J Korean Acad Nurs.  2010 Apr;40(2):202-212. 10.4040/jkan.2010.40.2.202.

Evaluation of an Education Program for Patients with Asthma who use Inhalers

• Lee JK
• Yang YH

• KMID: 987598
• DOI: http://doi.org/10.4040/jkan.2010.40.2.202

Abstract

PURPOSE
This study was done to evaluate the effectiveness of an education program for patients with asthma who use inhalers.
METHODS
The research design for this study was a non-equivalent control group quasi-experimental study. Participants in this study were 36 patients for the control group, and 43 patients for the experimental group. The experimental group participated in the education program. The control group received the usual care. Data were collected before and 1 month and 2 months after the program finished and were analyzed using the SPSS 12.0 program.
RESULTS
The experimental group had significantly higher scores of knowledge of inhalers, and inhalation technique compared to the control group. However, no significant differences were found between two groups for PEFR, asthma instability, and satisfaction with inhalers.
CONCLUSION
According to the results, the education program was effective in improving knowledge of inhalers, and inhalation technique. Therefore, it is recommended that this education program be used in clinical practice as an effective nursing intervention for patients with asthma on inhalers.

Keyword

Asthma; Metered dose inhaler; Education

MeSH Terms

Adult
Aged
Aged, 80 and over
Asthma/*therapy
Female
Health Knowledge, Attitudes, Practice
Humans
Interviews as Topic
Male
*Metered Dose Inhalers
Middle Aged
*Patient Education as Topic
Patient Satisfaction
Peak Expiratory Flow Rate
Program Evaluation
Questionnaires

Figure

• 

  Figure 1 Research design.

Reference

1. Basheti IA, Armour CL, Bosnic-Anticevich SZ, Reddel HK. Evaluation of a novel educational strategy, including inhaler-based reminder labels, to improve asthma inhaler technique. Patient Education and Counseling. 2008. 72:26–33.

2. Basheti IA, Reddel HK, Armour CL, Bosnic-Anticevich SZ. Counseling about turbuhaler technique: Needs assessment and effective strategies for community Pharmacists. Respiratory Care. 2005. 50:617–623.

3. Cohen J. Statistical power analysis for the behavioral science. 1988. 2nd ed. Hillsdale, NJ: Lawrence Erbaum Associates Publishers.

4. Epstein S, Maidenberg A, Hallett D, Khan K, Chapman KR. Patient handling of a dry powder inhaler in clinical practice. Chest. 2001. 120:1480–1484.

5. Fink JB, Rubin BK. Problems with inhaler use: A call for improved clinician and patient education. Respiratory Care. 2005. 50:1360–1375.

6. Giraud V, Roche N. Misuse of corticosteroid metered-dose inhaler is associated with decreased asthma stability. European Respiratory Journal. 2002. 19:246–251.

7. Hilton S. An audit of inhaler technique among asthma patients of 34 general practitioners. British Journal of General Practice. 1990. 40:505–506.

8. Johnson DH, Robart P. Inhaler technique of outpatients in the home. Respiratory Care. 2000. 45:1182–1187.

9. Khassawneh BY, Al-Ali MK, Alzoubi KH, Batarseh MZ, Al-Safi SA, Sharara AM, et al. Handling of inhaler devices in actual pulmonary practice: Metered-dose inhaler versus dry power inhalers. Respiratory Care. 2008. 53:324–328.

10. Kim SG, Jang AS, Kim YK, Lee S, Seo JP, Yang SW, et al. The effect of patient education on correct use of metered dose inhalers in patients with asthma. Journal of Asthma, Allergy and Clinical Immunology. 2000. 20:695–701.

11. Kwak JH, Kwon DY, Han SB, Jeon YJ. Validity of peak expiratory flow for assessing reversible airflow obstruction. Tuberculosis and Respiratory Diseases. 2000. 48:522–529.

12. Kwon MG, Jung HM, Jin YD. The approaches to enhance the efficiency of patient education for chronic respiratory diseases. Journal of Korean Society of Health-System Pharmacists. 2005. 22:19–22.

13. Lee MB. Clinical outcome of educational program using self-monitoring of peak expiratory flow rate for asthma patients. 1999. Seoul: Sookmyung Women's University;Unpublished master's thesis.

14. Luk HH, Chan PM, Lam FF, Lau KY, Chiu SY, Fung YL, et al. Teaching chronic obstructive airway disease patients using a metered-dose inhaler. Chinese Medical Journal. 2006. 119:1669–1672.

15. Markson LE, Vollmer WM, Fitterman L, O'connor E, Narayanan S, Berger M, et al. Insight into patient dissatisfaction with asthma treatment. Archives Internal Medicine. 2001. 161:379–384.

16. Mogil J. Many asthma patients experience persistent symptoms despite appropriate clinical and guideline-based treatment with inhaled corticosteroids. Journal of American Academy of Nurse Practitioners. 2007. 19:459–470.

17. Molimard M, Raherison C, Lignot S, Depont F, Abouelfath A, Moore N. Assessment of handling of inhaler devices in real life: An observational study in 3,811 patients in primary care. Journal of Aerosol Medicine. 2003. 16:249–254.

18. National Health Insurance Corporation. Analysis of patients with environmental disease in 2007. 2009. 01. 19. Retrieved July 20, 2009. from http://www.nhic.or.kr/cms/board/board/Board.jsp?act=VIEW&communityKey=B0070&boardId=489.

19. National Heart, Lung, and Blood Institute. National Asthma Education and Prevention Program Expert Panel Report III: Guidelines for the diagnosis and management of asthma. 2007. 08. 28. Retrieved July 8, 2008. from http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf.

20. Nunn AJ, Gregg I. New regression equations for predicting peak expiratory flow in adults. British Medical Journal. 1989. 298(6680):1068–1070.

21. Park SY, Cho YS, Ji HS, Lee JC, Kim YY, Lee TH, et al. Evaluation of the inhalation performance in patients with asthma. Journal of Asthma, Allergy and Clinical Immunology. 2003. 23:781–787.

22. Prabhakaran L, Lim G, Abisheganaden J, Chee CB, Choo YM. Impact of an asthma education programme on patients' knowledge, inhaler technique and compliance to treatment. Singapore Medical Journal. 2006. 47:225–231.

23. Savage I, Goodyer L. Providing information on metered dose inhaler technique: Is multimedia as effective as print? Family Practice. 2003. 20:552–557.

24. Scarpaci LT, Tsoukleris MG, Mcpherson ML. Assessment of hospice nurses' technique in the use of inhalers and nebulizers. Journal of Palliative Medicine. 2007. 10:665–676.

25. Son HY, Kim MG, Kwon MG, Jung HM, Jin YD. The assessment of the levels of patient satisfaction and the strategy for improvement of education program for patients with respiratory disease in Paik Hospital. Journal of Korean Society of Health-System Pharmacists. 2007. 24:124–130.

26. Song WS, Mullon J, Regan NA, Roth BJ. Instruction of hospitalized patients by respiratory therapists on metered-dose inhaler use leads to decrease in patient errors. Respiratory Care. 2005. 50:1040–1045.

27. Yu SK, Park SI, Park SY, Park JK, Kim SE, Kim JY, et al. The effect of repeated education using a computerized scoring system for the proper use of inhalation medicine. Tuberculosis and Respiratory Diseases. 2007. 63:491–496.