Adherenca pacientov pri obravnavi z ortozami za spodnje okončine : diplomsko delo

Dominković, Viktorija (author), Levec, Tina (mentor), Fošnarič, Miha (reviewer)

Uvod: Ortotični pripomočki imajo ključno vlogo pri spodbujanju, ohranjanju in krepitvi telesnega in psihičnega zdravja ter dobrega počutja številnih pacientov, ki potrebujejo podporo spodnjih okončin zaradi različnih bolezenskih stanj, ki omejujejo gibanje. Ortoze so ortotični pripomočki, ki so serijsko ali individualno izdelani in prilagojeni spodnji okončini pacienta. Nudijo podporo, nadzor položaja in gibanja sklepa in kompenzirajo šibkost specifičnih mišic. Ortoze se uporabljajo tudi kot zaščita sklepa pred poškodbami, za zdravljenje deformacij in preprečevanje bolečin. Komplianca izraža do kolikšne mere pacientovo ravnanje sledi različnim oblikam predpisane terapije. Pomenska podstava termina izključuje pacientovo avtonomijo in možnost izbire v smislu načrtovanja ali odločanja o lastnem zdravljenju oziroma terapiji. Adherenca je aktiven proces, ki izpostavlja pozitivno in proaktivno pacientovo izbiro pri upoštevanju predpisanega zdravljenja, s tem pa pacient delno prevzema tudi odgovornost za (ne)izboljšanje svojega zdravstvenega stanja. Namen: Namen diplomskega dela je na osnovi pregleda literature ugotoviti in pojasniti razloge za pacientovo nesodelovanje pri ortotični obravnavi z ortozami za spodnje okončine. Metode dela: V diplomskem delu je bila uporabljena deskriptivna metoda dela, kjer smo analizirali izbrano literaturo ter obdelali in primerjali dobljene rezultate. Rezultati: V diplomskem delu smo ob upoštevanju izključitvenih kriterijev analizirali 9 raziskav. V raziskavah je obravnavana adherenca pacientov pri uporabi ortoz za spodnje okončine in razlogi za (ne)uporabo predpisanega pripomočka. Med zaznanimi ovirami neustrezne adherence so neudobnost, teža, estetski izgled, okornost in težavna namestitev. Velik vpliv na pogostost uporabe pa ima tudi komunikacija med pacientom in zdravstvenim osebjem. Razprava in zaključek: Ortotični pripomočki za spodnje okončine pripomorejo k boljšemu delovanju, stabilnosti, položaju okončine, istočasno pa omogočajo razbremenitev in prerazporeditev sil na stopalo, gleženj in koleno. Redna uporaba ortotičnih pripomočkov je odvisna od številnih zdravstvenih, osebnostnih, čustvenih in kognitivnih značilnosti pacienta. Doslednost uporabe predpisanih pripomočkov označujemo s pojmoma komplianca in adherenca, ki označujeta tudi pacientovo avtonomijo v procesu rehabilitacije. Za boljšo adherenco je izjemnega pomena ustrezna komunikacija med pacientom in zdravstvenim timom. Priporočljivo je tudi kontinuirano spremljanje stanja in sprotno prilagajanje pripomočka glede na potrebe in želje pacienta. Rezultati raziskav nakazujejo potrebo po nadaljnjih študijah na večjih vzorcih, na osnovi katerih bi izdelali smernice za povečanje adherence pri pacientih, ki uporabljajo ortoze.

• Language: Slovenian
• Keywords: diplomska dela, ortotika in protetika, adherenca, sodelovanje pacientov, ortoze za spodnje okončine
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [V. Dominković]
• Year: 2023
• Number of pages: 26 str.
• PID: 20.500.12556/RUL-152227
• UDC: 617.3
• COBISS.SI-ID: 171828995
• Publication date in RUL: 12.11.2023

Secondary language

• Language: English
• Title: Adherence of patients in treatment with lower limb orthoses : diploma work

Abstract

Introduction: Orthoses serve a key role in enhancing, maintenance and promotion of physical and mental health along with the general well-being of numerous patients requiring lower limb support. Orthotic devices are either pre-made or custom made and are adjusted to the patient's lower limb. They provide support, control joint stability and movement and compensate for weakness of specific muscles. Orthoses are prescribed for protection of joint injury, treatment of deformities and pain control. The term compliance indicates the extent to which patient's behaviour corresponds with the prescribed therapy, however excluding their autonomy in planning and decision-making about their treatment and therapy. Adherence, on the other hand, is an active process which emphasises the patient's positive and proactive role as well as their responsibility for treatment outcomes. Purpose: The literature review conducted in the diploma work aimed to identify and explain the reasons for patients' non-adherence to the prescribed treatment with lower limb orthoses. Methods: A descriptive research method was applied, and the results of the study were analysed and compared. Results: Nine studies were included in the diploma work which discussed the reasons and barriers to patients' adherence to the prescribed orthoses, the most common of which are discomfort, excessive weight, aesthetic appearance, rigidness, and difficulty to put on. Proper communication between a patient and health providers is of utmost importance to improve the regular use of orthosis. Discussion and conclusion: Orthoses for lower limbs improve the function, stability, functional position of the limb and provide a relief and transfer of forces on foot, ankle, and knee. Adherence with orthoses depends on numerous personal, emotional, and cognitive characteristics of the patient. The extent to which a patient follows the prescribed treatment is described as compliance and adherence. The terms differ in their connotation relating to the level of patient’s autonomy in the rehabilitation process. Patient adherence will be improved by proper therapeutic communication, continuous monitoring of the patient’s condition and adjustment of the device. Results of the study suggest that further studies include larger samples and provide additional guidelines for the work with patients with orthoses.

• Keywords: diploma theses, orthotics and prosthetics, adherence, patient compliance, lower limb orthoses