The Effects of Inhaler Training on Self-Efficacy in Chronic Obstructive Pulmonary Disease Patients

Yıl 2023, Cilt: 26 Sayı: 1, 9 - 17, 29.03.2023

Derya Şimşekli Bakırhan , Yeliz Akkuş

https://doi.org/10.5152/JANHS.2023.221939

Öz

Objective: This study investigated the effects of 3 different inhaler use training methods on the self-efficacy of chronic obstructive pulmonary disease patients.

Methods: Between December 2017 and November 2018, a quasi-experimental study with a pretest and posttest was conducted with 120 patients in a public hospital. The patients were divided
into 3 groups according to their training methods. Data were collected using a patient information form, an inhaler use checklist, and the Chronic Obstructive Pulmonary Disease Self-Efficacy
Scale. The first group was trained using the show and perform method, the second group watched videos on inhaler use, and the third group was trained using a sample training material. After each training session, the participants were observed using inhalers to evaluate their performance.

Results: The differences between the mean pretest and posttest Chronic Obstructive Pulmonary Disease Self-Efficacy Scale total scores and subscale scores of the groups were statistically significant (P < .05). In terms of the types of inhalers, the users of pressurized metered-dose inhalers had the lowest mean scores (group 1: 5.8 ± 1.6, group 2: 5.1 ± 1.1, group 3: 5.0 ± 1.1). There was a
significant increase in the use of the pressurized metered-dose inhaler, Aerolizer, HandiHaler, and Diskus (P < .05).

Conclusion: Inhalation training given to chronic obstructive pulmonary disease patients using 3 different methods increased their self-efficacy, but there was no significant difference between
the training groups.

Anahtar Kelimeler

COPD, inhalers, self-efficacy

Kronik Obstrüktif Akciğer Hastalarına Verilen İnhaler Eğitiminin Öz-Etkililiğe Etkisi

Öz

Amaç: Bu çalışmada, KOAH hastalarına üç farklı yolla verilen inhaler eğitiminin öz-etkililiğe etkisi araştırıldı.

Yöntemler: Çalışma Aralık 2017-Kasım 2018 tarihleri arasında bir devlet hastanesinden 120 hasta ile ön test son test düzeninde yarı deneysel olarak yürütüldü. Hastalar eğitim yöntemlerine göre
üç gruba ayrıldı. Veriler hasta tanıtım formu, inhaler kullanım kontrol listesi ve KOAH öz-etkililik ölçeği ile toplandı. Birinci gruba gösterip yaptırma, ikinci gruba video izletilmesi ve üçüncü gruba
örnek eğitim materyali ile eğitim verildi. Her eğitim seansı sonrasında katılımcıların inhaler kullanımı gözlendi.

Bulgular: Eğitim öncesi ve sonrası gruplar arası KOAH Öz-etkililik ölçek toplam ve alt boyutları ortalamaları karşılaştırıldığında her üç grupta da eğitim sonrası öz-etkililik toplam puanı ve alt
boyut ortalamasındaki artışın istatistiksel olarak anlamlı olduğu saptanmıştır (P < ,05). Eğitim öncesi ve sonrası inhaler puan ortalamalarına bakıldığında en düşük puan ortalamasının ölçülü
doz inhaler kullanıcılarına ait olduğu bulunmuştur (1.grup: 5,8 ± 1,6, 2.grup: 5,1 ± 1,1, 3.grup: 5,0 ± 1,1) Eğitim sonrasında ölçülü doz inhaler, aerolizer, handihaler ve discus kullanım basamaklarında
anlamlı artış olmuştur (P < ,05).

Sonuç: KOAH' lı bireylere üç farklı yolla verilen inhaler eğitiminin öz-etkililik ortalamalarını arttırdığı ancak eğitim yolları arasında fark olmadığı saptanmıştır.

Anahtar Kelimeler

KOAH, inhaler, öz-etkililik

Kaynakça

• 1.Global Initiative for Chronic Obstructive Lung Disease. Pocket guide to COPD diagnosis, management, and prevention. A guide for health care professionals. Global Initiative for Chronic Obstructive Lung Disease; Accessed December 19, 2020. https://goldcopd.org/wpcontent/uploads/2020/12/GOLD-2020-FINAL-ver1.2-03Dec19_WMV.pdf
• 2.Turkish Statistical Institute: 2009-2018 cause of death statistics. Accessed December 19, 2020. https://data.tuik.gov.tr/Bulten/Index?p=Olum-ve-Olum-Nedeni-Istatistikleri-2019-33710
• 3.Klijn SL, Hiligsmann M, Evers SMAA, Román-Rodríguez M, Van Der Molen T, Van Boven JFM. Effectiveness and success factors of educational inhaler technique interventions in asthma & COPD patients: A systematic review. NPJ Prim Care Respir Med. 2017;27(1):24. [CrossRef]
• 4. Özkan ÇG, Kaşıkçı Kara M. Metered dose inhaler using and the role of the nurse in managing of the patient training process. Arch Heal Sci Res. 2015;2(3):355-362.
• 5. Ilic AD, Zugic V, Zvezdin B, et al. Influence of inhaler technique on asthma and COPD control: a multicenter experience. Int J COPD. 2016;11(1):2509-2517.
• 6. Özel F, Çıray Gündüzoğlu N, Durmaz Akyol A. COPD and asthma patients’ skills of using inhaler devices and satisfaction situations. Acıbadem Univ J Heal Sci. 2018;9(3):266-271.
• 7. Hashmi A, Soomro JA, Memon A, Soomro TK. Incorrect inhaler technique compromising quality of life of asthmatic patients. J Medicine. 2012;13(1):16-21. [CrossRef]
• 8. Leiva-Fernández F, Leiva-Fernández J, Zubeldia-Santoyo F, García Ruiz A, Prados-Torres D, Barnestein-Fonseca P. Efficacy of two educational interventions about inhalation techniques in patients with chronic obstructive pulmonary disease (COPD). TECEPOC: study protocol for a partially randomized controlled trial (preference trial). Trials. 2012;13(1):1-8. [CrossRef]
• 9. Aydemir Y. Misuse of inhalation devices-effective parameters and the role of education. Solunum. 2013;15(1):32-38. [CrossRef]
• 10. Luczak-Wozniak K, Dabrowska M, Domagala I, et al. Mishandling of pMDI and DPI inhalers in asthma and COPD – repetitive and nonrepetitive errors. Pulm Pharmacol Ther. 2018;51:65-72. [CrossRef]
• 11. Madkour A, Galal I. Do Egyptian patients use their inhalers correctly? A checklist auditing for inhalation devices usage techniques. Egypt J Chest Dis Tuberc. 2015;64(2):497-504. [CrossRef]
• 12. Ata A, Atik A. Video-sharing websites as an alternative educational environment: YouTube practices in universites. Soc Sci. 2016;11(4):312-325.
• 13. Tomisa G, Horváth A, Dombai B, Tamási L. Characteristics of an optimized patient information material for elderly patients with obstructive pulmonary diseases based on patients’ and experts’ assessment. Multidisciplinary Resp Medi. 2017;12(1):1-8.
• 14. Kara M, Mirici A. The validity and reliability of Turkish form of the COPD self-efficacy scale. Atatürk Univ Tıp Derg. 2002;34(3):61-66.
• 15. Vatansever Ö, Ünsar S. Determination of medical treatment adherence, self-efficacy levels of patients with essential hypertension and affecting factors. J Cardiovasc Nurs. 2014;5(8):66-74.
• 16. Selzler AM, Moore V, Habash R, et al. The relationship between self-efficacy, functional exercise capacity and physical activity in people with COPD: A systematic review and meta-analyses. COPD J Chronic Obstr Pulm Dis. 2020;0(0):1-10. [CrossRef]
• 17.Kar S, Zengin N. The relation between self-efficacy in patients with chronic obstructive pulmonary disease and caregiver burden. Scand J Caring Sci. 2020;34(3):754-761. [CrossRef]
• 18. Ng WI, Smith GD. Effects of a self-management education program on self-efficacy in patients with COPD: A mixed-methods sequential explanatory designed study. Int J Chron Obstruct Pulmon Dis. 2017;12:2129-2139. [CrossRef]
• 19. Bal Özkaptan B, Kapucu S. Home nursing care with the self-care model improves self-efficacy of patients with chronic obstructive pulmonary disease. Jpn J Nurs Sci. 2016;13(3):365-377. [CrossRef]
• 20. Poureslami I, Kwan S, Lam S, Khan NA, FitzGerald JM. Assessing the effect of culturally specific audiovisual educational interventions on attaining self-management skills for chronic obstructive pulmonary disease in Mandarin- and Cantonese- speaking patients: A randomized controlled trial. Int J Chron Obstruct Pulmon Dis. 2016;11:1811-1822.
• 21. Bourbeau J, Farias R, Li PZ, et al. The Quebec Respiratory Health Education Network: Integrating a model of self-management education in COPD primary care. Chron Respir Dis. 2018;15(2):103-113. [CrossRef]
• 22. Price PC, Jhangiani RS, Chiang ICA. Quasi-experimental research. Resaearch Methods in Psychology; Accessed February 2, 2022. https://ecampusontario.pressbooks.pub/researchmethods/chapter/quasi-experimental-research/
• 23. Siedlecki SL. Quasi-experimental research designs. Clin Nurse Spec. 2020;34(5):198-202. [CrossRef]
• 24. Kocabaş A, Atış S, Çöplü L, et al. Chronic obstructive pulmonary disease (COPD) prevention, diagnosis and treatment report. Turk Thorac Soc. 2014;15:1-76.
• 25. Chrystyn H, Van Der Palen J, Sharma R, et al. Device errors in asthma and COPD: Systematic literature review and meta-analysis. npj Prim Care Respir Med. 2017;27(1):22. [CrossRef]
• 26. Ceyhan YS, Unsal A. Comparison of the self-efficacy level of the people with different chronic diseases. Dokuz Eylul Univ e-Journal Nurs Fac. 2018;11(4):263-273.
• 27. Abedi H, Salimi SJ, Feizi A, Safari S. Effect of self-efficacy enhancement program on self-care behaviors in chronic obstructive pulmonary disease. Iran J Nurs Midwifery Res. 2013;18(5):421-424.
• 28. Kaşıkçı Kara M. Using self-efficacy theory to educate a patient with chronic obstructive pulmonary disease: a case study of 1-year follow up. Int J Nurs Pract. 2011;17(1):1-8. [CrossRef]
• 29. Topçu S, Oğuz S. Self-efficacy and quality of life after stroke. J Hum Sci. 2017;14(2):1388-1396.
• 30. Tanriverdi E, Özmen Süner K, Süner H, Iliaz S, Annakkaya AN. The evaluation of family physicians’ knowledge on the use of inhalation devices. Eurasian J Pulmonol. 2015;17(2):98-102. [CrossRef]
• 31. Ramadan WH, Sarkis AT. Patterns of use of dry powder inhalers versus pressurized metered-dose inhalers devices in adult patients with chronic obstructive pulmonary disease or asthma: an observational comparative study. Chron Respir Dis. 2017;14(3):309-320. [CrossRef]
• 32. Braido F, Chrystyn H, Baiardini I, et al. “Trying, But Failing” — the role of inhaler technique and mode of delivery in respiratory medication adherence. J Allergy Clin Immunol Pract. 2016;4(5):823-832. [CrossRef]
• 33. Ozoglu Aytac S, Kilic Parlar S, Ovayolu N. Effect of inhaler drug education on fatigue, dyspnea severity, and respiratory function tests in patients with COPD. Patient Educ Couns. 2020;103(4):709-716. [CrossRef]
• 34. Başlılar Ş, Şaylan B. Erratum: inhaler device usage skills in patients at pulmonology clinics. Turk J Fam Pract. 2018;22(4):66-77.
• 35. Melani AS, Bonavia M, Cilenti V, et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med. 2011;105(6):930-938. [CrossRef]
• 36. Arora P, Kumar L, Vohra V, et al. Evaluating the technique of using inhalation device in COPD and bronchial asthma patients. Respir Med. 2014;108(7):992-998. [CrossRef]
• 37. Bol P, Gül G, Işık O, Uslu Ö, Erbaycu AE. The assessment of the changes on inhalation drugs: Form, active ingredient, period and causes. Izmir J Chest Dis. 2017;2:73-78.
• 38. Banbury A, Parkinson L, Nancarrow S, Dart J, Gray L, Buckley J. Multisite videoconferencing for home-based education of older people with chronic conditions: The Telehealth Literacy Project. J Telemed Telecare. 2014;20(7):353-359. [CrossRef]
• 39. Stellefson M, Chaney B, Ochipa K, et al. YouTube as a source of chronic obstructive pulmonary disease patient education: A social media content analysis. Chron Respir Dis. 2014;11(2):61-71. [CrossRef]
• 40. Locke ER, Thomas RM, Woo DM, et al. Using video telehealth to facilitate inhaler training in rural patients with obstructive lung disease. Telemed J E Health. 2019;25(3):230-236. [CrossRef]
• 41. Yan Y, Liu L, Zeng J, Zhang L. Evaluation and exploration on the effect of the management of chronic obstructive pulmonary disease in rural areas through an internet-based network consulting room. Med Princ Pract. 2018;27(3):222-226. [CrossRef]