking the medicine as prescribed, and 36 cases participated in timely reviews, which was significantly better than the control group (P > 0.05; Table ​ Table5 5 ).

Table 5

Comparison of treatment compliance between the two groups [n (%)]

Nursing satisfaction

Finally, we assessed patient satisfaction with the intervention measures from three perspectives: comprehensive nursing knowledge, nursing quality, and nursing responsibility. In the observation group, the scores for these indicators were 91.20 ± 7.13, 89.43 ± 5.10, and 87.48 ± 6.32, respectively. In the control group, the scores were 83.31 ± 8.19, 81.16 ± 6.38, and 81.23 ± 5.71, respectively. The data from the observation group were significantly superior to those from the control group (P < 0.01; Table ​ Table6 6 ).

Table 6

Comparison of nursing satisfaction between the two groups (mean ± SD, point)

DISCUSSION

In the realm of nursing, the advent of professional practices in developed nations was relatively delayed, initially dominated by the functional nursing paradigm. This model principally positioned nurses as adjuncts to physicians, executing medical directives and routine tasks without an in-depth comprehension of the patient's condition. Subsequently, this rudimentary approach was superseded by the model of responsibility nursing, which pivots on patient-centric care. Under this regime, a single nurse assumes comprehensive accountability for a patient's care continuum, from admission through to discharge, facilitating a personalized, one-to-one caregiving relationship. This framework not only enhances the nurse's understanding of the patient and their familial context but also fosters a heightened sense of professional responsibility, engendering a rapport akin to friendship between patients, their families, and the nursing staff. Within such a conducive atmosphere, concerted efforts are directed towards the patient's physical well-being, with the nursing process encompassing evaluation, diagnosis, planning, and execution, all centered around the patient and adhering to stringent nursing standards aimed at facilitating patient recovery and augmenting the recognition of nursing efforts by patients and their families[8-10].

The contemporary nursing paradigm has evolved to encompass humanistic care services and modern nursing methodologies, underscoring a "patient-first" ethos. This approach accentuates the intrinsic value of the patient, ensuring respect, and consideration for their personal and medical milieu, thereby rendering more compassionate care services. This evolution of nursing practices has engendered a shift towards diversified health education, a model that emerged amidst the progressive reforms in nursing. Initially introduced by Fond and Luciano in 1972, its foundational principles advocate for the respect of patients and their families, prioritizing the conveyance of health information, honoring the choices of pediatric patients, and emphasizing collaborative dynamics among children, their families, and healthcare providers. This model aims to empower and support, ensuring adaptability in care provision[11-14].

The fundamental principle of diversified health education lies in fostering a collaborative partnership between families and caregivers, aimed at facilitating the recuperation of pediatric patients. This approach is underpinned by several core values: Respect for the patients and their families, provision of robust support systems, adaptability in care strategies, emphasis on cooperative interactions, effective dissemination of health information, empowerment of patients through authorization, and reinforcement of the patients' and families' capacities to manage health challenges[15,16]. (1) Respect entails acknowledging the unique characteristics of each family, which may vary in terms of economic status, cultural heritage, and customs. It is crucial to value the health-related and background information provided by families to the nursing staff, recognizing the diversity and individuality of each familial unit; (2) Support involves fostering a positive familial atmosphere characterized by mutual assistance and emotional solidarity. Nursing professionals should strive to establish a symbiotic support system with the children and their family members, where families endorse the efforts of healthcare professionals, thereby facilitating enhanced care for the pediatric patients; (3) Flexibility requires healthcare professionals to tailor the dissemination of asthma-related knowledge to the specific needs and circumstances of each child's family. This includes understanding the pathology of asthma, nursing interventions during exacerbations, and lifestyle and dietary considerations, ensuring that the selection of information and nursing strategies is adaptable to individual family situations; (4) Cooperation is a pivotal element that distinguishes diversified health education from conventional nursing paradigms. This approach underscores the collaborative dynamics between nursing personnel and families, transcending the traditional model where nurses solely attend to the child's medical needs without engaging with the family unit. Emphasis is placed on the synergy among nursing staff, the child, and the family, facilitating psychological support for the child and fostering a deeper understanding among family members of the challenges faced by medical professionals. This, in turn, encourages adherence to medical advice, potentially enhancing therapeutic outcomes for the child. Unlike traditional nursing models that focus primarily on disease assessment and child care, this approach also considers the broader economic and psychological impacts on the family as a whole; (5) Information sharing is integral to the diversified health education and nursing model, necessitating extensive communication between nursing staff and the families. This exchange encompasses not only the child's health information but also encompasses emotional and background aspects of the family, enabling a more patient-centered and personalized approach to care for both the patient and their family; and (6) Authorization involves granting healthcare professionals increased autonomy in their interactions and collaborative efforts with families, thereby reducing undue skepticism or interrogation from family members. Concurrently, medical personnel are empowered to impart caregiving skills to the family members of pediatric patients, delegating the responsibility of child care to them. This enables parents to competently manage their child's needs post-discharge, applying professional care standards within the home environment. Diversified health education champions a family-centered approach, extending its focus beyond the individual patient to incorporate the integral role played by the family unit in managing pediatric asthma. Through this educational model, families acquire specialized knowledge and skills in asthma care, enhancing their capacity to support their child's health needs. Post-discharge, the function of nursing staff transitions from direct caregivers to providers of medical information and ongoing health support, ensuring continuity of care even after the patient has left the hospital setting. Nursing professionals maintain engagement with the patient and family, conducting regular assessments and advising on the importance of continued medical oversight and hospital visits[17-20].

Pediatric asthma is characterized as a chronic inflammatory disorder of the airways, involving a diverse array of cellular elements such as lymphocytes, eosinophils, and mast cells, with bronchial hyperresponsiveness being a hallmark clinical manifestation. The presentation of asthma in children varies with age and etiological factors. Typically, asthma in younger populations is attributed to infections of the upper respiratory tract, exhibiting a gradual onset, whereas allergen inhalation is a common trigger in older children, leading to a more abrupt onset of symptoms. The initial manifestation often includes an irritating dry cough, progressing to include wheezing of varying intensity. In cases of mild wheezing, patients do not experience significant dyspnea but may exhibit isolated wheezing sounds and notably extended expiratory phases on pulmonary auscultation. In contrast, severe cases are marked by pronounced shortness of breath, agitation, and other distress symptoms, with physical signs including pallor, nail cyanosis, and the distinct presence of the 'tripod sign' indicative of respiratory distress.

Several studies have underscored the pivotal role of comprehensive health education in the recuperation process for pediatric asthma patients. Controlled trials have demonstrated that parents in the intervention cohort, who were engaged through educational seminars, illustrative films, and group discussions, exhibited a marked improvement in the quality of life and psychological well-being of their asthmatic children, as opposed to those receiving standard nursing care. This evidence supports the notion that family involvement in diversified health education exerts a beneficial impact on the management of childhood asthma. Further research has highlighted the efficacy of nursing practices centered on diversified health education in both the prevention and management of pediatric asthma. Comparative analyses between traditional care and innovative approaches incorporating diversified health education and continuous care for children with non-severe asthma have revealed that such integrative strategies can significantly reduce medication dosage, decrease healthcare utilization, shorten hospital stays, and alleviate the financial strain on patient families. In a specific study involving 100 asthmatic children with an average age of 10 years, a two-week intervention focusing on self-management and educational efforts was implemented. Nursing professionals also engaged in active dialogue with family members, prioritizing information dissemination within the household. The findings indicated a superior recovery trajectory in children who underwent the intervention compared to those without such engagement, illustrating the efficacy of nursing interventions in ameliorating pediatric asthma conditions. The study advocates for tailored intervention strategies that consider the unique circumstances of each family, emphasizing the importance of personalized care plans based on a thorough assessment of the child's health and respectful consideration of family preferences. For children with chronic conditions like asthma who possess the cognitive capacity for learning, the intervention content may be expanded to suit individual needs without extending the duration of the intervention, to prevent potential disengagement or resentment from the children and their families[21-22].

Diversified health education is progressively being recognized as a benchmark for evaluating the quality of nursing practices. This holistic approach to nursing, which encompasses a wide array of factors conducive to patient care within the familial context, has demonstrated efficacy in addressing both the physical and psychological aspects of patient health. While the adoption of diversified health education in nursing is more established in international contexts, with numerous publications dedicated to its principles and practices, its inception in China has been relatively recent. Hospitals are encouraged to integrate theoretical knowledge with clinical practice actively, tailoring the application of diversified health education to accommodate the unique socio-cultural landscape of China. This involves deriving empirical insights from practical applications to refine and adapt the theoretical framework of diversified health education, thereby developing a model that resonates with the Chinese populace. Currently, the implementation of diversified health education in nursing is primarily confined to community healthcare settings within China, with its adoption in larger hospital settings not yet widespread or systematically documented. Moreover, even within institutions where diversified health education approaches are employed, there is a lack of standardization across different hospitals. The nursing personnel often lack specialized training in this area, rendering much of the diversified health education initiatives in a nascent and evolving state, yet to reach full maturity and integration into mainstream nursing practice.

The implementation of a diversified health education nursing model can significantly bolster familial support mechanisms, enhance the caliber of nursing care, provide superior humanistic care, alleviate discomfort in pediatric patients, expedite patient recovery, and mitigate parental stress and anxiety. This approach fosters a conducive nurse-patient rapport, thereby augmenting the adherence of patients and their families to prescribed care regimens. Nonetheless, the integration of diversified health education within pediatric nursing encounters several challenges. For instance, in the realm of internal medicine, the absence of definitive diagnoses for numerous conditions and the dynamic nature of therapeutic and nursing interventions complicate the communication of patient status updates by responsible nursing staff. Despite these obstacles, diversified health education remains an efficacious nursing strategy, capable of yielding substantial benefits when adeptly employed. It is imperative for healthcare institutions to focus on the development of familial support structures and the pivotal role of health education, alongside the provision of training and guidance within nursing management frameworks, to fully realize the potential of diversified health education in enhancing patient care outcomes.

Considering the existing clinical environments and the strained nurse-patient dynamics, which hinder the seamless execution of diversified health education initiatives, it is essential for national healthcare authorities to advocate for the broader implementation of diversified health education strategies. This involves disseminating comprehensive information about diversified health education to the public, thereby enhancing societal appreciation for the efforts and commitment of nursing and medical personnel. Such enlightenment is crucial for ameliorating the current nurse-patient tensions. Optimal outcomes are achievable when patients and their families acknowledge and value the dedication of healthcare providers, fostering a collaborative atmosphere conducive to effective treatment. Conversely, this acknowledgment enables healthcare professionals to render services with greater zeal and compassion. A unified approach, akin to a cohesive force, is pivotal in surmounting health challenges. It is anticipated that, with sustained efforts, the diversified health education and nursing model will gain widespread acceptance and endorsement from both patients and their families in the foreseeable future, thereby becoming a mainstay in healthcare practices[23-25].

Therefore, our study is meaningful for the disease management of children with asthma. Based on our findings, we recommend the development of more learning channels for children with asthma in future clinical practice and daily life, particularly in outpatient settings. Healthcare professionals must provide specialized educational materials such as professional knowledge brochures, which are beneficial for both patients and their relatives' learning. Additionally, it is crucial to actively use social channels to access educational content through online health portals, fostering effective interaction.

This study has the following limitations: In terms of sample size and representativeness, the number of participants involved in this study is limited (a total of 100 children), which may affect the generalizability of the results and the statistical power. Additionally, the selection of the sample may have regional characteristics, which may not represent all children with asthma. In terms of data collection and analysis methods: Although multiple evaluation indicators were used, some data relied on subjective reports, such as quality of life scores and satisfaction ratings, which may be influenced by the participants' subjective perceptions. These limitations will be addressed in future studies by expanding the sample size.

CONCLUSION

In summary, the implementation of a diversified health education model in the management of pediatric asthma has been demonstrated to enhance disease understanding and symptom management, bolster adherence to treatment protocols, elevate levels of nursing satisfaction, and contribute to an overall enhancement in the quality of life for affected children. Furthermore, this study acknowledges the multifactorial etiology of asthma exacerbations, underscoring the necessity for reinforced clinical health education initiatives aimed at incrementally augmenting disease awareness and facilitating sustained advancements in the control and management of asthma.

Footnotes

Institutional review board statement: The study was ethically approved by First Affiliated Hospital of Guangxi Medical University.

Informed consent statement: The data used in the study were not involved in the patients’ privacy information, and all patient data obtained, recorded, and managed only used for this study, without any harm to the patient. So the informed consent was waived by the ethics committee of First Affiliated Hospital of Guangxi Medical University.

Conflict-of-interest statement: There are no conflicts of interest involved in this study.

Provenance and peer review: Unsolicited article; Externally peer reviewed.

Peer-review model: Single blind

Specialty type: Medicine, research and experimental

Country of origin: China

Peer-review report’s classification

Scientific Quality: Grade C

Novelty: Grade C

Creativity or Innovation: Grade B

Scientific Significance: Grade B

P-Reviewer: Mervat H, Slovakia S-Editor: Lin C L-Editor: A P-Editor: Che XX

Contributor Information

Guang-Qun Lin, Department of Pediatrics, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.

Zu-Qiong Ye, Day Surgery Ward, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.

En-Lian Song, Department of Pediatrics, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.

Yu-Nan Lin, Anesthesia & Operation Center, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China. moc.361@nnnanuynil.

Data sharing statement

All data can be requested by contacting the corresponding author.

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