Alhaddad Bothaina, Taylor Kevin Mg, Robertson Tricia, Watman Geoffrey, Smith Felicity J
Public Authority for Applied Education & Training, College of Health Sciences, Shwaikh, Kuwait.
Department of Pharmaceutics, UCL School of Pharmacy, London, UK.
Eur J Hosp Pharm. 2016 May;23(3):156-160. doi: 10.1136/ejhpharm-2015-000735. Epub 2015 Nov 2.
For many patients with chronic conditions, such as chronic obstructive pulmonary disease (COPD), the assistance of family carers with medicines is vital for optimal treatment outcomes. The aim of this study was to identify the assistance carers provide to patients with COPD using nebuliser-delivered therapy at home, and the problems experienced that may impact on the safety and effectiveness of therapy and contribute to carer burden.
A cross-sectional, qualitative descriptive study was conducted with participants recruited from primary and intermediate care. Home interviews were conducted with 14 carers who assisted a family member with COPD using a nebuliser. Qualitative procedures enabled analysis of nebuliser-related activities and problems experienced by carers.
The carer sample included 10 female and 4 male carers, with a mean age of 61 years: 11 spouses and 3 daughters. They had assisted patients with use of their nebuliser and associated medications for, on average, 4.5 years. Assistance ranged from taking full responsibility for nebuliser use to providing help with particular aspects only when required. Nebuliser-related activities included assembling and setting up equipment, mixing medicines, operating the device, dismantling and cleaning equipment. Difficulties were described with all aspects of care. Carers reported concerns about medication side effects and the lack of information provided.
The study revealed the vital role of carers in enabling effective therapy. The wide-ranging responsibilities assumed by carers and problems experienced relate to all aspects of COPD management with nebulisers, and have a potential impact on treatment outcomes and carer burden. A systematic approach to addressing carers' needs and prioritising support would be anticipated to have positive consequences for patients, carers and health services.
对于许多患有慢性疾病的患者，如慢性阻塞性肺疾病（COPD），家庭护理人员协助用药对于实现最佳治疗效果至关重要。本研究的目的是确定护理人员在家中对使用雾化器治疗的慢性阻塞性肺疾病患者提供的协助，以及所经历的可能影响治疗安全性和有效性并导致护理人员负担的问题。
开展一项横断面定性描述性研究，研究对象从初级和中级护理机构招募。对14名使用雾化器协助家庭成员治疗慢性阻塞性肺疾病的护理人员进行了家访。定性研究方法有助于分析护理人员在雾化器相关活动及遇到的问题。
护理人员样本包括10名女性和4名男性护理人员，平均年龄61岁，其中11名是配偶，3名是女儿。他们平均已协助患者使用雾化器及相关药物4.5年。协助范围从完全负责雾化器的使用到仅在需要时提供特定方面的帮助。雾化器相关活动包括组装和设置设备、调配药物、操作设备、拆卸和清洁设备。护理的各个方面都存在困难。护理人员报告了对药物副作用的担忧以及所提供信息的不足。
该研究揭示了护理人员在实现有效治疗方面的重要作用。护理人员承担的广泛责任及遇到的问题涉及慢性阻塞性肺疾病雾化治疗的各个方面，对治疗效果和护理人员负担可能产生影响。预计采用系统方法满足护理人员需求并优先提供支持将对患者、护理人员和卫生服务产生积极影响。
