Ocena znanja pacientov o zdravljenju z neposrednimi oralnimi antikoagulanti : diplomsko delo

Muhič, Anja (author), Kvas, Andreja (mentor), Janša-Trontelj, Katja (comentor), Ovijač, Darja (reviewer)

Uvod: Neposredna oralna antikoagulantna zdravila se uporabljajo za zdravljenje trombembolij in atrijske fibrilacije. Zdravljenje navadno poteka v obliki ambulantne oskrbe, ki od pacienta zahteva prepoznavanje zapletov in pravilno ukrepanje ob njih. Zdravstvena vzgoja je v antikoagulacijski ambulanti prilagojena pacientovi starosti in stopnji izobrazbe. Pacient v procesu zdravstvene vzgoje pridobi znanja, ki mu omogočajo voditi bolezen in živeti z njo. Odnos s pacientom vključuje entuziazem, motivacijo in odzivnost na potrebe pacienta. Namen: Namen raziskave je bil ugotoviti znanje pacientov o zdravljenju z neposrednimi oralnimi antikoagulanti. Metode dela: Z deskriptivno metodo dela smo izvedli presečno študijo s kvantitativnim pristopom. Vzorec so predstavljali pacienti, ki so se z neposrednimi oralnimi antikoagulanti zdravili v antikoagulacijski ambulanti na Polikliniki v Ljubljani. Zbiranje podatkov je bilo izvedeno v letu 2019 z anketnim vprašalnikom. Obdelava podatkov je potekala z računalniškim programom Microsoft Excel 2016, s katerim smo izvedli osnovno statistično analizo ter uporabili test hi-kvadrat. Rezultati: Na vprašanje o časovnem razmiku med posameznimi odmerki je pravilno dogovorilo le 12 % anketiranih. Nizek delež pravilnih odgovorov je bil pri vprašanjih glede ukrepanja ob krvavitvi iz dlesni in prepoznavanja krvavitve iz prebavil. Približno polovica anketirancev je vedela, da je šentjanževka kontraindicirano prehransko dopolnilo in da je cepljenje proti gripi priporočljivo. Višji delež pravilnih odgovorov so imela vprašanja glede ukrepanja ob načrtovanem operativnem posegu, ureznini in pravilnem izboru protibolečinske terapije. 86,7 % anketiranih je poznalo pravilne ukrepe ob dilemi, ali je oseba zdravilo vzela ali ne. Višjo stopnjo znanja so pokazali anketiranci iz mlajše starostne skupine, z višjo stopnjo izobrazbe in anketiranke ženskega spola. Razprava in zaključek: Rezultati raziskave kažejo potrebo po višji stopnji znanja za zagotavljanje varne uporabe zdravil v okviru ambulantne obravnave pacientov, ki se zdravijo z neposrednimi oralnimi antikoagulanti. Identificirali smo področja v sklopu zdravstvene vzgoje, ki jih je treba dodelati, in na katero skupino pacientov glede na demografske dejavnike se je treba še posebej osredotočiti. Zaposleni naj se nenehno izobražujejo in usposabljajo, saj bistvo kakovostne zdravstvene vzgoje predstavljajo dobro poznavanje bolezni, potek zdravljenja ter sposobnost prilagajati se pacientu in njegovim bližnjim.

• Language: Slovenian
• Keywords: diplomska dela, zdravstvena nega, trombembolija, atrijska fibrilacija, zdravljenje, ambulantna oskrba, zdravstvena vzgoja
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [A. Muhič]
• Year: 2020
• Number of pages: 38 str., [2] str. pril.
• PID: 20.500.12556/RUL-117130
• UDC: 616-083
• COBISS.SI-ID: 21056771
• Publication date in RUL: 25.06.2020

Secondary language

• Language: English
• Title: Assessment of patients' knowledge of treatment with direct oral anticoagulants : diploma work

Abstract

Introduction: The direct oral anticoagulants are used to treat thromboembolisms and atrial fibrillation. Treatment is usually performed as outpatient care, which requires the patient to identify complications and act on them properly. Health education is adjusted to the patient's age and level of education. During the process, the patient acquires knowledge which enables them to manage and live with the disease. The relationship between healthcare workers and patients involves enthusiasm, motivation and responsiveness to the patient’s needs. Purpose: The purpose of the research was to determine the level of the patients' knowledge about the treatment with direct oral anticoagulants. Methods: We used the descriptive method of research to perform a cross-sectional study with a quantitative approach. Our sample consisted of the patients who are being treated with the direct oral anticoagulants in the anticoagulation clinic at the Poliklinika Ljubljana. The data was gathered in 2019 with the use of a questionnaire and processed with Microsoft Excel 2016 program. We performed the basic statistical analysis and the chi-square test. Results: On the question regarding the timing between each medication intake, only 12% of respondents answered correctly. There was a low proportion of correct answers to the questions about the management of gum bleeding and identification of gastrointestinal bleeding. Almost half of the respondents knew that St. John's wort is a contraindicated dietary supplement and that influenza vaccination is recommended. More correct answers had questions related to the correct behaviour in case of the planned surgery, management of the incision and correct choice of pain therapy. 87 % of respondents knew what to do when you are not sure whether you have already taken your dose of the medication or not. Younger respondents, women and those with higher level of education showed more knowledge than the rest. Discussion and conclusion: The research reveals the need for a higher level of knowledge to ensure the safe use of direct oral anticoagulants in the outpatient care. We have identified areas within healthcare education that need to be improved and researched which demographic groups require special focus. Healthcare workers have to constantly educate themselves, because having knowledge of the disease, its treatment and the ability to adapt to the patient and his family is the base of a successful health education.

• Keywords: diploma theses, nursing care, thromboembolism, atrial fibrillation, treatment, outpatient care, health education