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The matters of patients foreknowledge about inhalant systems.
BLÁHOVÁ, Zdeňka
This bachelor thesis follows up the problems of awareness of patients about inhalation systems. It focuses primarily on who and how the patients are informed about the handeling with inhalation systems, how patients can handle with inhalation systems, which mistakes they are doing, and which inhalation system suits the patients best. It is about patients, who have bronchial asthma of they suffer from chronical obstructive pulmonary disease. The theoretical part deals with bronchial asthma and chronic obstructive pulmonary disease. It focuses on definitions of both asthma and chronic obstructive pulmonary disease. It also deals with their causes, symptoms, classification, diagnosis and treatment. In the next part, this bachelor thesis deals with are inhalation systems, types of inhalation systems, and their handling. At the end of the theoretical part is mentioned the role of the nurse in the education proces of the patient, within the proper handling of the inhalation system. The research part was processed by qualitative research. The data collection technique was semi-structured interview and observation. The interview was made up of 21 questions and the observation was written down in an observation sheet. The research group consisted of 11 patients, 4 of whom had chronical obstructive pulmonary disease and 7 patients had bronchial asthma. It came out from the research that the informations are forwarded to the patients by the doctors. Nurses are not very involved in forwarding informations to the patients, even though they have the necessary competencies to do so. Furthermore, the research had revealed that nurses spend only a few time with patients, in some cases just a few minutes. As part of a doctor's check, it became clear that nurses only control the patient's inhalation technique, only when patients are learning to handle with the inhalation system. Over time, they do not control the inhalation technique of the patients and therefore patients practice their inhalation technique wrong and make mistakes. It has emerged that the most widely used inhalation system is an aerosol dispenser, despite the fact that the powder inhaler is easier to handle. Furthermore,it became clear that patients were the most mistaken in aerosol dispensers. From the research came out, that the patients make the most mistakes, while using aerosol dispensers. The most common mistake are not holding the breath and not shaking the inhaler. With powder inhalers, patients made mistakes too. The fault was mainly in the exhalation through the inhaler, in the small force of the inhalation, and holding the inhalator in wrong position. Based on these results, there was made an helpful information brochure which will help all patients, who can not handle their inhalation system correctly.
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Use of inhalation systems with asthma in connection with nursing
KLEINOVÁ, Irena
Asthma bronchiale is a chronic inflammatory disease of the airways, connected to bronchial hyperactivity leading to shortness of breath, wheezing, chest tightness and cough. It effects people of all age categories and cannot be efficiently cured nor prevented. The incidence ranks this disease among the most common children´s chronic diseases. It affects a significant part of the global population - records say about 300 million people. Its prevalence has dramatically increased over the last 20 years. It is estimated that in 2025 about 400 million people will suffer from asthma. Cornerstones of asthma control are based on early diagnostics, efficient treatment, adherence to lifestyle changes and proper use of inhalation devices. Once the treatment is effective and check-ups and the use of inhalation therapy are regular, the prognosis of asthma is very favourable and it is possible to improve the patient´s quality of life. The control over asthma and its maintenance is the main objective of treatment. This can be achieved by using anti-inflammatory therapy, especially in inhalation form. This Bachelor´s thesis focuses on mapping inhalation systems with patients with asthma bronchiale. To a large extent it deals with the issue of use of inhalation systems, keeping to lifestyle changes and the role of the nurse in asthma-specialized outpatient´s departments. We see the relevance of this topic in the fact that, despite all available literature and medical advice, many asthmatics still make mistakes in the inhalation technique. Wrongly selected inhalation systems or wrongly selected inhalation techniques results in therapeutic failures and problems of patients get worse. This does not maintain control over asthma. The fact that many asthmatics do not know their exact diagnosis and underestimate some symptoms is very alarming. In the introduction, the theoretical part focuses on the definition of the disease. Other chapters include causes and symptoms of asthma, its classification, diagnostics and treatment. It also provides information about the treatment of acute asthma attacks - exacerbation and the role of the nurse in examination of an asthmatic patient. A great part of the thesis deals with inhalation systems, their types and effects. The preparation for the use of manual handheld inhalers and nursing care for the asthmatic patient in outpatient and inpatient care is developed at the end of the theoretical part. The objective of this part was to summarize the current knowledge about this issue. The objective of the Bachelor´s thesis was to map the use of inhalation systems in patients with asthma bronchiale. The following research questions were used: How do nurses inform patients about the use of inhalation systems? What type of inhaler do patients like? What is the nurse´s involvement in the examination of asthmatic patients? What are the most common mistakes in the application with an inhaler? How do asthmatics keep to lifestyle changes? The practical part of the thesis contains the results of qualitative research which was made on the basis of the semi-structured interview. Final interviews were transcribed and subsequently processed by the technique of open coding. The research sample was made of 12 asthmatics and 9 nurses working in selected asthma-specialized outpatient´s departments. With respect to the results found, an information brochure was created - see Annex 7 - which is intended for use by asthmatics. We believe that the results of this thesis will be helpful for asthmatics and increase the interest of experts in this issue and will also address other people willing to take part in its solution.
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