| Summary: | 碩士 === 慈濟醫學院 === 護理學研究所 === 86 === The purpose of this study was to evaluate the effect of
postural drainage (PD) and postural drainage with mechanical
chest percussion (MP/PD) on airway clearance and perceived
comfort for chronic lung disease (CLD) patients. A quasi-
experimental research design was used to collect the data .
The purposive sample of 25 CLD inpatients who were extracted
from the two regional hospitals in Hualien city was recruited
between October 1997 and March 1998. The PD and MP/PD were
alternatively intervened in CLD patients. Several data were
measured, such as pulmonary function parameter, oxygen
saturation, heart rate variation , sputum quantity, and
subjective comfort. All data were analized by SPSS for windows
7.0 statistical software.
The results were as follows. Subjects treated with PD only
showed increasing sputum quantity and airway clearance, as
denoted by a significant increase in the forced vital capacity
(FVC) and forced expiratory volume, FEV1 after 45 minutes of
intervention. Decrease in heart rate was significant after 5,
30 and 45 minutes, while a rise in SpO2 was significant
throughout the whole period. Data from the MP/PD group also
showed increases in sputum quantity and airway clearance.
Improvement in FVC was significant after 15 minutes of
intervention and after 30 minutes, a significant rise in the
peak expiratory flow rate (PEFR) was noted. A significant
increase in SpO2 was noted after 5 and 45 minutes of
intervention while a decrease in heart rate was noted after
30 minutes. However, comparison of all the parameters between
the two methods of intervention did not reveal any statistical
significance.
Subjectively, patients receiving MP/PD had better perceived
comfort than those receiving PD only (p<0.05). Also, a higher
subscale score of patients' subjective perceived comfort after
airway sputum cleared were shown from MP/PD. However, there was
no significant correlation between the objective airway clearance
efficiency and the subjective comfort.
The findings of the study indicated that performing postural
drainage combined with mechanical chest percussion on patients
with chronic lung diseases not only improve sputum clearance but
also enhance the subjective perceived comfort. For home care patients
without assistance in chest percussion or those who do not possess
an electronic percussor device, this study demonstrated the
effectiveness of performing postural drainage alone in airway
clearance. Therefore, education of patients in carrying out postural
drainage correctly may promote the ability of self-care in home
care patients.
. The PD was forced expiratory volume in 1 second (FEV1) deployed for 45 minutes, revealed the forced vital capacity (FVC) and obviously increased (P<0.05) as well as extracted sputum, oxygen saturation (SpO2) constantly increased (p<0.05) during 45 minutes, and the heart rate significantly decreased at 5, 30 and 45 minutes. The MP/PD result revealed, the FVC and FEV1 apparently started statistical increasing after 15 minutes and the peak expiratory flow rate (PEFR) apparently started statistical increasing after 30 minutes, as well as extracted sputum, SpO2 apparently started statistical increasing at 5 and 45 minutes, and the heart rate significantly, statistically decreased after 30 minutes. However, there is no significant statistical difference appeared on the pulmonary function parameter, oxygen saturation, heart rate and sputum quantity between PD and MP/PD.
Key Words: chronic lung disease, ineffectiveness of airway clearance, postural drainage, mechanical chest percussion, airway clearance efficiency, comfort
Nursing practice, base on this study, can utilize MP/PD method to assist CLD patients to clear their airway sputum. Meanwhile, adding their subjective perceived comfort is the common goal that every nursing person must constantly pursue. In addition, for those persons who are under treatment without assistance or percussion machines can utilize PD manner to clear the airway. Therefore, this report provides a simple, correct skill for either medical education or nursing individual to treat patients or self-treatment.
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