Anafilaksi tedavisinde epinefrin oto-enjektör kullanımı konusunda ebeveynlerin uyumu: gerçek yaşamdan bir çalışma

Year 2023, Volume: 48 Issue: 1, 234 - 242, 31.03.2023

Mahir Serbes , Ayşe Şenay Şaşihüseyinoğlu , Dilek Özcan , Rabia Miray Kisla Ekinci , Sibel Balcı , Derya Altintas

https://doi.org/10.17826/cumj.1246648

Abstract

Amaç: Bu çalışmanın amacı, ebeveyn(ler)in epinefrin oto-enjektörlerinin (EAI) kullanımına ilişkin pratik becerilerini değerlendirerek ve bunları etkileyen faktörleri belirleyerek anafilaksi yönetimindeki eksikleri belirlemektir.
Gereç ve Yöntem: Çalışma, anafilaktik riski olan ve EAI reçete edilen 114 çocuk hastanın birincil bakıcısını yani ebeveynleri içeriyordu. Ebeveynlerle hem yüz yüze görüşme hem de bir EAI demo cihazı kullanılarak pratik beceri testi uygulanmıştır.
Bulgular: Epinefrin, 93 ebeveyn (%81.6) tarafından anafilaksi için hayat kurtarıcı ve birinci basamak tedavi olarak tanımlandı. Ancak sadece 53 ebeveyn (%46.5) günlük yaşamlarında EAI cihazını düzenli olarak taşıdıklarını belirtti. 38 çocukta (%33.3) tekrarlayan ataklar olduğu saptandı. Bu hastalarda EAI cihazını taşımasına rağmen sadece 6 ebeveynin (%20) EAI cihazını uyguladığı saptandı. Katılımcılara göre AEI'nin düzenli taşınmasını engelleyen ana faktör, gerekliliğe olan inanç eksikliğiydi (18, %29.5). Katılımcılar arasında, ebeveynlerin sadece 13'ü (%11.4) EAI'yi tüm basamaklarda doğru şekilde uygulayabildi. Cihazı kullanma becerisi ile son ziyaretten bu yana geçen süre arasında ters bir ilişki bulundu.
Sonuç: Ebeveynler arasındaki EAI kullanımı konusunda bulunan düşük uyum seviyeleri, bu durumu iyileştirmeye yönelik acil ihtiyacın altını çizmiştir. Ebeveynlere yönelik düzenli EAI doğru kullanım eğitimlerinin yanı sıra psikolojik destek de dahil olmak üzere daha kapsamlı müdahaleler sağlanmalıdır, ancak bu müdahaleler bile gerçek hayatta EAI'lere kazanılmış uyumu sürdürmeyi garanti etmeyebilir.

Keywords

anafilaksi, çocuklar, ebeveynler, epinefrin otoenjektör, uyum

The adherence of parents regarding epinephrine auto-injector use in anaphylaxis management: a real-life study

Abstract

Purpose: The purpose of this study was to identify unmet needs in the management of anaphylaxis by assessing the practical skills of the parent(s) regarding the use of epinephrine auto-injectors (EAIs) and determining the factors influencing them.
Materials and Methods: The study included 114 primary caregivers of children prescribed an EAI with an anaphylaxis risk. A structured mini-interview with a practice test using a trainer device was performed.
Results: Epinephrine was described as a life-saving and first-line treatment for anaphylaxis by 93 parents (81.6%). However, only 53 parents (46.5%) stated that they carry an EIA device with them regularly in their daily lives. 38 children (33.3%) had relapsing episodes, but among those experiencing anaphylaxis, only 6 parents (20%) used EAI despite carrying. According to respondents, the main factor avoiding AEI's regular carriage was a lack of belief in necessity (18, 29.5%). Among participants, only 13 (11.4%) of the parents were able to administer EAI correctly in all 5 steps. An inverse relationship between the ability to use the device and the time elapsed since the last visit s was found.
Conclusion: Low adherence levels among parents highlighted the urgent need to improve this situation. Interventions including regular EAI training and psychological support should be provided among parents, but may not guarantee to maintain acquired adherence to EAIs in real life.

Keywords

anaphylaxis, children, parents, epinephrine auto-injector, adherence

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