Navodila bolnikom s kronično obstruktivno pljučno boleznijo za uporabo vdihovalnikov : diplomsko delo

Ševerkar, Klavdija (author), Bobnar, Albina (mentor), Gogova, Tina (reviewer)

Uvod: Kronična obstruktivna pljučna bolezen je posledica kroničnega vnetja dihalnih poti, ki povzroči zadebelitev sten dihalnih poti, povečano nastajanje sluzi in sčasoma trajne spremembe v strukturi pljuč. Eden od primarnih načinov zdravljenja so zdravila, ki se dajejo preko vdihovalnikov - torej zdravil za vdihovanje. Zdravilo gre neposredno v pljuča, kjer se absorbira in zagotavlja hiter učinek ter zmanjša tveganje za sistemske stranske učinke. Pomembno je, da se vdihovalniki pravilno pripravijo, hranijo, vzdržujejo in jemljejo s pravilno tehniko vdihovanja. Namen: Namen diplomskega dela je ugotoviti, katera zdravila v obliki vdihovalnika uporabljajo bolniki s kronično obstruktivno pljučno boleznijo. Poleg tega smo želeli ugotoviti, ali so napisana farmacevtska navodila za uporabo vdihovalnika usklajena z dokazi podprto teorijo v praksi. Metode dela: V diplomskem delu smo uporabili deskriptivno oziroma opisno metodo dela s pregledom domače in tuje literature. Strokovno in znanstveno literaturo smo iskali po naslednjih podatkovnih bazah: Medline, Science Direct in CINAHL, z iskalnikom PubMed ter na spletnih portalih Google Učenjak in DiKul, v časovnem obdobju med junijem 2022 in septembrom 2022. (Ne)ustreznost farmacevtskih navodil za uporabo vdihovalnikov smo prikazali v preglednicah. Rezultati: Poiskali in analizirali smo 30 farmacevtskih navodil za jemanje zdravil za vdihovanje. Ugotovili smo, da bolniki uporabljajo vdihovalnike s potisnim plinom, suhim prahom in mehko meglo. Najpogosteje sta neustrezno navedena postopka za jemanje, oziroma se ne ujemata s standardi, postopka za počasen izdih pred vdihom zdravila, stran od ustnika ter zadrževanje diha za 10 sekund po vdihu. Večina farmacevtskih navodil ne vsebuje podatka o odmiku vdihovalnika od ust pred izdihom in počasnem izdihu. Najbolj pomanjkljiv ali sploh ni opisan postopek o splahovanju ust po jemanju zdravil z vdihovanjem. Ustrezno navedeni postopki so samo pri vdihovalnikih s suhim prahom z napravo diskus. Razprava in zaključek: Farmacevtska navodila, niso najbolj usklajena s teorijo, ki je podprta z dokazi v praksi. Najučinkovitejša tehnika usposabljanja bolnikov za uporabo različnih vdihovalnikov so verbalna navodila, v kombinaciji z demonstracijo izvajalca in nato vzajemno demonstracijo bolnika. Bolniki in njihovi svojci se ne morejo nanašati zgolj na farmacevtska navodila za uporabo vdihovalnikov, služijo le za obnovitev znanja in kot pomoč pri uporabi v domačem okolju.

• Language: Slovenian
• Keywords: diplomska dela, zdravstvena nega, zdravila za vdihovanje, vdihovalniki, zdravstvena vzgoja bolnikov, tehnika vdihovanja
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [K. Ševerkar]
• Year: 2023
• Number of pages: 41 str., [3] str. pril.
• PID: 20.500.12556/RUL-151226
• UDC: 616-083
• COBISS.SI-ID: 166629123
• Publication date in RUL: 01.10.2023

ŠEVERKAR, Klavdija, 2023, Navodila bolnikom s kronično obstruktivno pljučno boleznijo za uporabo vdihovalnikov : diplomsko delo [online]. Bachelor’s thesis. Ljubljana : K. Ševerkar. [Accessed 17 April 2025]. Retrieved from: https://repozitorij.uni-lj.si/IzpisGradiva.php?lang=eng&id=151226

Secondary language

• Language: English
• Title: Instructions for patients with chronic obstructive pulmonary disease for the use of inhalers : diploma work

Abstract

Introduction: Chronic obstructive pulmonary disease is caused by chronic inflammation of the airways, leading to thickening of the airway walls, increased mucus production and, eventually, permanent changes in the structure of the lungs. One of the primary treatments is medication administered via inhalers - that is, inhaled medicines. The medicine goes directly to the lungs, where it is absorbed, providing a rapid effect and reducing the risk of systemic side-effects. It is important that inhalers are properly prepared, stored, maintained and administered with the correct inhalation technique. Purpose: The purpose of this thesis is to find out which inhaler medications are used by patients with chronic obstructive pulmonary disease. In addition, we wanted to determine whether the written pharmaceutical guidance for inhaler use is consistent with evidence-based theory in practice. Methods: In this thesis, we have used a descriptive or descriptive method of work with a review of domestic and foreign literature. We searched for professional and scientific literature in the following databases: Medline, Science Direct and CINAHL, with the PubMed search engine and on the Google Scholar and DiKul web portals, during the time period between June 2022 and September 2022. The (in)appropriateness of the pharmaceutical instructions for inhaler use was presented in tables. Results: We searched for and analysed 30 pharmaceutical package leaflets for inhaled medicines. We found that patients use inhalers with propellant, dry powder and soft mist. The two most frequently inadequately stated, or not compliant with the standards, administration procedures are to exhale slowly before inhaling the medicine, away from the mouthpiece and to hold the breath for 10 seconds after inhalation. Most pharmaceutical instructions do not include information on moving the inhaler away from the mouth before exhalation and slow exhalation. The procedure for rinsing the mouth after taking inhaled medicines is most lacking or not described at all. Only dry powder inhalers with a disc device have adequately stated procedures. Discussion and conclusion: Pharmaceutical guidance is not the most consistent with evidence-based theory in practice. The most effective technique for training patients to use different inhalers is verbal instructions, combined with a demonstration by the provider and then a reciprocal demonstration by the patient. Patients and their relatives cannot only refer to the pharmaceutical instructions for using inhalers, they only serve to restore knowledge and help with use in the home environment.

• Keywords: diploma theses, nursing care, inhaled medicines, inhalers, patient health education, inhalation technique