Awareness regarding Deep Breathing Exercise among the Chronic Obstructive Pulmonary Disease patients

 

Heera Jayasheela

Associate Professor, College of Nursing, Pravara Institute of Medical Sciences (DU), Loni (Bk)

District Ahmednagar, Maharashtra, India

 

ABSTRACT:

Chronic obstructive pulmonary disease (COPD) is an inflammatory disease of airways which is irreversible airway disease characterised by emphysema and chronic bronchitis which results to increase airflow resistance leading to breathlessness, cough and sputum. Deep breathing exercise minimizes dyspnoea, improve oxygenation and maintain normal respiratory rate.  A cross sectional study was undertaken to assess the awareness regarding Deep breathing exercise among the Chronic Obstructive Pulmonary Disease patients Objectives: To assess the awareness of deep breathing exercise among COPD patient, to determine the association of level of knowledge scores regarding deep breathing exercise with their selected demographic variable. Method: A total of 300 patients were enrolled using convenient sampling in this cross sectional study. Structured questionnaire was used to collect data from the subjects Result: The study findings shows that majority 198 (66%) had inadequate knowledge, followed by 69 (23%) had moderate knowledge and 33 (11%) had adequate knowledge regarding deep breathing exercise among the COPD patients. In the present study there is a significant association between demographic characteristics namely; History of exposure to smoke, Duration of exposure to pollutants, Duration of Illness (p<0.05) and remaining characteristics are not significant (p>0.05) Conclusion: This study showed the Chronic Obstructive patients have inadequate knowledge regarding deep breathing exercise.

 

 

INTRODUCTION:

The World Health Organization (WHO) presumes COPD to become the 3rd most leading cause of death and the 5th leading cause of loss of ‘Disability Adjusted Life Years’(DALYs) as per projection of the Global Burden of Disease Study (GBDS).⁽¹⁾

 

Chronic Obstructive Pulmonary Disease (COPD) is a progressive inflammatory disease characterized by chronic obstruction in the peripheral bronchus and pulmonary emphysema.⁽²⁾

 

The disease is disabling with symptoms such as chronic cough, phlegm, wheezing, shortness of breath and increased infections of the respiratory passage. Changes in the lungs result in mucus hyper secretion, dysfunction of the cilia, airflow limitation and hyper inflation of the lungs, gas exchange.⁽³⁾

 

Breathing exercises help entire lung and keep chest muscles active. They allow to get more oxygen with each breath and to breathe with less effort. Breathing exercises also can reduce symptoms caused by anxiety and stress. Patients awareness enables him/her to acquire better self management skills, reduces exacerbations and prevent hospitalizations and improves health related quality of life.^{(4), (5)}

 

STATEMENT OF THE PROBLEM:

“Awareness regarding Deep Breathing Exercise among the Chronic Obstructive Pulmonary Disease patients”

 

OBJECTIVES:

1.     To assess the awareness of deep breathing exercise among the COPD patients

2.     To determine the association of level of knowledge scores regarding deep breathing exercise with their selected demographic variables

 

MATERIAL AND METHODS:

Research design and approach: 

Non-experimental, Descriptive cross-sectional survey approach

 

Setting of the study:

The study was conducted at Pravara Rural Hospital, Taluka Rahata, District Ahmednagar, Loni (Bk). Maharashtra

 

Population:

Chronic Obstructive Pulmonary Disease patients admitted at Pravara Rural Hospital

 

Sampling technique:

Non-probability purposive sampling technique was used for the selection of Chronic Obstructive Pulmonary Disease patients for the present study.

 

Sample size:

300 Chronic Obstructive Pulmonary Disease patients

 

Inclusion criteria:

Patients who are

1)   Diagnosed to have Chronic Obstructive Pulmonary Disease

2)   Age group above 35 years

3)   Able to understand and read Marathi.

4)   Willing to provide written informed consent.

 

Tools and technique:

Section A:

Socio Demographic Profile of COPD, Clinical Characteristics of COPD

 

Section B:

Structured knowledge questionnaire on Deep breathing exercise

 

Data Collection procedure:

Formal permission was obtained from concerned authority Medical Superintendent, Head of Department of Medicine and Chest Physician of Pravara Rural Hospital, Loni (Bk), Maharashtra The study proposal was reviewed and approved by the Research Ethical Committee. Subjects was selected according to the selection criteria and assured the confidentiality of the sample Informed Written Consent was obtained after explaining the purpose of the study and assured the anonymity and confidentiality of information by the investigator.

 

Data analysis:

Descriptive statistics like mean, SD, mean percentage was used for description of demographic characteristics of Chronic obstructive pulmonary disease patient. Inferential statistics like chi-square test was used to find out the association of level of knowledge scores regarding deep breathing exercise with their selected demographic variables among the COPD patients.

 

RESULTS AND DISCUSSION:

Section: A Description of Demographic variables

Majority (87%) of the subjects were in age group of above 65 years, highest (76%) subjects were males ,maximum (91%) subjects were Hindus, majority (83%) of the subjects were illiterate, highest (97%) of the subjects belonged to rural area, majority of the subjects were farmers (97%) and maximum (68%) of the subjects had income below 3000/-per month.

 

Clinical Characteristics of COPD patients:

Maximum (92%) of the subjects were passive smokers, followed by majority (71%) of the subjects smoke above one packet per day, maximum (70%) had allergy of pollens, majority (82%) of the subjects had exposure to allergens above 5 years and most of the subjects (83%) had duration of illness below above 5 year.

 

Section: B

Assessment of knowledge regarding Deep breathing exercise among COPD patients

 

Table -I Frequency and percentage distribution of knowledge regarding Deep breathing exercise among the COPD patients n=300

S. No	Level of knowledge	Frequency	Percentage
1	Inadequate	198	66%
2	Moderate	69	23%
3	Adequate	33	11%

 

Maximum 198 (66%) had inadequate knowledge, followed by 69 (23%) had moderate knowledge and 33 (11%) had adequate knowledge regarding Deep breathing exercise among the COPD patients.

 

Section: C

Association of level of knowledge scores regarding deep breathing exercise with selected demographic variables of COPD patients:

In the present study there is a significant association between demographic characteristics namely; History of exposure to smoke, Duration of exposure to pollutants, Duration of Illness (p<0.05) and remaining characteristics are not significant (p>0.05)

 

DISCUSSION:

The study findings showed inadequate knowledge regarding deep breathing exercise among the COPD patients. Similar study conducted by Lt Col Sreekala B, Lt Col Mini Mathai to assess the knowledge on deep breathing exercises depicts inadequate knowledge regarding deep breathing exercise among the COPD patients. ⁽⁶⁾

 

CONCLUSION:

The findings of the study concludes that majority of the COPD patients had inadequate knowledge regarding deep breathing exercise. The present study indicates the need of education intervention through video assistance, self instructional module, modular training and planned teaching programme by the nurses to enhance the knowledge of deep breathing exercise for the self management of COPD. Awareness regarding deep breathing exercise enables him/her to acquire better self management skills and improve the quality of life.

 

REFERENCES:

1.      The Global Burden of Disease, 2008.www.who.int/healthinfo/global_burdern_disease/inhtml

2.      Holland AE, Hill CJ, Jone AJ. Et al. Breathing exercises for Chronic Obstructive Pulmonary Disease. Cochrane database of Systemic Reviews.2012(10)

3.      European COPD Coalition. Prevalence in EU 2014.Availaible: http://www.copdcoalition:.eu/about-copd/prevalence. Accessed: 25 Nov 2015

4.      Puhan MA, Gimeno-Santos E, Cates CJ, Troosters T. Cochrane Database Syst Rev. 2016 Dec 8; 12:CD005305. Epub 2016 Dec 8.

5.      Suja Shamili. Effectiveness of structured teaching program on breathing and coaching exercise among post operative clients in Bollineni super specialty hospital, Nellore. Narayana Nursing Journal. 2016, 5(1).

6.      Lt Col Sreekala B, Lt Col Mini Mathai A Study to Assess the Knowledge and Practice of Breathing Exercises among Patients with COPD in Tertiary Care Hospital. International Journal of Science and Research (IJSR) Volume 5 Issue 12, December 2016.

 

 

 

Received on 21.11.2018          Modified on 16.01.2019

Accepted on 27.02.2019     © A&V Publications all right reserved