喀布尔一家三级保健医院住院患者中呼吸吸入器的误用情况。
Misuse of Respiratory Inhalers Among Hospitalized Patients in a Tertiary Health Care Hospital in Kabul.
机构信息
Department of Pharmacology, Kabul University of Medical Sciences, Kabul, Afghanistan.
Department of Nursing Skills, Aliabad Teaching Hospital, Kabul University of Medical Sciences, Kabul, Afghanistan.
出版信息
Int J Chron Obstruct Pulmon Dis. 2023 Mar 18;18:365-371. doi: 10.2147/COPD.S396019. eCollection 2023.
OBJECTIVE
Evaluation of the techniques of respiratory inhaler use among stable inpatients with COPD in Ali Abad Teaching Hospital.
METHODS
This cross-sectional study was conducted between April 2020 and October 2022 at the cardiopulmonary department of Ali-Abad Teaching Hospital. Participants were requested to demonstrate how to use their prescribed inhalation devices. The inhaler's accuracy was evaluated using checklists that had been previously established and included key procedures.
RESULTS
We studied 318 patients performing a total of 398 inhalation maneuvers with five different IDs. Across all studied inhalation maneuvers, the maximum number of misuses was observed in those using the Respimat (97.7%), and the minimum number of misuses was observed in those using the Accuhaler (58.8%). For the pMDI, the steps "take a deep breath after activating the inhaler" and "hold the breath a few seconds" were most frequently inaccurately performed. Regarding the pMDI with spacer, the steps "exhale fully" were most commonly carried out in mistake. For the Respimat, the steps "hold the breath a few seconds after inhalation activation" and "exhale fully" were most frequently inaccurately performed. According to gender, the misuse was less in females for all studied inhalers (p<0.05). Higher proportion of literate participant correctly used all types of inhalers as compared to the illiterate patients (p<0.05). According to the findings of this study, the majority of patients (77.6%) lacked knowledge of proper inhaler technique.
CONCLUSION
The misuse rates were high for all studied inhalers; however, among studied inhalers, the Accuhaler had the greatest proportion of correct inhalation techniques. In order to ensure proper inhaler technique, patients should be educated before receiving inhaler medicines. Therefore, it is crucial for doctors, nurses, and other healthcare professionals to comprehend the problems with the performance and proper usage of these inhaler devices.
目的
评估 COPD 稳定期住院患者使用呼吸吸入器的技术。
方法
本横断面研究于 2020 年 4 月至 2022 年 10 月在阿里阿巴德教学医院心肺科进行。要求参与者展示如何使用他们规定的吸入装置。使用先前建立的包含关键步骤的检查表评估吸入器的准确性。
结果
我们研究了 318 名患者，总共进行了 398 次使用 5 种不同 ID 的吸入操作。在所有研究的吸入操作中，Respimat 的误用率最高（97.7%），Accuhaler 的误用率最低（58.8%）。对于 pMDI，“在激活吸入器后深吸一口气”和“屏住呼吸几秒钟”这两个步骤最常被错误执行。对于带喷雾器的 pMDI，最常被错误执行的步骤是“完全呼气”。对于 Respimat，“在吸入激活后屏住呼吸几秒钟”和“完全呼气”这两个步骤最常被错误执行。按性别划分，所有研究的吸入器中，女性的误用率都较低（p<0.05）。与文盲患者相比，文化程度较高的参与者正确使用了所有类型的吸入器（p<0.05）。根据本研究的结果，大多数患者（77.6%）缺乏正确使用吸入器技术的知识。
结论
所有研究的吸入器都存在较高的误用率；然而，在研究的吸入器中，Accuhaler 具有最大比例的正确吸入技术。为了确保正确的吸入器技术，在给患者提供吸入药物之前，应该对其进行教育。因此，医生、护士和其他医疗保健专业人员了解这些吸入器装置的性能和正确使用问题至关重要。
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