Paper
Friday, July 11, 2008
Self-Care for Medication Use in Older Patients with Chronic Obstructive Pulmonary Disease
Porntip Malathum, RN, PhD, Ramathibodi School of Nursing, Mahidol University, Bangkok, Thailand, Panida Krainara, RN, MNS, Medical Nursing, Mahidol University, Prachuapkhirikhun, Thailand, Surakit Nathisuwan, PharmD, BCPS, Pharmacy, Mahidol University, Bangkok, Thailand, and Theerasuk Kawamatawong, MD, Medicine, Mahidol University, Bangkok, Thailand.
| Learning Objective #1: To describe self-care for medication use in older patients with chronic obstructive pulmonary disease |
| Learning Objective #2: To describe the basic conditioning factors for medication use according to older patients’ perceptions regarding physical status, family support, and healthcare professional support. |
This descriptive study aims to describe self-care for medication use and related basic factors for medication use. The conceptual framework of the study was developed using Orem's self-care theory. Purposive sampling was used to recruit 70 older persons with chronic obstructive pulmonary disease at the Out-patient Department, Prachuapkhirikhun Hospital, Thailand, from February to April 2007. Findings revealed that most subjects took the right dose of oral medicine and at appropriate times as indicated by the physician's prescription. However, as for inhaled medications, they used a higher number of puffs than indicated. When acute exacerbation occurred, most of them inhaled three to ten puffs or more, before going to the hospital. Most subjects were unable to hold their breath for at least 5-10 seconds nor slowly exhaling. The physical status examination revealed that the number of incisors was positively related to the ability to cover the mouthpiece of the metered dose inhaler, a tremoring hand was related to the low ability to press the canister, and the capacity of pulmonary function was positively associated with the subjects' ability to breathe and hold their breath. The subjects received family support regarding oral medicine. For the inhaled medications, family members assisted only when they had acute exacerbation. The study findings also indicated that healthcare professionals gave all subjects advice on the time and dose of oral medications, but did not provide the step to use inhaled bronchodilator appropriately. As the result, the subjects did not realize the importance of each step. From the findings, it can be concluded that to ensure appropriate self-care for medication use in older patients with chronic obstructive pulmonary disease, assistance from family members and healthcare professionals is needed. Additionally, physical examination regarding medication use should also be taken into account.