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Tæknileg færni og öndun við notkun innöndunartækja hjá einstaklingum með langvinna lungnateppu og astma

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Authors
Anna María Leifsdóttir
Helga Jónsdóttir
Þorbjörg Sóley Ingadóttir
Issue Date
2016

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Other Titles
Capacity to use inhaler devices in individuals with chronic obstructive pulmanary diseas and asthma: technical and breathing capability
Citation
Tímarit hjúkrunarfræðinga 2016, 92(2): 10-18
Abstract
Tilgangur: Innöndunarlyf, gefin með innöndunartækjum, eru kjörmeðferð við langvinnri lungnateppu (LLT) og astma. Ófullnægjandi notkun innöndunartækja, sem innihalda þessi lyf, er hins vegar algengt vandamál. Tilgangur rannsóknarinnar er að lýsa færni einstaklinga með langvinna lungnateppu og astma við notkun innöndunartækja, einkum sjúklinga með langvinna lungnateppu. Aðferð: Í þessari þverskurðarrannsókn var skjólstæðingum með langvinna lungnateppu og astma á 8 heilsugæslu-stöðvum á höfuðborgarsvæðinu og 6 stofum lungnalækna í Læknasetrinu boðin þátttaka. Nýtt mælitæki, Notkun innöndunartækja, var notað í rannsókninni. Mælitækið var útbúið og forprófað af höfundum, fjögurra gilda Likert-kvarði mælir tæknilega færni (5 atriði) og öndun (5 atriði), annars vegar fyrir dufttæki og hins vegar fyrir innúðatæki. Niðurstöður: Þátttakendur (N=125) voru 59 karlmenn og 66 konur. Meðalaldur var 59,5 ár. Alls 100 einstaklingar voru með LLT og 25 með astma. Meirihluti þátttakenda (n=91) notaði innöndunarlyf reglulega, 12 notuðu eftir þörfum og 21 notaði ekki innöndunarlyf. Tvenns konar innöndunartæki voru prófuð, 97 notuðu dufttæki og 31 notaði innúðatæki. Tæknileg færni var fullnægjandi hjá 63% til 100% þátttakenda. Mest var tæknilega færnin í að hrista innúðatæki. Lökust var færnin í að halda innúðatæki eða dufttæki uppréttu við notkun. Öndun var fullnægjandi við notkun hjá 39% til 100% þátttakenda. Allir þátttakendur sátu í æskilegri stöðu við notkun beggja tækjanna. Meira en helmingur þátttakenda tæmdi lungun ekki nægilega vel áður en þeir önduðu lyfi að sér og um helmingur hélt ekki niðri í sér andanum á fullnægjandi hátt eftir lyfjagjöf. Ekki reyndust tengsl á milli bakgrunnsbreyta og tæknilegrar færni og öndunar nema á milli alvarleika sjúkdóms og getu til að anda lyfi djúpt og rólega að sér úr innúðatæki. Ályktanir: Tæknilega færni við notkun innöndunartækja má bæta umtalsvert. Erfiðara er að álykta um möguleika til að bæta öndun þó vísbendingar séu þar um. Rannsóknir og kennslu í notkun innöndunartækja þarf að efla.
Purpose: Inhaler medications is the optimal medical treatment in managing chronic obstructive pulmonary disease (COPD) and asthma. Correct usage of inhaler devices is paramount. However mishandling is common. The aim of the study is to evaluate the capacity of using inhalers among patients with COPD and asthma, focusing on patients with COPD. Method: In this cross-sectional study clients from 8 primary health care centres in the Reykjavik capital area and 6 offices of private lung physicians at Læknasetrið were invited to participate in the study. A new four point Likert scale instrument was developed and pre-tested by the authors. The instrument measures technical (5 items) and breathing capability (5 items), for both dry powder inhaler (DPI) and pressurized metered-dose inhaler (pMDI). Results: Participants were 59 males and 66 females (N=125) with mean age of 59.5 years. The majority (n=100) was diagnosed with COPD and one fifth with asthma (n=25). Most participants (n=91) used inhaler on a daily basis, 12 used inhaler when needed, 21 did not use inhaler. Of the participants 97 used DPI and 31 used pMDI. Full technical capacity was between 63% to 100% on pMDI and DPI. The best aspect of the technical capacity was shaking pMDI. The least technical capacity on both pMDI and DPI was to hold the device upright. Full breathing capability was between 39% and 100%. All of the patients were in optimal position while using pMDI and DPI. More than half did not exhale sufficiently before inhaling and about half of the patients did not hold their breath as prescribed after inhaling. No correlation was between demographic variables and technical and breathing capacity except for the severity of the disease and the capacity to inhale deeply and slowly from pMDI. Conclusions:Technical capacity to use inhaler devices was deficient but might be improved. Deficient breathing capacity was also demonstrated, but improvement might be more difficult to achieve. Further research, along with better patient instructions, are needed.
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Efst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn
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