Maepa H M, Wong M L, Menezes C N
Division of Pulmonology, Department of Internal Medicine, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Afr J Thorac Crit Care Med. 2019 Sep 17;25(3). doi: 10.7196/AJTCCM.2019.v25i3.003. eCollection 2019.
The Global Initiative for Asthma (GINA) estimates that South Africa (SA) has over 3.9 million asthma sufferers, of whom 1.5% die of the condition annually. SA has the world's fourth highest asthma death rate among 5 - 35-year-olds. Chronic obstructive pulmonary disease (COPD) will be the third leading cause of death globally by 2030, and will surpass HIV/AIDS in Africa. Uncontrolled asthma and COPD are frequent causes of emergency department visits and hospital admissions. Poor metered-dose inhaler (MDI) technique is probably a major contributory cause. It is the responsibility of all treating doctors and healthcare professionals to educate patients on inhaled therapy with the correct MDI technique, as well as to routinely check and repeatedly demonstrate the technique to them.
This study evaluated study participants' knowledge of MDI technique, and their compliance in checking and demonstrating MDI use to patients prescribed inhaled therapy. The study participants included doctors, nurses and final-year medical students at Helen Joseph Hospital and Chris Hani Baragwanath Academic Hospital, in the Departments of Internal Medicine and Emergency Medicine, and the Division of Pulmonology.
A total of 195 study participants volunteered to take part in the study. A questionnaire was administered to participants to gauge their perceptions, level of knowledge and understanding of MDI technique. They were then requested to demonstrate correct inhaler technique via a placebo MDI. Participants' use of a placebo MDI was evaluated by a scoring system.
The total sample of 195 comprised 130 (67%) female and 65 (33%) male participants. Of these, 133 (68%) were qualified medical staff, and 62 were final-year medical students. Only 32 (16%) could demonstrate correct MDI technique. Over 50% of participants did not demonstrate MDI technique to patients, or check their patients' technique at every hospital-related visit.
Healthcare professionals and final-year medical students have poor knowledge of inhaler technique and are ill-prepared to teach patients. Also of concern is that the majority do not routinely demonstrate or observe patients' inhaler technique.
全球哮喘防治创议（GINA）估计，南非有超过390万哮喘患者，其中每年有1.5%死于该疾病。在5至35岁人群中，南非的哮喘死亡率在世界上排名第四。到2030年，慢性阻塞性肺疾病（COPD）将成为全球第三大主要死因，并且在非洲将超过艾滋病毒/艾滋病。未得到控制的哮喘和COPD是急诊科就诊和住院的常见原因。定量吸入器（MDI）使用技术欠佳可能是一个主要促成因素。所有治疗医生和医护人员有责任对患者进行正确MDI技术吸入治疗的教育，并定期检查并反复向他们演示该技术。
本研究评估了研究参与者对MDI技术的了解程度，以及他们在为接受吸入治疗的患者检查和演示MDI使用方面的依从性。研究参与者包括海伦·约瑟夫医院和克里斯·哈尼·巴拉干纳特学术医院内科、急诊科和肺病科的医生、护士和医学专业最后一年的学生。
共有195名研究参与者自愿参加该研究。向参与者发放了一份问卷，以评估他们对MDI技术的看法、知识水平和理解程度。然后要求他们通过安慰剂MDI演示正确的吸入器技术。通过评分系统评估参与者对安慰剂MDI的使用情况。
195名参与者的总样本中，女性有130名（67%），男性有65名（33%）。其中，133名（68%）是合格的医务人员，62名是医学专业最后一年的学生。只有32名（16%）能够演示正确的MDI技术。超过50%的参与者没有向患者演示MDI技术，或在每次与医院相关的就诊时检查患者的技术。
医护人员和医学专业最后一年的学生对吸入器技术了解不足，没有做好教授患者的准备。同样令人担忧的是，大多数人没有定期演示或观察患者的吸入器技术。
