Tameling, C.M. (2016) Young Asthma Patients’ Experience and Opinion of the Instruction Inhalation Technique : A qualitative, explorative study. thesis, Medicine.
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Abstract
Summary Background: Inhalation therapy is the cornerstone of asthma management. However, general inhalation technique is poor: 70-80% of patients do not use their inhalers correctly, which is associated with poor asthma control. Inhalation technique instruction improves the inhalation technique. However, even if patients receive an instruction, 50% still has a poor inhalation technique. There is increasing awareness about this, but while different inhalation instruction methods are being developed patients’ opinion of the instruction of inhalation instruction is still unknown. The aim of this study was to evaluate patients’ opinion of the instruction of inhalation technique. Methods: We developed a semi-structured in-depth interview schedule for asthma patients aged 6-45 years. We made different schedules for three age groups (6-16 years, 16-25 years, 25-45 years). The writer of this report performed the interviews until saturation was achieved. The interviews were audio-recorded, transcribed verbatim and analyzed using coding software Nvivo. We video-recorded patients’ inhalation technique. A specialized nurse assessed these video-recordings. We used a background questionnaire, the Asthma Control Questionnaire (ACQ), the Inhaled Corticosteroid Questionnaire short-version (ICQ-S) and asked the patients’ GsP for more information in order to gain more insight in characteristics of our patient population. These data were analyzed using SPSS. Results: 24 asthma patients from eight general practices were interviewed, eight in each age group. Our patient population used nine different inhaler type devices. There was a slight agreement between professionals’ judgment of inhalation technique and patients’ judgment of their own inhalation technique. 75% of the inhaler devices were used incorrectly while 72% of patients thought they used these devices correctly (Kappa -0.096). General asthma control was partially controlled (average total-ACQ scores for different age groups ranged from 0.88-1.19). The data showed that in the two youngest age groups, there appears to be a trend that patients with a worse asthma control (high ACQ) had a more sufficient inhalation technique. Patients’ opinion of instruction of inhalation technique was that every patient should receive a personal inhalation instruction. The overall opinion was that a qualified instructor should give the instruction and should include a hands-on training, explanation of the reasoning behind inhalation technique and feedback. This instruction should be embedded in providing information about asthma and the medication, using airway models. Most patients would like to receive additional information like an application for smartphone or tablet, webpage, video-instruction or instruction leaflet. Patients differ in feeling a need for follow-up of inhalation technique. Most patients would only search for information at the start of inhalation therapy or when questions arise. Conclusion: We obtained a wide variation of experiences and opinions about the instruction of inhalation technique. We obtained many new ideas for improving the instruction of inhalation technique, but the most important, new finding is that patients want to receive information about asthma and medication. Healthcare professionals should explain to the patient the reasoning behind inhalation technique since this helps the patient to understand steps of the inhalation technique and enhances motivation.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisor: and Molen, Prof. dr. T. van der and Daily supervisor: and Metting, Drs. E.I. and Department: General practice, University Medical Centre Gron |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:41 |
| Last Modified: | 25 Jun 2020 10:41 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/240 |
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