ABSTRACT
Objective To understand the cognitive level of chronic obstructive pulmonary disease (COPD) disease management and pulmonary rehabilitation among medical staff in the respiratory departments and community of public health institutions in Panyu of Guangzhou, in order to assess the status of prevention and treatment of COPD in this area. Methods From March to October 2017, a questionnaire survey was conducted among 339 medical staff in Panyu, including respiratory doctors, nurses and therapists of four tertiary hospitals, five secondary hospitals, and three first-level hospitals, GPs, nurses and therapists at 16 community health service centres, among them, there are 147 respiratory and general practitioners (hereinafter referred to as doctors), 171 respiratory and general nurses (hereinafter collectively referred to as nurses), and 22 rehabilitation therapists (hereinafter collectively referred to as therapists). Using Epidata software to create questionnaire database entry data. Results The awareness rate of COPD airflow limitation severity of nurses was only 19.9％, which was lower than that of doctors (39.7％) and therapists (22.7％). Doctors, nurses, and therapists are familiar with the low percentage of the GOLD guidelines, which are respectively only 12.3％, 7.6％, and 4.5％. Nurses were diagnosed with pulmonary function as a basis for COPD, and the awareness rate was only 60.2％ lower than that of doctors (82.9％) and therapists (81.8％). In alleviating COPD patients′shortness of breath, only 31.8％therapists chose short-acting beta-agonists, lower than doctors (61％) and nurses (45％). There is disagreement about the long-term use of inhaled corticosteroids in COPD. Medical staff have the highest awareness of lip-reducing and abdominal breathing, followed by Taiji and Ba Duan Jin exercises, and low awareness of modern rehabilitation programs such as elastic bands, upper and lower limb exercises. The effective pulmonary rehabilitation program should last at least 8 weeks, and the awareness rate of this therapy practice was 40.9％, higher than doctors (13.7％) and nurses (18.1％). Medical staff believe that the main factors affecting patient compliance are the cost of the drug and the patient′s lack of understanding of the benefits of the treatment. Additionally, 40.4％ of doctors, 51.5％ of nurses, and 54.5％of therapists believe that community health services cannot manage COPD. The reasons that affect community management of COPD, doctors believe that patient compliance and lack of man power, nurses believe that the main shortage of manpower and equipment, the therapist believes that the lack of medical awareness and poor patient compliance. Conclusion Doctors, nurses, and therapists have inconsistent understandings of COPD disease management and pulmonary rehabilitation, and each has its own focus. It is necessary to strengthen learning exchanges for each weak knowledge point. The awareness rate of modern rehabilitation exercise for pulmonary rehabilitation is not as high as that of traditional Chinese medicine. It is necessary to pay attention to the promotion of the benefits and significance of COPD pulmonary rehabilitation treatment and improve compliance.
ABSTRACT
Objective To evaluate the effect of health education combined with lung function test on smoking cessation in smoking sanitation workers. Methods Sixty-nine sanitation workers who smoke were divided into two groups by using the table of random number, routine group (n=35) and lung function test group (n=34). The routine group was given health education. According to the lung function, those in the lung function test group were divided into normal lung function group (19 cases) and abnomal lung function group (15 cases) who received both health education and lung function test. Success rate of smoking cessation and the relapse rate were compared at 2 and 6 months follow-up. Results At 2 and 6 months follow-up, the smoking cessation rates of routine group were [10(29%), 4(11%)], which were lower than those of the normal lung function group [7(37%), 3(16%)], the differences were not statistically significant (P>0.05). The smoking cessation rates of routine group were lower than those in abnormal lung function group[11 (73%), 10(67%)] (P<0.05). The smoking cessation rates of the normal lung function group were significantly lower than those of abnormal lung function group (P<0.05). The relapse rate of routine group[6(17%) and the normal lung function group[4(21%)]at 6 months follow-up were not significantly different. The relapse rate of the normal lung function group and that of abnormal lung function group were not significantly different. Conclusion Health education combined with lung function test could help smokers with abnormal lung function to give up smoking successfully.
ABSTRACT
Objective To explore influence and variation of smoking and occupational exposure to air pollution on lung function.Methods Ninety eight sanitation staffs from Panyu District were divided into smoking and non-smoking sanitation groups; and all subject accepted the Chronic Obstructive Pulmonary Disease Assessment Test (CAT) scales,questionnaires,lung function test,and data statistical analysis.Healthy people accepted health examination from Guangzhou Panyu medical health center were used as the control group.Results (1) Forced expiratory volume in the first second (FEV1％),forced expiratory volume in the first second/ forced vital capacity(FEV1/FVC),maximal expiratory flow in 50％ vital capacity (FEF50％),maximal expiratory flow in 75％ vital capacity (FEF75％),maximal mid-expiratory flow (MMEF) of non-smoking sanitation group was significantly lower than non-smoking healthy group (P ＜ 0.01).(2) Abnormal rates of FEF50％,FEF75％,and MMEF of non-smoking sanitation group were significantly higher than non-smoking healthy group (P ＜ 0.01).(3) Abnormal rates of FEF50％,and FEF75％ of sanitation group were significantly higher than healthy group with or without smoking.(4) Abnormal rates of FEV1％ and FEV1/FVC did not have significant difference between non-smoking sanitation group and non-smoking healthy group,but had significant difference between non-smoking and smoking healthy groups.It means smoking and occupational exposure had different impacts on pulmonary function.(5)Moderate score of nonsmoking sanitation group and smoking healthy group were significantly higher than non-smoking healthy group by P =0.049 and P =0.001,respectively.Conclusions Occupational exposure to air pollution and smoking can lead to small airway damage,which was not as obvious as pulmonary function changes.It is necessary to regularly monitor lung function for sanitation staffs who risk occupational exposure to air pollution.Increasing physical exercise would benefit to improve sport lung endurance of the people in our country.