Aile Hekimlerine Yönelik Ofis Spirometresi ve Peak Flow Metre Kullanma Eğitimi Hazırlanması ve Etkinliğinin Değerlendirilmesi
Abstract
Amaç: Kronik obstrüktif akciğer hastalığının (KOAH) ve astımın tanısı, tedavisi ve
izlenmesi aile hekimleri için oldukça önemlidir. Bununla birlikte, Türkiye'de solunum
fonksiyon testlerinin kullanımı yeterli değildir ve spirometrik test sonuçlarının
yorumlanması da eğitim ihtiyacından dolayı yetersizdir. Bu çalışma, aile hekimleri için
ofis spirometresi ve peakflowmetre kullanımı ile ilgili bir eğitim vermeyi ve aile
hekimlerinin solunum sistemi hastalıklarına yaklaşımında yardımcı olmayı
amaçlamaktadır.
Gereç ve Yöntem: Özgün içeriğe sahip bir kurs geliştirildi ve aile hekimlerine
uygulandı. Katılımcılara her kurstan önce ve sonra eğitim içeriğini kapsayan 20
maddelik bir test uygulandı. Kurs programını değerlendirmek için katılımcılardan sözlü
ve yazılı geri bildirim alınmıştır.
Bulgular: Çalışmaya 115 aile hekimi katıldı. Ön test ve son test puanları sırasıyla %
40,39±12,8 ve % 75,22±11,12 idi. Çalışmanın en önemli çıktısı, eğitim öncesi ve
sonrası ortalama test puanlarındaki fark olup, bu durum anlamlı bulunmuştur (p
<0.001).
Sonuç: Bu tür kursların tüm aile hekimlerine yaygınlaştırılmasıyla; solunum
hastalıklarının tanısının kolaylaşması, tedavisinin daha bilinçli yapılması, sağlık
kaynaklarının daha etkili bir biçimde kullanılması ve sağlık çıktılarının iyileşmesi
beklenebilir.
Supporting Institution
TÜBİTAK
Project Number
114S040
References
- 1. Ruppel GL, Enright PL. Pulmonary function testing. Respir Care 2012; 57(1): 165–75. 2. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J 2005; 26(2): 319–38. 3. Ergun S, Yontem M, Yerlikaya A, Ozata A, Uysal K, Kurt H. Influence of dietary oils on liver and blood lipid peroxidation. Saudi Med J 2005; 26(3): 442–6. 4. Robert OC. Pulmonary-function testing. N Engl J Med 1994; 331(1): 25–30. 5. Bouti K, Benamor J, Bourkadi JE. Predictive regression equations of flowmetric and spirometric peak expiratory flow in healthy Moroccan children. J Clin Diagnostic Res 2017; 11(8): 1–4. 6. Reddel HK, Marks GB, Jenkins CR. When can personal best peak flow be determined for asthma action plans? Thorax 2004; 59(11): 922–4. 7. Guendelman S, Meade K, Benson M, Chen YQ, Samuels S. Improving asthma outcomes and self-management behaviors of inner-city children: A randomized trial of the Health Buddy interactive device and an asthma diary. Arch Pediatr Adolesc Med 2002; 156(2): 114–20. 8. Sağlık Bakanlığı. Sağlık Bakanlığı Hastalık Yükü Final Raporu. 2005. 9. Faul F, ErdFelder E, Lang A-G, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007; 39(2): 1149–60. 10. Represas-Represas C, Botana-Rial M, Leiro-Fernandez V, Gonzalez-Silva AI, Garcia-Martinez A, Fernandez-Villar A. Short- and Long-Term Effectiveness of a Supervised Training Program in Spirometry Use for Primary Care Professionals. Arch Bronconeumol 2013; 49(9): 378–82. 11. Derom E, Van Weel C, Liistro G, Buffels J, Schermer T, Lammers E, et al. Primary care spirometry. Eur Respir J 2008; 31(1): 197–203. 12. Masa JF, González MT, Pereira R, Mota M, Riesco JA, Corral J, et al. Validity of spirometry performed online. Eur Respir J 2011; 37(4): 911–8. 13. Burgos F, Disdier C, De Santamaria EL, Galdiz B, Roger N, Rivera ML, et al. Telemedicine enhances quality of forced spirometry in primary care. Eur Respir J 2012; 39(6): 1313–8. 14. Carr R, Telford V, Waters G. Impact of an educational intervention on the quality of spirometry performance in a general practice: An audit. Prim Care Respir J 2011; 20(2): 210–3. 15. Söğüt A, Çayır Y, Çayır A, Turan Mİ, Çankaya CH VS. Aile Hekimlerinin Astım Hastalarını Yönetme Becerisi ve Eğitim İhtiyacı. Eurasian J Fam Med 2014; 3(1): 21–6. 16. Walker PP, Mitchell P, Diamantea F, Warburton CJ, Davies L. Effect of primary-care spirometry on the diagnosis and management of COPD. Eur Respir J 2006; 28(5): 942–52. 17. Yu WC, Fu SN, Tai ELB, Yeung YC, Kwong KC, Chang Y, et al. Spirometry is underused in the diagnosis and monitoring of patients with chronic obstructive pulmonary disease (COPD). Int J COPD 2013; 8: 389–95. 18. Miravitlles M, Andreu I, Romero Y, Sitjar S, Alteś A, Anton E. Difficulties in differential diagnosis of COPD and asthma in primary care. Br J Gen Pract 2012; 62(595): 68–75. 19. Llauger Roselló MA, Pou MA, Domínguez L, Freixas M, Valverde P, Valero C. Treating COPD in Chronic Patients in a Primary-Care Setting. Arch Bronconeumol 2011; 47(11): 561–70. 20. Hueto J, Cebollero P, Pascal I, Cascante JA, Eguía VM, Teruel F, et al. [Spirometry in primary care in Navarre, Spain]. Arch Bronconeumol 2006; 42: (7326–331). 21. Schermer TR, Jacobs JE, Chavannes NH, Hartman J, Folgering HT, Bottema BJ, et al. Validity of spirometric testing in a general practice population of patients with chronic obstructive pulmonary disease (COPD). Thorax 2003; 58(10): 861–6. 22. Poels PJP, Schermer TRJ, Thoonen BPA, Jacobs JE, Akkermans RP, De Vries Robbé PF, et al. Spirometry expert support in family practice: A cluster-randomised trial. Prim Care Respir J 2009; 18(3): 189–97. 23. Eaton T, Withy S, Garrett JE, Mercer J, Whitlock RML, Rea HH. Spirometry in primary care practice: The importance of quality assurance and the impact of spirometry workshops. Chest 1999; 116(2): 416–23. 24. Pruitt WC. Teaching your patient to use a peak flowmeter. Nursing (Lond) 2005; 35(3): 54–5. 25. Ayala GX, Gillette C, Williams D, Davis S, Yeatts KB, Carpenter DM, et al. A prospective examination of asthma symptom monitoring: Provider, caregiver and pediatric patient influences on peak flow meter use. J Asthma 2014; 51(1): 84–90. 26. Bursch B, Schwankovsky L, Gilbert J, Zeiger R. Construction and validation of four childhood asthma self-management scales: Parent barriers, child and parent self-efficacy, and parent belief in treatment efficacy. J Asthma 1999; 36(1): 115-28.
A Course Proposal on Office Spirometry and Peak Flowmetry Usage for Family Physicians and Evaluation of its Effectiveness
Abstract
Aim: The diagnosis, treatment, and follow-up of chronic
obstructive pulmonary disease (COPD) and asthma are crucial in family
practice. However, the utilization of pulmonary function tests in Turkey is not
sufficient and also the interpretation of spirometric test results is not
adequate due to lack of knowledge. This study aimed to provide a course on
using office spirometry and peak flowmetry for family physicians and helping
them become competent in approaching the respiratory system.
Methods: A course with unique content was developed and
administered to family physicians. A 20-item test covering the educational
content was applied to the participants before and after each course. Oral and
written feedback was taken from the participants to evaluate the course
program.
Results: 115 family physicians joined the study. Pre-test and
post-test scores were 40.39±12.8% and 75.22±11.12%, respectively. Primary
outcome of the study was the difference in the mean test scores before and
after the trainings, which revealed significant (p<0.001).
Conclusion: Extending this kind of courses to all family physicians
might be useful in facilitating the diagnosis of respiratory diseases, enabling
more conscious diagnoses, and possibly more efficient utilization of the health
resources, leading to better health outcomes.
Project Number
114S040
References
- 1. Ruppel GL, Enright PL. Pulmonary function testing. Respir Care 2012; 57(1): 165–75. 2. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J 2005; 26(2): 319–38. 3. Ergun S, Yontem M, Yerlikaya A, Ozata A, Uysal K, Kurt H. Influence of dietary oils on liver and blood lipid peroxidation. Saudi Med J 2005; 26(3): 442–6. 4. Robert OC. Pulmonary-function testing. N Engl J Med 1994; 331(1): 25–30. 5. Bouti K, Benamor J, Bourkadi JE. Predictive regression equations of flowmetric and spirometric peak expiratory flow in healthy Moroccan children. J Clin Diagnostic Res 2017; 11(8): 1–4. 6. Reddel HK, Marks GB, Jenkins CR. When can personal best peak flow be determined for asthma action plans? Thorax 2004; 59(11): 922–4. 7. Guendelman S, Meade K, Benson M, Chen YQ, Samuels S. Improving asthma outcomes and self-management behaviors of inner-city children: A randomized trial of the Health Buddy interactive device and an asthma diary. Arch Pediatr Adolesc Med 2002; 156(2): 114–20. 8. Sağlık Bakanlığı. Sağlık Bakanlığı Hastalık Yükü Final Raporu. 2005. 9. Faul F, ErdFelder E, Lang A-G, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007; 39(2): 1149–60. 10. Represas-Represas C, Botana-Rial M, Leiro-Fernandez V, Gonzalez-Silva AI, Garcia-Martinez A, Fernandez-Villar A. Short- and Long-Term Effectiveness of a Supervised Training Program in Spirometry Use for Primary Care Professionals. Arch Bronconeumol 2013; 49(9): 378–82. 11. Derom E, Van Weel C, Liistro G, Buffels J, Schermer T, Lammers E, et al. Primary care spirometry. Eur Respir J 2008; 31(1): 197–203. 12. Masa JF, González MT, Pereira R, Mota M, Riesco JA, Corral J, et al. Validity of spirometry performed online. Eur Respir J 2011; 37(4): 911–8. 13. Burgos F, Disdier C, De Santamaria EL, Galdiz B, Roger N, Rivera ML, et al. Telemedicine enhances quality of forced spirometry in primary care. Eur Respir J 2012; 39(6): 1313–8. 14. Carr R, Telford V, Waters G. Impact of an educational intervention on the quality of spirometry performance in a general practice: An audit. Prim Care Respir J 2011; 20(2): 210–3. 15. Söğüt A, Çayır Y, Çayır A, Turan Mİ, Çankaya CH VS. Aile Hekimlerinin Astım Hastalarını Yönetme Becerisi ve Eğitim İhtiyacı. Eurasian J Fam Med 2014; 3(1): 21–6. 16. Walker PP, Mitchell P, Diamantea F, Warburton CJ, Davies L. Effect of primary-care spirometry on the diagnosis and management of COPD. Eur Respir J 2006; 28(5): 942–52. 17. Yu WC, Fu SN, Tai ELB, Yeung YC, Kwong KC, Chang Y, et al. Spirometry is underused in the diagnosis and monitoring of patients with chronic obstructive pulmonary disease (COPD). Int J COPD 2013; 8: 389–95. 18. Miravitlles M, Andreu I, Romero Y, Sitjar S, Alteś A, Anton E. Difficulties in differential diagnosis of COPD and asthma in primary care. Br J Gen Pract 2012; 62(595): 68–75. 19. Llauger Roselló MA, Pou MA, Domínguez L, Freixas M, Valverde P, Valero C. Treating COPD in Chronic Patients in a Primary-Care Setting. Arch Bronconeumol 2011; 47(11): 561–70. 20. Hueto J, Cebollero P, Pascal I, Cascante JA, Eguía VM, Teruel F, et al. [Spirometry in primary care in Navarre, Spain]. Arch Bronconeumol 2006; 42: (7326–331). 21. Schermer TR, Jacobs JE, Chavannes NH, Hartman J, Folgering HT, Bottema BJ, et al. Validity of spirometric testing in a general practice population of patients with chronic obstructive pulmonary disease (COPD). Thorax 2003; 58(10): 861–6. 22. Poels PJP, Schermer TRJ, Thoonen BPA, Jacobs JE, Akkermans RP, De Vries Robbé PF, et al. Spirometry expert support in family practice: A cluster-randomised trial. Prim Care Respir J 2009; 18(3): 189–97. 23. Eaton T, Withy S, Garrett JE, Mercer J, Whitlock RML, Rea HH. Spirometry in primary care practice: The importance of quality assurance and the impact of spirometry workshops. Chest 1999; 116(2): 416–23. 24. Pruitt WC. Teaching your patient to use a peak flowmeter. Nursing (Lond) 2005; 35(3): 54–5. 25. Ayala GX, Gillette C, Williams D, Davis S, Yeatts KB, Carpenter DM, et al. A prospective examination of asthma symptom monitoring: Provider, caregiver and pediatric patient influences on peak flow meter use. J Asthma 2014; 51(1): 84–90. 26. Bursch B, Schwankovsky L, Gilbert J, Zeiger R. Construction and validation of four childhood asthma self-management scales: Parent barriers, child and parent self-efficacy, and parent belief in treatment efficacy. J Asthma 1999; 36(1): 115-28.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Articles |
| Authors | |
| Project Number | 114S040 |
| Publication Date | October 23, 2019 |
| Acceptance Date | September 23, 2019 |
| Published in Issue | Year 2019 |