Abstract:
Introduction In patients with severe chronic pulmonary diseases, there is often a need for oxygen therapy to continue after discharge from hospitalization. Long-term oxygen therapy (LTOT) has been shown to significantly reduce mortality in such patients and improve longevity by helping to correct oxygen deficiency in the bloodstream and prevent organ failure and the development of cor pulmonale (right-sided heart failure). Therefore, considering the sociocultural background of India, the objective of the present study was to evaluate patients\' perceptions of LTOT using semi-structured interviews, to evaluate patients\' perceptions of activities and participation, and to evaluate the quality of life (QOL) of patients with LTOT. Methodology A mixed-method study was performed at a tertiary care hospital for six months. Twenty-four chronic respiratory patients were included in the present study. The patients\' perception was evaluated about LTOT using semi-structured interviews, activities, and participation using a validated activity and participation checklist and the QOL of patients with LTOT using the World Health Organization Quality of Life Brief Version (WHOQOL-BREF) questionnaire. Results Twenty-four patients were interviewed and transcripts were analyzed through thematic analysis. Descriptive statistical analysis was performed for activity and participation along with QOL. The mean age of the patients involved was 58.5 ± 9.54 years, which involved a maximum of male patients consisting of 13 (54.2%) in comparison to female patients. The duration of oxygen use in months was 31.4 ± 29.4, the daily oxygen usage in hours was 17.3 ± 6.6, and the oxygen flow rate (L/min) was found to be 2.3 ± 0.97 at rest and 3.6 ± 1.4 on activity. In addition, the oxygen use by the patients was preferable as prescribed by 15 (62.5%) patients. Patients\' perspectives on LTOT demonstrated that 10 (41.7%) patients perceived oxygen as relieving symptoms while most patients used oxygen during walking indoors activity involving 22 patients (91.7%), with 17 (77.3%) reporting improved ability and five (22.7%) facing obstacles. Instrumental activities involving walking shorter distances (less than 1 km) involved a high usage of oxygen with 20 patients (83.3%) using it, where 15 (75%) found it beneficial, three (15%) encountered obstacles, and two (10%) noted no effect from its use. Social interaction found that only one patient (4.20%) used oxygen at work, finding it helpful, but the majority, 20 (83.4%), did not go to work at all. Moreover, oxygen usage during transportation reported that travel using private vehicles involved a maximum of patients (16, 66.7%). Furthermore, for inquiries related to QOL, the results demonstrated that for the four domains of WHOQOL-BREF, consisting of physical health, psychological, social relationships, and environment, the mean values were found to be 48.33 ±10.66, 54.79 ± 13.7, 55.75 ±11.1, and 60.25 ± 12.6, respectively. Conclusion LTOT has been perceived to be a life-saving intervention by majority of the chronic respiratory disease patients of increased severity. Patients experienced various issues in daily activities and participation, which have affected their QOL. Overall, a lack of awareness and knowledge regarding the purpose, dosage, benefit, and usage of oxygen therapy was found to be evident and needs to be focused.
摘要:
简介在患有严重慢性肺部疾病的患者中,出院后通常需要继续氧疗.长期氧疗(LTOT)已被证明可以显着降低此类患者的死亡率,并通过帮助纠正血液中的氧气不足并预防器官衰竭和肺心病(右侧心力衰竭)的发展来延长寿命。因此,考虑到印度的社会文化背景,本研究的目的是使用半结构化访谈评估患者对LTOT的看法,评估患者对活动和参与的看法,并评估LTOT患者的生活质量(QOL)。方法在三级护理医院进行了为期六个月的混合方法研究。本研究包括24名慢性呼吸系统患者。使用半结构化访谈评估患者对LTOT的感知,活动,并使用经过验证的活动和参与清单以及使用世界卫生组织生活质量简报版(WHOQOL-BREF)问卷的LTOT患者的QOL进行参与。结果对24例患者进行了访谈,并通过主题分析对笔录进行了分析。对活动和参与以及QOL进行描述性统计分析。患者平均年龄为58.5±9.54岁,与女性患者相比,男性患者最多13例(54.2%)。月用氧时间为31.4±29.4,小时每日用氧量为17.3±6.6,静息时氧气流量(L/min)为2.3±0.97,活动时为3.6±1.4。此外,根据15例(62.5%)患者的处方,患者使用氧气是优选的。患者对LTOT的看法表明,有10名(41.7%)患者认为氧气可以缓解症状,而大多数患者在室内步行活动中使用氧气,涉及22名患者(91.7%),17人(77.3%)报告能力提高,5人(22.7%)面临障碍。涉及步行较短距离(小于1公里)的仪器活动涉及大量使用氧气,有20名患者(83.3%)使用氧气,其中15(75%)发现它有益,三人(15%)遇到障碍,和两个(10%)注意到它的使用没有影响。社交互动发现只有一名患者(4.20%)在工作中使用氧气,发现它有帮助,但大多数人,20(83.4%),根本没有去上班。此外,运输期间的氧气使用报告说,使用私人车辆旅行涉及最多的患者(16,66.7%)。此外,有关QOL的查询,结果表明,对于WHOQOL-BREF的四个域,包括身体健康,心理,社会关系,和环境,平均值分别为48.33±10.66,54.79±13.7,55.75±11.1和60.25±12.6.结论大多数严重程度增加的慢性呼吸系统疾病患者认为LTOT是一种挽救生命的干预措施。患者在日常活动和参与中经历了各种问题,这影响了他们的QOL。总的来说,缺乏对目的的认识和知识,剂量,benefit,发现氧疗的使用很明显,需要重点关注。