Respiratory Care Patient Education Program - Assignment Example

Development and Implementation of Respiratory Care Patient Education Program Introduction: Chronic obstructive pulmonary disease (COPD) is a common, often unrecognized source of mortality and morbidity throughout the world. This is a condition well-known by the students of medicine largely as a chronic condition unresponsive to therapy. This therapeutic failure on the doctor's part is often excused by the recognition that the condition itself is usually brought on by cigarette smoking and therefore is "patients' fault." Given the changes in the understanding of the causes and consequences of COPD as well as the availability of more effective therapy, the prognosis of such disorder is not that grim, but the patient's behavioral modification in terms of smoking cessation remains still the mainstay of therapeutic success. Despite encouraging reductions in the use of cigarettes, especially by the middle aged men, the problems of COPD patients persist and are likely to do so in the future. The management of COPD patients is increasingly multidisciplinary, and the patients themselves are entitled to explanation and education not only how their disease arises or what they can do to prevent this disease but also what the different treatments recommended do and what kind of benefits they are likely to achieve from these treatments and smoking cessation (Pauwels, R.A. and Rabe, K.F., 2004). Definitions: COPD is a spectrum of disease that includes chronic bronchitis, emphysema, long-standing asthma that has become relatively unresponsive to treatment, and small airways disease. The unifying feature of COPD is that it is chronic, slowly progressive disorder characterized by airflow obstruction that is not fully reversible and varies very little from day to day and month to month (Pauwels, R.A. and Rabe, K.F., 2004). Cigarette Smoking: Cigarette smoking is the most commonly identified correlate with COPD. Experimental studies have shown that prolonged cigarette smoking impairs ciliary movement, inhibits the function of alveolar macrophages, and leads to hypertrophy and hyperplasia of mucus secreting glands. Inhaled cigarette smoke is overwhelmingly the most important risk factor for the development of COPD. Although, COPD can occur in nonsmokers, about 90% cases are thought to be a direct result of cigarette smoking (Jamrozik, K., 2004). On the other hand, lung function decreases after the age of 30-35 years as a part of the ageing process. In normal healthy nonsmokers, the rate of decline of forced expiratory volume at 1 minute is 25 to 30 mL a year; whereas, in at-risk smokers, the rate of decline may be double, that is, 50 to 60 mL a year. What is clearly known is although lost lung function is not regained when smoking is stopped, the rate of decline returns to that of a nonsmoker. The FEV1 often drops below 50% of the predicted before symptoms of COPD appear, and the patients usually present with symptomatic disease at the age of 50 to 70 years. This highlights the importance of the early detection of such high-risk smokers and persuading them to stop smoking. If they can be persuaded to stop, they may never suffer from severe, disabling, and symptomatic disease. Even when a smoker has developed symptomatic disease, stopping smoking will still result in worthwhile salvage of lung function and improved life expectancy (National Collaborating Centre for Chronic Conditions, 2004). Development of Patient Education Program: Stopping smoking is the single most important intervention in COPD and the only thing that significantly alters the natural history of the disease. It is of primary importance at every stage and must be encouraged actively and continuously. In mild COPD it may be the only treatment needed and may prevent the patient ever developing severe, disabling and life-threatening illness. Therefore, a patient education program with an intention for awareness about the disease could be an acceptable approach in the early stages of the disease. Drugs or medical therapy alone cannot satisfactory ensure short or long term outcomes. As a consequence, the importance of patient education in respiratory care is being utilized and perceived to a greater extent. Therefore, all patients suffering from COPD would need to be referred to pulmonary rehabilitation (Celli, B.R. and MacNee, W., 2004). There, these patients, irrespective of age, functional limitation, and smoking status are exposed to a management where holistic and structured care id offered to these patients with chronic respiratory impairment. Since this care plan is individually tailored and designed to optimize physical and social performance and autonomy, there is a scope that during these contact hours, the patients are educated about their disease. For this purpose, the patient education brochures can be designed where the facts about COPD, its relationship with smoking, importance of respiratory therapy in prevention of acute exacerbation, smoking cessation, what to do to prevent an attack, where to go in case of an attack, how to measure the seriousness of the disease can be printed in a booklet (Man, W.D., Polkey, M.I., Donaldson, N., Gray, B.J., and Moxham, J., 2004). These booklets would be read by the patients, and the language should be lucid. A suitable education program is important in breaking the vicious cycle of worsening breathlessness, reduced physical activity, and deconditioning, and respiratory therapy plays a major role in restoring patients to an optimally functioning state. Early intervention after an acute exacerbation of COPD can produce clinically significant improvements in exercise capacity and health. This program will have three components, early intervention with exercise training, education for disease and smoking cessation, and nutritional support. Implementation of Education: This would comprise of various forms of goal-directed and systemically applied communication aimed at improving understanding and motivation. This program would be structured, and the topics would include breathing control, relaxation, benefits of exercise, and values and motivation for smoking cessation (British Thoracic Society guidelines, 2001). For implementation of the program, both individualized and group-based education will be offered. Participants would be encouraged to take responsibility of their own health after understanding it and would be ensured support for smoking cessation. Followup sessions would be necessary. Reference British Thoracic Society guidelines (2001). Pulmonary rehabilitation. Thorax;56:827-34 Celli, B.R. and MacNee, W., (2004). Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. European Respiratory Journal;23:932-46. Jamrozik, K., (2004). Population strategies to prevent smoking. BMJ;328:759-62 Man, W.D., Polkey, M.I., Donaldson, N., Gray, B.J., and Moxham, J., (2004). Community pulmonary rehabilitation after hospitalisation for acute exacerbations of chronic obstructive pulmonary disease: Randomised controlled study. BMJ;329:1209-11 National Collaborating Centre for Chronic Conditions, (2004). National clinical guideline on management of chronic obstructive pulmonary disease in adults in primary and secondary care. Thorax;59(suppl 1):1-3, 192-4 Pauwels, R.A. and Rabe, K.F., (2004). Burden and clinical features of chronic obstructive pulmonary disease (COPD). Lancet; 364:613-20. Read More