Acceptability and feasibility of a novel postural management night-time intervention to improve respiratory health of children and young people with complex neurodisability (Breathe-Easy): proof of concept study
Abstract
OBJECTIVES
Children and young people with complex neurodisability (CYPCN) are at high risk of respiratory illness, frequent hospital admissions and premature death. This study aimed to test the acceptability and feasibility of Breathe-Easy, a novel night-time postural intervention to improve respiratory health in CYPCN.
DESIGN
Case series design incorporating a pre-post interventional study and qualitative study.
SETTING
Intervention conducted at home by parents/carers.
PARTICIPANTS
CYPCN aged 2 to 18 years, dependent on others to move, swallowing difficulties, gastrostomy/jejunostomy, and under care of a respiratory paediatrician.
INTERVENTION
Breathe-Easy protocol included CYPCN lying on a flat bed, three-quarters prone or side-lying using existing night-time positioning equipment. A bile-bag was used to minimise reflux. CYPCN trialled intervention for 6 months.
MAIN OUTCOME MEASURES
Measures of respiratory health and sleep were collected at baseline, three and six months. Semi-structured interviews were conducted with parents, CYPCN, and healthcare professionals post intervention. Data analysis comprised descriptive statistics and thematic analysis.
RESULTS
Eleven CYPCN were recruited; eight completed the trial. We interviewed 5 CYPCN, 9 parents, 8 healthcare professionals, 6 carers and one teaching assistant. Positive views were expressed regarding sleep quality, breathing, secretion management and reduced hospitalisation. Overall improvement in respiratory health and…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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