Database of diseases - Asthma

Education for self-control

Self-control means independent, daily monitoring and treatment of the variable course of the disease. The measure of correctness of asthma self-control is effective prevention of exacerbations and preventing worsening of dyspnea, inflammation and other symptoms of the disease. Self-control enables education. Thanks to it, the patient is properly trained and prepared, he reacts rationally to exacerbating the symptoms of the disease and normalizes the state of health by taking appropriate drugs in the right dose.


 Why is it better to take the risk of self-medication in exacerbating asthma than to wait for contact with a doctor?

Self-control of the course of the disease reduces the frequency and severity of asthma symptoms. Even in exacerbations of asthma, when the patient feels severe symptoms of the disease often more risky for health, it is costly and unreasonable organization every time waiting for the arrival of an ambulance, or access to the hospital. In many cases, it is better for the patient, if he / she uses the previously prepared for such a circumstance by the doctor, the scheme of self-medication and immediately apply it.


What is the condition for good self-control?

1. Having sufficient knowledge about the disease and treatment goals;
2. Mastering the skills of self-diagnosis, i.e. monitoring of the variable course of asthma;
3. Having knowledge provided by the doctor - how to use drugs, especially in exacerbations of the disease;
4. Access to more and more effective medicines and modern therapy rules.


Why is the knowledge about the disease and its independent daily treatment by the patient called self-control - so important?

The best example of an extraordinary level of knowledge in the patient's self-control over dangerous, chronic disease is diabetes. "A person who knows more - lives longer!" - that's how recognized authorities recognize the role of knowledge in the treatment of diabetes. Although asthma is also a dangerous, chronic disease - the knowledge of it is not addictive, so dramatically long life of the patient. However, the risk of death due to this disease, although quite rare: about 1-4 per 100,000 patients - can not be underestimated!


"Patient with asthma who knows more - lives better and the healthcare system saves money"

- thus formulates the rank of knowledge in the self-control of asthma - an eminent expert of prof. dr med. Wacław Droszcz. Let us add that a patient who lives better - works more efficiently, earns better, suffers less and often spend less on medication. Knowledge about the disease and its practical application by the patient thus improves the comfort of life, gives the patient safety and independence.
 

When there is no knowledge - "the patient lives very bad!"

Let's quote a description of the nightmare, which can be the life of ill-treated asthmatics: "... The patient wakes up suddenly among violent shortness of breath, which usually grows so much that he simply can not catch his breath ... Feeling the sudden air hunger usually tosses into the window - he opens it even in winter. The necessity to activate additional muscles involved in the process of breathing makes the patient take a characteristic posture with his hands on the parapet, which reduces the respiratory effort.An face shows anxiety, tremendous anxiety and fear! ... "The example implicitly describes what it is means that "the patient lives very bad!". Meanwhile, thanks to medical advances and the increasing knowledge of patients, such situations can be avoided.




 

HOW DO YOU KNOW KNOWLEDGE? About ASTM?

Knowledge should not be learned from your mistakes, in fear and fear ...

An experienced patient, i.e. who has been treating asthma for many years, generally has practical knowledge about the disease. Thanks to that, he copes better with her. He knows when, in what doses and form should be taken additional drugs, when it is necessary to report to the doctor, and when to go straight to the hospital.The patient who starts his / her experience with the disease has to learn a lot. However, he should not learn from mistakes - in fear and fear. It is worth finding a better way - training, understanding and scrupulously analyzing the symptoms of the disease. Knowledge is like a medicine - it reduces anxiety and fear, which usually intensifies dyspnea.


How, then, to gain knowledge about the disease?
 
The patient acquires elementary knowledge about the disease from the attending physician (in the case of young children or people with disabilities - this knowledge should be gained by the carer and family). Already during the first medical visits the patient should be informed about the mechanism of disease development and for what treatment goals he should strive for. Later, the educational role should be supported by a specially trained nurse, if the medical center employs and trains them appropriately. One can not overestimate the self-supplementation of knowledge from educational books, magazines or the Internet.


Education is a continuous process ...

In education, occasional meetings with the doctor are not enough. The patient should receive information materials as soon as possible, discussing the principles of self-control and treatment of the disease, in the form of brochures, books, as well as instructions on what he should read. Patients with asthma and his family should be provided with appropriate training, thanks to which it will be possible to implement self-control of the disease. In self-monitoring, i.e. in the monitoring of the disease and dosing of medications by the patient, the point is that on the basis of jointly developed with the doctor procedures for exacerbating the disease - the patient himself modified the treatment as needed. It turns out that the use of written plans for independent treatment by patients reduces the frequency of medical interventions - both in adults and in children.


How to summarize the goals of education?

Education aims to provide the patient with knowledge and practical skills about the disease, its chronic character, factors triggering exacerbations and asthma attacks, but also knowledge about how to avoid them and the types of therapy. It is necessary to make the patient aware of the need to actively participate in the treatment process. Schools for people with Asthma play an important role in education. The attending physician should contact the patient nearest to the school in the area.


Goals of education and goals of self-regulation

Education for self-control requires an absolute awareness of the purpose of treatment. Skills to be acquired can not be art for art. With the help of the received instructions, knowledge and tips from the doctor, the patient should normalize the course of the disease in long sections of time. The prime goal of self-control is to daily prevent asthma exacerbations. No less important is the control of chronic inflammation that accompanies asthma, ie, for example, accurate asthma monitoring using PEF measurement


Where should I start my education?

The patient should work out with the doctor to develop an individual treatment plan and define his or her own tasks in it. These tasks result from the general rules for the treatment of asthma as well as from individual differences in health.


 

TASKS OF THE SICK IN SELF-CONTROL
 
It is obvious that to master yourself, you must master many skills:

Why is the treatment of inflammation in asthma an important goal of self-control?

In the long-term, no less dangerous to health, from asthma exacerbations is chronic inflammation. Under his influence, the smooth muscles of the bronchi grow "inwards" by minimizing their respiratory patency. Under the bronchial epithelium fibrous collagen is deposited, causing both organic changes: hypertrophy of the bronchial wall and reduction of their light, as well as disturbances of bronchial tree function: reduced elasticity (susceptibility to air pressure) of the respiratory tract. It intensifies the symptoms of breathlessness, cough, as well as increases the sensitivity of the mucous membrane to factors that trigger attacks and exacerbation of asthma. Inflammation destroys the ciliary epithelium lining the inside of the bronchial tubules. This epithelium is responsible for the self-cleaning of the airways; thanks to the movements of numerous microscopic cilia, it removes a sticky mucus that absorbs germs and air pollution. Degradation of the epithelium is accompanied by the growth of the number of goblet cells that produce mucus. Disturbing the mechanism of self-cleaning increases the risk of inflammatory infections exacerbating the symptoms of asthma.


What practical skills should he learn?

Independent monitoring of the course of the disease - that is, the daily diagnosis of asthma, especially its exacerbations. The basis is to measure the airflow rate through the bronchi using a peak flow meter. For this purpose, the patient should master this skill, as well as knowledge enabling the interpretation of results in PEF units, based on the so-called PEF standards due. The patient should also be able to assess the course of asthma by means of self-observation of the severity and duration of audible and perceived symptoms (fetters, wheezing, coughing, dyspnoea, etc.), methods of taking medication, especially inhaling medications in aerosolization; control of asthma symptoms - the smallest, effective doses of drugs, including the prevention of exacerbations and severe asthma attacks, by their early detection and treatment; ongoing prevention, ie avoiding environmental factors triggering exacerbations and stressful situations - allergens, bronchial irritants (cigarettes, irritating gases and vapors, some medicines (eg aspirin), etc.), stress.

How to assess the correctness and effectiveness of self-control?

The following health indicators provide good self-control:
1. Most of the time, there are no symptoms of the disease (dyspnoea cough expectoration feeling chest tightness, wheezing).
2. Symptoms of the disease are rare - they quickly disappear after the use of medicines
3. The patient leads a normal lifestyle
4. The indicator of health in the long-term distance: - 10 - 20 and more years - is the lack of complications caused by chronic inflammation, ie symptoms of unfavorable reconstruction of the walls of the bronchial tubules narrowing their light.

When self-monitoring and treatment is incorrect

If left untreated or treated incorrectly, after several dozen years of life, it induces emphysema and fibrosis of the interstitial lung tissue, which can reduce the vital capacity of the lungs by around twice. The correct result of a spirometric test, exceeding 50% of the normal norm, is evidence of the proper self-control and satisfactory patency of the bronchial tubes and their correct elasticity (susceptibility).

Ed. Edward Ozga Michalski

1. One of the most important is taking medication in a dose appropriate to the severity of symptoms.
2. To take the medicine, you must first learn to use the dosing devices - inhalers.
3. The decisive factor for self-control is the ability to recognize different degrees of disease severity. This skill is self-diagnosis - independent monitoring of the course of asthma.
4. Acquiring the skill of precise monitoring determines the calculation of the right dose and determining the appropriate time of admission prescribed by the doctor drugs.
5. Contemporary asthma monitoring is based on the measurements of air flow through the bronchi using special measuring devices - pikflometers - which are usually the patient's personal property. The quality of monitoring depends on the ability to use these modern diagnostic devices.
6. The less important goal and education acquired by the patient is the prevention of asthma symptoms - "healing without drugs".
7. Finally - it is good to have a full set of important criteria to assess the quality of daily self-control - that is, the most important health indicators characteristic of well-treated asthma.