Oláh Máté, Kresznerits Szilvia, Kun Csaba, Perczel-Forintos Dóra, Csánky Eszter, Mészáros Ágnes
Egyetemi Gyógyszertár és Gyógyszerügyi Szervezési Intézet, Semmelweis Egyetem Budapest, Hőgyes Endre u. 9., 1092.
Általános Orvostudományi Kar, Klinikai Pszichológia Tanszék, Semmelweis Egyetem Budapest.
Orv Hetil. 2020 Jan;161(3):95-102. doi: 10.1556/650.2020.31617.
Chronic obstructive pulmonary disease (COPD) is a health burden for the patient and the society. We have sought to find the optimal education content to alleviate this burden. (1) To create patient education content based on the pulmonologists' opinion; (2) to understand the pulmonologists' attitudes and perceptions; (3) to evaluate the options to improve patient adherence. We have performed 20 interviews with pulmonologists working in inpatient, outpatient and rehabilitation settings. The structure of the interviews has been designed to determine the key elements of a patient education programme and to discover perception and therapeutic attitudes. The average COPD patient is a smoker, male, under-socialized, coughs, has dyspnoea and is older than 40 years. He does not take his illness seriously, and seeks medical attention only in case of worsening of the disease, and improvement in adherence is only present in such cases. The latter phenomenon is frequently transient, and limited to worse periods. Three adherence groups can be defined: marginal good adherence (approx. 10%), the average is around 30-40%, and minimal adherence (60%). Correct inhaler use should be taught in maximum three steps, which should be easily reproduced and explained. The aspects defining the framework of the education programme are the adequate patient profile (tailor-making), on-the-spot education in the pulmonology centre, the relationship between the patient and the doctors, patient attitudes and lifestyle changes (smoking cessation), and choosing the adequate inhaler. Orv Hetil. 2020; 161(3): 95-102.
慢性阻塞性肺疾病（COPD）对患者和社会来说都是一项健康负担。我们一直在寻求找到最佳的教育内容以减轻这一负担。（1）根据肺科医生的意见创建患者教育内容；（2）了解肺科医生的态度和看法；（3）评估提高患者依从性的方法。我们对在住院、门诊和康复环境中工作的肺科医生进行了20次访谈。访谈结构旨在确定患者教育计划的关键要素，并发现看法和治疗态度。COPD患者平均为男性吸烟者，社交不足，咳嗽、呼吸困难，年龄超过40岁。他不重视自己的疾病，仅在病情恶化时才寻求医疗帮助，且只有在这种情况下依从性才会提高。后一种现象通常是短暂的，且仅限于病情较重的时期。可以定义三个依从性组：边缘良好依从性（约10%），平均约为30 - 40%，以及最低依从性（60%）。正确使用吸入器应分最多三步进行教授，且应易于重复和解释。教育计划框架的定义要素包括合适的患者概况（量身定制）、在肺科中心进行现场教育、患者与医生的关系、患者态度和生活方式改变（戒烟）以及选择合适的吸入器。《匈牙利医学周报》。2020年；161(3): 95 - 102。
