STUDY DESKRIPTIF PENANGANAN PRE-HOSPITAL STROKE LIFE SUPPORT PADA KELUARGA

Keberhasilan penanganan stroke sangat tergantung dari kecepatan, kecermatan dan ketepatan terhadap penanganan awal. Keluarga sangat berperan penting dalam menangani serangan stroke anggota keluarganya. Waktu emas (golden window) dalam penanganan stroke adalah ± 3 jam, artinya dalam 3 jam awal setelah mendapatkan serangan stroke, pasien harus segera mendapatkan terapi secara komprehensif dan optimal. Penelitian ini dilakukan untuk mengidentifikasi penanganan pre hospital stroke life support yang dilakukan oleh keluarga mulai dari deteksi dini, pengiriman maupun rujukan cepat di Kabupaten Kendal. Penelitian ini dilakukan di Ruang rawat inap RSUD Dr. H. Soewondo Kendal pada 45 responden (keluarga pasien stroke). Desain penelitian ini menggunakan deskriptif observasional menggunakan kuesioner penanganan prehospital pada stroke. Hasil penelitian menunjukkan bahwa Penanganan Pre Hospital Stroke Life Support mayoritas dalam kategori baik (60%) baik dari segi deteksi dini, pengiriman, maupun rujukan cepat pada pasien stroke. Penelitian ini dapat menjadi dasar dalam pemberian edukasi bagi masyarakat pada dimensi Deteksi pasien stroke dalam hal deteksi wajah dan pemberian posisi serta pada dimensi Pengiriman pasien dan transportasi stroke dalam hal penggunaan ambulance. Kata kunci: pre hospital, stroke, penanganan awal, keluarga Abstract Descriptive study of handling prehospital stroke life support in family. The success of handling stroke depends on the speed, accuracy and accuracy of the initial treatment. Families are very important in handling stroke attacks by family members. Golden time in handling stroke is ± 3 hours, meaning that in the first 3 hours after getting a stroke, the patient must immediately get a comprehensive and optimal therapy. This study was aimed to identify the treatment of pre hospital stroke life support carried out by the family in the early treatment of stroke patients ranging from early detection, delivery and rapid referral in Kendal Regency. This research was carried out in the inpatient room of Dr. H. Soewondo Kendal in 45 respondents (family of stroke patients). The design of this study used an observational descriptive using a prehospital handling questionnaire on stroke. The results showed that the majority of Pre Hospital Stroke Life Support was in the good category (60%) both in terms of early detection, delivery, and quick reference in stroke patients. This research can be the basis for giving education to the community on the dimensions of detection of stroke patients in terms of face detection and the provision of positions as well as the dimensions of patient delivery and stroke transportation in terms of ambulance use. Keywords: pre hospital, stroke, early treatment, family

Cultural and linguistic validation of the NHQ-2 Questionnaire: a specific instrument for assessing patient’s usability of inhalation devices

Background: An increasing number of inhalation devices are presently available in the market. They are differently characterized in terms of their handling and usability, both factors which may affect the outcomes of respiratory treatment. The assessment of the preference and the usability rate of all devices can be carried out by means of specific questionnaires. Before their use, the identification of errors due to the incorrect wording of questions included in the questionnaires, together with the trans-cultural reliability represents the main issues of their cultural and linguistic validation. Methods and results: The New Handling Questionnaire - NHQ-2 is a novel specific questionnaire aimed to measure both the preference and the usability of all kinds of inhalation devices. The method used for its validation has been summarized in the first section of the present paper, while the results of the specific validation and translation process have been described in the second section, together with the grading of improvement achieved over the process. The comprehensibility and the reproducibility rates achieved for both the Italian and the English final versions of the NHQ-2 questionnaire were very high, such as >90 % for each question included. Conclusions: The novel NHQ-2 questionnaire proved very high comprehensibility and reproducibility in both its Italian and English final versions. It can be proposed for the trans-cultural clinical use when the usability, and not only the patients’ preference of devices, should be assessed.

Acceptability and preference of three inhalation devices assessed by the Handling Questionnaire in asthma and COPD patients

Background: The patients’ criteria of preference for inhalation devices can affect the extent of their adherence to treatment and outcomes. Aim of this study was to assess and compare the patients’ preference and acceptability (PPA) for Breezhaler and Genuair (both Dry Powder Inhalers), and for Respimat (a Soft Mist Inhaler) in asthma and COPD out-patients by means of the Handling Questionnaire. Methods: The Handling Questionnaire is a validated instrument which allows the investigation of different domains of PPA; it also takes into account the patients’ age and gender, together with their previous experience with the inhalation devices and their previous education approach to them. Differences in terms of preference, acceptance and usability were assessed by linear and logistic regressions in order to evaluate factors influencing the proper actuation. Results and Discussion: Data from 333 patients were collected: Genuair and Respimat were the most liked and perceived as the easiest to use at glance by patients, but also as the least problematic according to the patients’ and nurse’s judgments. Mean number of attempts for achieving the first effective actuation was the highest with Breezhaler (2.6 vs 1.6; p <0.0001). Linear regressions showed that longer the explanation, higher was the number of attempts to the first proper actuation (0.58 additional attempts every 10 s increase in the first explanation, p <0.0001). Devices requiring less manoeuvres for the actuation were used properly after less attempts (0.38 increase in the number of attempts every additional manoeuvres, p <0.0001). Respimat proved to be the most indicated in COPD patients since it was the most liked and its successful rate at first attempt was the highest. Logistic regressions confirmed these data. Previous experience with DPIs and/or MDIs did not affect the patient preference and acceptability, independently whether suffering from asthma or COPD. Conclusions: Substantial differences are existing in patient’s preference and acceptability for inhalation devices, mainly related to the handling and the understanding of the different devices.

Cultural and linguistic testing of the Handling Questionnaire: a specific instrument for assessing the patient’s acceptability of dry powder inhalers

The testing and checking phases of a questionnaire are briefly described in this paper, identifying the common errors due to incorrect formulation of questions and the main issues. The theoretical methods for “testing” a questionnaire has been examined in the first section, in the second section the testing process for a specific questionnaire for assessing the patient’s acceptability of a dry powder device (the Handling Questionnaire) has been described, together with the grading of improvement achieved.