Education Experiences of Adult Subjects and Caregivers for Mechanical Insufflation-Exsufflation at Home.
BACKGROUND: In 2014, the Ministry of Health of Ontario, Canada, approved a program of public funding for specialist-prescribed mechanical insufflation-exsufflation (MI-E) devices for home use by individuals with neuromuscular respiratory insufficiency. Since 2014, 1,926 MI-E devices have been provid...
| Publicado en: | Respiratory Care Vol. 65; no. 12; pp. 1889 - 1897 |
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| Autores principales: | , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Dec2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=147154396&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 147154396 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Dec2020 vid: 65 iid: 12 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 147154396 147154396 147154396 10.4187/respcare.07534 147154396 ppf: 1889 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Education Experiences of Adult Subjects and Caregivers for Mechanical Insufflation-Exsufflation at Home. aug: au: Dale, Craig M. McKim, Doug Amin, Reshma Carbone, Sarah Fisher, Tom Goldstein, Roger Katz, Sherri Gershon, Andrea Leasa, David Nonoyama, Mika Pizutti, Regina Tandon, Anu Rose, Louise affil: Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada sug: subj: Health Education Psychosocial Factors Caregivers Education Caregivers Psychosocial Factors Insufflation Education Insufflation Psychosocial Factors Home Health Care Insufflation Equipment and Supplies Confidence Health Services Accessibility Human Funding Source Semi-Structured Interview Descriptive Statistics Patient Satisfaction Uncertainty Professional Knowledge Neuromuscular Diseases Respiratory Failure Cough Self-Management Teaching Descriptive Research Qualitative Studies Canada Purposive Sample Data Analysis Software Male Female Adult Middle Age Aged Thematic Analysis Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: BACKGROUND: In 2014, the Ministry of Health of Ontario, Canada, approved a program of public funding for specialist-prescribed mechanical insufflation-exsufflation (MI-E) devices for home use by individuals with neuromuscular respiratory insufficiency. Since 2014, 1,926 MI-E devices have been provided, exceeding device-use projections. Few studies describe the initial and ongoing education and support needs of home MI-E users and their family caregivers. This study aimed to explore the requirements of initial and ongoing education and support for MI-E device use, user confidence, and barriers and facilitators to home MI-E. METHODS: We conducted semi-structured interviews with new (< 6 months) and established (6-48 months) MI-E users and family caregivers. Device users rated their confidence on a numeric rating scale of 1 (not confident) to 10 (very confident). RESULTS: We recruited 14 new and 14 established MI-E users and caregivers (including 9 dyads), and we conducted 28 interviews. Both new and established users were highly confident in use of MI-E (mean ± SD scores were 8.8 ± 1.2 and 8.3 ± 2.1, respectively). Overall, the subjects were satisfied with their initial education, which consisted of a 1-2 h one-on-one session at home or in the clinic with a device demonstration and hands-on practice. Subjects viewed hands-on practice and teaching of caregivers as more beneficial than written materials. Ongoing support for device use was variable. Most subjects indicated a lack of specific follow-up, which resulted in uncertainty about whether they were using the MI-E device correctly or whether MI-E was effective. Facilitators to device utilization were ease of use, initial training, support from formal or informal caregivers, and symptom relief. Barriers were inadequate education on MI-E purpose, technique, and benefit; lack of follow-up; and inadequate knowledge of MI-E by nonspecialist health providers. CONCLUSIONS: The current model of home MI-E education at initiation meets user and caregiver needs. Better ongoing education and follow-up are needed to sustain the benefits through assessment of MI-E technique and its effectiveness. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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