门诊氧疗：为何 COPD 患者未按规定使用便携式系统？一项定性研究。
Ambulatory oxygen: why do COPD patients not use their portable systems as prescribed? A qualitative study.
机构信息
School of Health Sciences, Highfield Campus, University of Southampton, Hampshire, UK.
出版信息
BMC Pulm Med. 2011 Feb 11;11:9. doi: 10.1186/1471-2466-11-9.
BACKGROUND
Patients with COPD on long term oxygen therapy frequently do not adhere to their prescription, and they frequently do not use their ambulatory oxygen systems as intended. Reasons for this lack of adherence are not known. The aim of this study was to obtain in-depth information about perceptions and use of prescribed ambulatory oxygen systems from patients with COPD to inform ambulatory oxygen design, prescription and management.
METHODS
A qualitative design was used, involving semi-structured face-to-face interviews informed by a grounded theory approach. Twenty-seven UK community-dwelling COPD patients using NHS prescribed ambulatory systems were recruited. Ambulatory oxygen systems comprised cylinders weighing 3.4 kg, a shoulder bag and nasal cannulae.
RESULTS
Participants reported that they: received no instruction on how to use ambulatory oxygen; were uncertain of the benefits; were afraid the system would run out while they were using it (due to lack of confidence in the cylinder gauge); were embarrassed at being seen with the system in public; and were unable to carry the system because of the cylinder weight. The essential role of carers was also highlighted, as participants with no immediate carers did not use ambulatory oxygen outside the house.
CONCLUSIONS
These participants highlighted previously unreported problems that prevented them from using ambulatory oxygen as prescribed. Our novel findings point to: concerns with the lack of specific information provision; the perceived unreliability of the oxygen system; important carer issues surrounding managing and using ambulatory oxygen equipment. All of these issues, as well as previously reported problems with system weight and patient embarrassment, should be addressed to improve adherence to ambulatory oxygen prescription and enhance the physical and social benefits of maintaining mobility in this patient group. Increased user involvement in both system development and service provision planning, could have avoided many of the difficulties highlighted by this study.
背景
接受长期氧疗的 COPD 患者经常不能遵守医嘱，也不能按预期使用他们的便携式氧气系统。造成这种不依从的原因尚不清楚。本研究旨在从 COPD 患者那里获得有关他们对处方便携式氧气系统的看法和使用的深入信息，以便为便携式氧气系统的设计、处方和管理提供信息。
方法
采用半结构式面对面访谈的定性设计，以扎根理论为指导。招募了 27 名在英国社区居住并使用 NHS 处方的便携式氧气系统的 COPD 患者。便携式氧气系统包括重 3.4 公斤的钢瓶、一个肩背包和鼻插管。
结果
参与者报告说：他们没有接受过如何使用便携式氧气的指导；不确定使用便携式氧气的好处；担心在使用时系统会耗尽（由于对钢瓶量表缺乏信心）；在公共场合被人看到使用系统时感到尴尬；由于钢瓶的重量而无法携带系统。照顾者的重要作用也得到了强调，因为没有直接照顾者的参与者不在家外使用便携式氧气。
结论
这些参与者强调了以前未报告的问题，这些问题阻止了他们按照医嘱使用便携式氧气。我们的新发现表明：对缺乏具体信息提供的关注；对氧气系统不可靠性的看法；在管理和使用便携式氧气设备方面，照顾者的重要问题。所有这些问题，以及以前报告的系统重量和患者尴尬问题，都应该得到解决，以提高对便携式氧气处方的依从性，并增强这组患者保持活动能力的身体和社会益处。增加用户在系统开发和服务提供规划方面的参与，本研究中强调的许多困难本来是可以避免的。
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