Investigation Of Inhalation Therapy Adherence In Patients With Chronic Obstructive Pulmonary Disease

Objectivs: To investigate the inhalation treatment adherence of patients with chronic obstructive pulmonary disease in Kunming third grade class-A hospital,and to understand the present situation of inhalation treatment adh erence of patients with chronic obstructive pulmonary disease.To explore the factors affecting the adherence of inhalation therapy and provide some guidance for clinical practice.Methods: On the basis of referring to existing questionnaires abroad,the initial questionnaire items of COPD patients’ satisfaction with the use of inhalation devices were formed.Form the initial questionnaire after consulting experts.Exploratory factor analysis was used to test the validity of the questionnaire,and internal consistency reliability and retest reliability were used to test the reliability of the questionnaire.A total of 231 patients with chronic obstructive pulmonary disease were selected from outpatient and inpatient departments of 5 Kunming third grade class-A Hospitals by cluster random sampling method.General data questionnaire,test of adherence to inhalers’,CAT rating sheet,COPD-Q questionnaire,Family Caring index questionnaire,and HADS were used to collect relevant data of patients.Kruskal-Wallis test and Chi-square test were used for univariate analysis of inhalation treatment adherence in patients with chronic obstructive pulmonary disease,and multiple Logistic regression was used for multivariate analysis.Results: 1.The development of a questionnaire on the use satisfaction of patients with chronic obstructive pulmonary disease with inhalation devices:The questionnaire consists of 10 items.The S-CVI of the questionnaire was 0.9,the I-CVI was between0.833 and 1.0,and the Cronbach’s α coefficient was 0.761,The retest reliability was0.915(P < 0.01).2.Investigation of inhalation therapy for patients with chronic obstructive pulmonary disease:A total of 240 questionnaires were sent out and 231 were recovered,with effective recovery of 96.3%.The mean age was 70.3±9.3 years.Among 231 patients,92(39.8%)had high adherence,64(27.7%)had moderate adherence,and 75(32.5%)had low adherence.Overall satisfaction with inhaler use score in COPD patients was 45.0(43.0,47.0)points.The overall frequency of at least one operating error with the inhalation device was 167(72.3%)patients.Among the steps of operation errors,the most mistakes were made by exhalation 96(41.6%)people,followed by breath holding 89(38.5%)people and inhaling 84(36.4%)people.3.Analysis of influencing factors of inhalation treatment adherence:Univariate analysis showed that age,educational background,monthly income,mental state,error of inhalation operation,patients’ satisfaction with the use of inhalation devices and knowledge score were factors affecting the compliance of patients with chronic obstructive pulmonary disease(P<0.05).Multiple Logistic regression analysis showed that COPD patients’ inhalation operation errors,satisfaction with the use of inhalation devices and knowledge scores had statistically significant effects on the inhalation treatment adherence(P<0.05),and the correlation coefficients were-0.259,0.254,0.189(P < 0.01).Conclusions: 1.The risk factors for low adherence of inhalation therapy include many errors in inhalation operation,low satisfaction with the use of inhalation devices and low understanding of diseases.2.Age,educational background,monthly income and mental state may be factors affecting the inhalation adherence of COPD patients,which still need to be further explored.3.The reliability and validity of COPD patients’ satisfaction questionnaire on the use of inhalation devices are good,which has a certain popularization role.