The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts

THE ROLE OF CARE-GIVERS IN ASSISTING COPD PATIENTS WITH THE USE OF NEBULIZERS AT HOME

Bothaina Alhaddad1, Felicity Smith1, Kevin Taylor2, Tricia Robertson3, Geoffery Watman3; 1Department of Practice and Policy, The School of Pharmacy, London, United Kingdom; 2Department of Pharmaceutics, The School of Pharmacy, London, United Kingdom; 3Harrow Primary Care Trust, Harrow, United Kingdom

Background: The contribution of informal care-givers in the delivery of care is increasingly recognised by governments throughout the world as vital. Many patients with long-term illness depend on care-givers for assistance in the use of medicines. Medicines-related activities are known to be an integral part of care-giving and to contribute to carer-burden. The aim of this study was to identify the types of assistance that care-givers provide for COPD patients using nebulizers, to identify the problems they experience which may impact on the safety and effectiveness of therapy and contribute to carer-burden. Method: Face-to-face semi-structured home interviews were conducted with 15 care-givers who assisted a family member or friend with COPD in the use of a nebulizer. Detailed data were gathered on the extent and type of assistance provided in the use of nebulizers for COPD care, and any problems experienced. Structured instruments were included to obtain data on personal characteristics and carer-burden. Qualitative analytical procedures, using a Framework approach enabled an analysis of care-giving activities and problems in the context of which they occurred. Results: The majority of care-givers were females (n=10), and the mean age of care-givers was 61.2 (range 26–79). Care-givers assissted with the use of nebulizers on an average of 4.5 years, provided a considerable amount of assistance (3.5 hours per week), and had a mean burden score of 21.5. Assistance provided ranged from taking full responsibility for use of the nebuliser to providing assistance with particular aspects only when required. Care-givers activities included assembling and setting up equipment, mixing of medicines, and operation, dismantling and cleaning of equipment. A wide range of difficulties were described with all aspects of care. Care-givers also reported concerns about side-effects from medication and the lack of information about the equipment. Conclusion: Optimal health outcomes for patients with COPD often depend on the effective use of nebulizers; and many patients may depend on a care-giver for vital assistance. The responsibilities that may be assumed by care-givers and the problems and concerns they experience are hugely varied. Support must be directed to care-givers if therapy is to be effective, and their needs and perspectives are to be addressed. Sponsored Research - None