Delotvornost pravilne inhalacijske tehnike na kvalitet života dece sa bronhijalnom astmom

Uvod: Astma je vodeća hronična bolest kod dece. Pravilna primena postojećih lekova, uz mere kontrole okoline i uz dobru edukovanost, kod većine pacijenata omogućuje postizanje dobre kontrole bolesti. Ciljevi: Primarni cilj ovog istraživanja bio je da se utvrdi uticaj edukacije dece sa astmom na pravilnu upotrebu inhalera. Drugi cilj je bio razumevanje koji aspekti kvaliteta života mogu biti značajno unapređeni posle edukacije i identifikacija faktora koji utiču na nivo unapređenja. Materijal i metode: Studija je opservaciona, prospektivna, po principu panel studije koja je sprovedena tokom 18 meseci ( od januara 2016 do juna 2017 godine. Studija se odvijala kroz tri faze: prva faza ( prva studija preseka), druga faza (faza edukativne intervencije) i treća faza ( druga studija preseka). Studijska populacija (293 deteta i 293 roditelja) je imala dve grupe bolesnika i članova njihovih porodica: 1. prva grupa (interventna grupa) - 147 pacijenata i isto toliko roditelja koji su podvrgnuti edukativnoj intervenciji o pravilnoj upotrebi inhalera i 2. druga grupa (kontrolna grupa) – 146 pacijenata i isto toliko roditelja prema kojima edukativna intervencija nije bila usmerena. Ispitanici su regrutovani iz populacije dece starosti od 7 do 17 godina. Za merenje funkcionalnih problema koji se najčešće javljaju kod dece sa astmom korišćen je The Pediatric Asthma Quality of Life Questionnaire (PAQLQ), a kvalitet života roditelja meren je PACQLQ upitnikom . Test za kontrolu astme (ACT) korišćen je za utvrđivanje stepena kontrole astme. Takođe mereni su i forsirani eksiratorni volumen u 1 sekundi (FEV1) vršni ekspiratorni protok (PEF). Rezultati: Pre obuke najviše je bilo dece sa nekontrolisanom astmom. Nakon obuke značajno je povećan broj pacijenata koji su imali delimično kontrolisanu astmu, dok se broj dece sa nekontrolisanom smanjio sa 80 na 37(χ2= 28,962; p <0,001). Vanredne posete domu zdravlja smanjene su za 19,1%, izostanci iz škole smanjeni za 18,6% posle sprovedene obuke
Introduction: Asthma is a leading chronic disease in children. Proper administration of existing drugs, with environmental controls and good education, allows most patients to achieve good disease control. Objectives: The primary objective of this study was to determine the impact of the education of children with asthma on the proper use of inhalers. The secondary objective was to understand what aspects of quality of life can be significantly improved after education and to identify factors that influence the level of improvement. Material and Methods: The study was conducted as an observational, prospective, panelbased study for 18 months (from January 2016 to June 2017) through three phases: the first phase (first cross-sectional study), the second phase (intervention phase – education), and the third phase (second cross-sectional study). We included a total of 293 children and 293 parents who were divided into two groups. The first group (intervention group) included 147 patients and as many parents who were educated on the proper use of inhalers, while the second group (control group) included 146 patients and as many parents who were not targeted by the educational intervention. Respondents were recruited from a population of children aged 7 to 17 years. The Pediatric Asthma Quality of Life Questionnaire (PAQLQ) was used to measure the functional problems that most commonly occur in children with asthma, and the quality of life of parents was measured by the PACQLQ questionnaire. Asthma Control Test (ACT) was used to determine the degree of asthma control. We also measured the forced expiratory volume in the first second (FEV1) and peak expiratory flow (PEF). Results: At the beginning of the study, the majority of children were with uncontrolled asthma. After education, the number of patients with partially controlled asthma increased significantly, while the number of children with uncontrolled decreased from 80 to 37 (χ2 = 28,962; p <0.001). Unscheduled vis