Chronic Obstructive pulmonary disease (COPD) is known as a condition of endless wind current confinement and is a primary reason for unending dismalness and mortality in the whole world. The symptoms of COPD are only visible after the lung has lost an approximate of 60% of its function. Most studies about COPD though have been performed in Europe and America. Asia has also been represented in a few studies. COPD is among the main sources of death in the UK and is anticipated to become the third driving reason for death worldwide by 2020.
The rationale used to select the two articles was based on the fact that the articles in their best ways were able to explore and comprehend the adapting procedures that the immigrants living in Korean and particularly suffers from asthma and COPD cases use to adapt to dyspnea. This article also compares the similarities and the contrasts present in the adapting systems between the two conditions. The main journal that was chosen to explore the whole idea of the topic is the Journal of Transculture Nursing written in 2014 with an issue number 25. There was also the Plos ONE journal issue number 4 written in the year 2016.
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Critical Thinking
These two articles were able to stimulate my critical thinking in that I was able to find out more about COPD and Asthma. The strategies that I learn will be used to educate other people who might be suffering from the illness and lacks proper knowhow on how to reduce or prevent it. For example I learnt that people suffering from COPD experience either a productive or a non-productive cough and that chronic sputum is related to chronic bronchitis (Soo-Kyung et al., 2014).
I would also use the information that I acquired from the articles to discourage the Korean people who smoke to quit it immediately. I would reach out to many people by posting blog articles related to the illness or use Facebook to educate more people.
Reflective Feelings
As much as the journal articles talks about COPD and Asthma and the preventive measure to be taken, the articles can also provoke anger to the reader upon finding out that the issue of treatment for both Asthma and COPD has not yet been fully investigated. According to Soo-Kyung article (2014), the author states that even though the illness has good strategies and treatment approaches, not all patients can afford them. I feel that government should alter its budget implementations and allocate more funds to the medical sector to help COPD and Asthma patients access medications and all strategies available.
Application to NP Core Competencies
The article journal gives an overview of the competencies that are required on how to take care of patients suffering from COPD and Asthma and how the best strategic ways should be used. The article prepares the medical practitioners who might use it in the future to have effective methods to care for COPD patients as well as the Asthma patients. The core competencies used focus on the strategies that patients suffering from chronic illness should use to reduce the illness and also control its prevalence.
These two articles provide well established timeless real time experiences where a number of Korean patients were surveyed and their experiences with the chronic illness assessed and the best measures to curb the illness taken. These articles ensure that the medical practitioners or the trainees in health care can give the best medical attention and care to patients. The three most used core competencies include: The assessment of health status and in this case the COPD and Asthma cases, the diagnosis of the health problem and finally the plan of care and implementation of the treatment.
Risk Factors
Cigarette smoking is the most critical hazard that is commonly known to trigger COPD advancement and development. Cigarette Smoking assumes a focal part in disease pathogenesis and advances the failure of the lung to perform its duties in the body, and this might even lead to the death of the individual. Other risk factors include inhaled pollution that can either happen indoor or when a person is outdoors. Severe lung infection during childhood is another risk factor that promotes COPD. In addition, the coexistence of asthma; reduced lung development and female sex are also contributing factors (Minsu et al., 2016).
Clinical Features
Dyspnea is the essential incapacitating side effect of Chronic Obstructive pulmonary disease. Furthermore, this chronic illness is the most well-known. A complex phenomenon that makes its movements from individual to individual, this challenging, relentlessly drudged breathing is enacted by extended ventilation discretionary to extended moments of breathing. However; dyspnea is more than only a physiologic marvel. It is additionally activated by components, for example, nervousness and dread. Individuals suffering from the chronic illness i.e. COPD have been known to be afraid of the sensation of dyspnea that is known to result from ineffective breathing. These people in return try to avoid physical exercises as dyspnea progresses. This, however, is a disadvantage to these patients as lack of exercises lead to a downward spiral of disability. Without exercising the body, dyspnea tends to increase even when the patient is resting.
Screening and Diagnosis
Human services suppliers or practitioners ought to make wise judgements and thus have the patients’ family members screened especially those that have a family history of AAT deficiency. The health screening helps to assess for clinical elements of COPD or other pneumonic sicknesses like asthma. The lung function abnormalities are difficult to distinguish at the early stages; however, using the sputum to screen for any signs of the disease might be helpful. Spirometry is a commonly used to test and confirms the diagnosis of COPD (Kim et al., 2013).
COPD and Anxiety
People who have been treated with COPD in Korea, for various reasons have been associated with being anxious. When individuals find out that they have difficulties to breathe, their brain will automatically set an alarm that something is wrong. This, therefore, causes panic to the individual, creating anxious feelings as the person thinks of a possible asthma attack. Uneasiness and COPD frequently make a cycle of shortness of breath which incites panic, making it significantly harder for the patient to breath. Sometimes, experiencing some anxiety when a person has a chronic illness is regarded as a blessing in disguise. This is because stress prompts the patient to follow their medical treatment plan as well as pay attention to their symptoms seeking medical advice when necessary.
Coping Strategies
The effect of stress brought on by an incessant ailment can have broad results on day by day working and personal satisfaction. Conformity to an incessant sickness relies on upon how far the malady has spread in the body of the patient or the rate of infection. Adaptation can also be impacted by an individual's ability to assess and respond to stressors. Korean immigrants are known to be from a country where the smoking rate and air pollution is very high. This, therefore, increases the prevalence of COPD among this population (Soo-Kyung et al., 2014). The following study seeks to explore the potential similarities and differences, and the impact of coping resources and style between asthma and COPD patients among Korean immigrants.
Methods
Sample and Data Collection
The present study uses a cross-sectional data from a Korean study among asthma and COPD patients in primary care. The participants in this study were issued with questionnaires on which they were requested to fill in data that was related to their health information. The participants agreed to be part of the study through their good will. Some of them heard about the study while others were referred by their medical practitioners. The questions were based on asthma and COPD medical cases. The participants had to undertake a medical examination in a local health care clinic and issued with the results later on. This research was affirmed by the Institution Review Board of the Korean Centers for Disease Control and anticipation. The participants who were involved in the research signed a consent form as this was a requirement before proceeding with the survey.
Participants
A purposive sample of 73 participants who were suffering from asthma (n=25) and COPD (n=48), were recruited through a respiratory specialist clinic and a local Lung Association between June and October 2008. Thirty-three of the informants were men, and 40 were women. They ranged from the age of 27 years to 80 years. The majority 62% were married and lived with their spouses. The instruments that were used for data collection included interviews, filling questionnaires and visual analog scale.
COPD Knowledge
The level of learning in regards to COPD was measured utilizing surveys that included questions. This was to test how much knowledge or awareness the participants were exposed to regarding asthma and COPD.
Pulmonary Function
All the participants underwent a pulmonary function test, and its level was measured.
Unplanned Hospital Visits
Spontaneous doctor's facility visits were measured and the respondents were asked to specify the number of times that they had gone to see a doctor in the past 12 months. They were also directed to show the number of times that they had visited a hospital in emergency cases as well as the number of times that they have been admitted. The quantity of spontaneous doctor's service visits depended on the question; ‘in the past one year how frequent have you seen a doctor or have been admitted to a hospital?’
Demographic and Clinical Information
Information on demographics and clinical qualities was collected using organized surveys that involved questionnaires issued to the participants. Demographic data included age, the level of education for each participant, job status, economic and marital status. Health care information included dyspnea symptoms, history of vaccination and hospital visits, weight, smoking comorbid medical conditions.
Fatigue
The participants were interviewed through open ended questions and data was collected. Participants explained their experience of fatigue and related it to asthma and COPD.
Health behavior and status
The smoking history of those who were involved in the survey was categorized. Psychosocial wellbeing and practical wellbeing were communicated. The presence of sorrow and depression among the participants was additionally measured so were the self-destructive contemplations in a period of the previous one year.
Traditional medicines and herbs
The participants were interviewed and the researcher found out that of the 73 participants, 30 were taking traditional herbs and medicine. Those taking the herbs had a significant improvement in their quality of life scores as compared to no treatment. Those who were taking the herbs and at the same time pharmaceutical treatment also had a significant higher score. 50 % of the participants indicated that they would prefer the traditional herbs to the pharmaceutical medication, 20% would take a combination of both traditional and pharmaceutical while 10 % did not want anything to do with the traditional herbs.
Results
The results indicated that 73 participants completed this study and it was discovered that an approximate of 80% of them suffered comorbidities. Both groups of informants stated that they have breathing difficulties and lack the energy to perform activities. However, the asthma group had high scores for dyspnea. It was also found out that most participants lacked enough education. The place of residence for the participants had a high percentage of known smoking zones. The family unit income and body mass record contrasted between the two survey groups. Patients with COPD had more comorbid infections than those in the ordinary lung work bunch. The levels of psychological stress were similar in the two groups. Patients with a history of vaccination reported higher adherence to COPD.
There was a huge relationship that was found to divide the AP adherence and immunization, impromptu clinic visits, COPD adaptation teachings and nervousness and dejection in patients with the chronic illness. The delayed consequence of this research is strong as data collected indicated that the Meta examination of the articles that were engaged reported a supportive result of Chronic Obstructive pulmonary disease on self-administration learning and no impact of asthma and lung work. Some subgroup difference was identified predicting multiple or specific types of strategies. Although most of the participants used more than one modality, 10 participants were using two or more approaches especially those who had severe symptoms.
Significance differences in prevalence were present in the strategies. It was found out that those who suffered from asthma most often used home remedies and kept off from things that were a health hazard to them. In short participants who had asthma took the strategies more seriously than those who were suffering from COPD.
Management
Coping Suggestions
Patients suffering from dyspnea should be taught on the best activities that they should engage themselves into so as to reduce or control the illness. The patient ought to be taught on the best breathing strategies like pressed together lip breathing which diminishes breaths while improving the expiratory phase. The patient should also know the proper positioning on which to sit or stand or when performing activities. The patient should be advised on the techniques that are energy conservative like taking frequent rests and using assistive devices. In addition, the patient should learn how to handle their daily activities bit by bit so that they do not suffer from lack of breathiness when they get tired. This way, the patients are able to reduce dyspnea development.
Smoking Avoidance
The most critical preventive measure for asthma and COPD cases is for individuals to completely quit smoking. At the point when people quit smoking at an early stage, the odds are that the infection would decrease the ensuing rate of decrease in lung working. This would also reduce future mortality. Smoking cessation counseling is thus effective to smokers in Korea. Moreover, support networks and individual self-management are significantly helpful to patients and help them cope with COPD. Pulmonary rehabilitation has also been known to enhance the personal satisfaction, practice limit and self-adequacy in outpatient and group settings (Soo-Kyung et al., 2014).
Emotion-focused Strategies
Feeling centered systems allude to measures helpful to dealing with the enthusiastic reaction to an issue. From the two groups view, 53% of the patients see their disease in a positive light and have an inspirational point of view all in all. Tolerating the physical impediments both witnesses with COPD and those with asthma acknowledge their conditions and live within the restrictions forced. Taking control of COPD was a compelling system for the individuals who could accomplish it. These patients were resolved and decided that COPD would not control their life, and they proceeded with a dynamic life experience like nothing serious was happening in their lives. They involved themselves with activities that kept them actively involved and also helped them to get away from loneliness despite their physical limitations.
Medication
Almost all members who were participating in the survey utilized endorsed medicine for COPD and majority of them reported that the prescription was viable. However, 1% found their inhalers ineffective due to the difficulty in using them when breathless. In addition, 20% of the participants managed COPD with medication alone. COPD patients should receive pneumonia and influenza vaccines. It was found out that of all the participants 50% claimed that serious complications had been reduced due to the yearly flu vaccines that they received. Antibiotics are also useful for patients with intense intensifications when a bacterial disease seems to be present.
Exercising
The researcher found out that 25 participants reported exercising on a regular basis like walking, jogging and rope skipping. They indicated that the regular physical activities helped them maintain their well-being or reduced medication reliance. Breathing exercises learnt either at PR, relaxation classes, swimming or singing lessons were also helpful. 90% of the participants agreed that exercising helps improve the symptoms and their quality of life. Patients with COPD should thus exercise until they feel a little breathless but should not push the exercise activity too far than the requirement.
Oxygen
Oxygen treatment best works for patients who are suffering from hypoxemia. While it doesn't improve the function of the lung work, it helps patients suffering from hypoxemia increase their survival period. The goal is to achieve an oxygen immersion estimation of 90% or higher. When performing the oxygen treatment, it ought to be endorsed in liters per minute to help the patient rest, get enough sleep and be able to breathe with no difficulties. The oxygen treatment controls the blood vessels limiting the amount of air that the patient breathes in or out.
Pulmonary Rehabilitation
The management of COPD is not an easy task, whoever some pathological changes can be done to reduce the symptoms. For patients with unending respiratory disability, practitioners and nurses may endorse pneumonic restoration. This program is exclusively custom fitted to upgrade the patient's physical and social working and addition self-governance. It demonstrates to patients industry standards to manage reactions and accomplish their most outrageous working level. The experimental premise for PR has been entrenched through various randomized, controlled center trials. Improved action resilience diminishes debilitating side effects and enhances personal satisfaction (Foo et al., 2016).
Nutritional Guidance
COPD patients normally have issues in trying to keep up with sufficient intake of the required food intake. As the illness advances, numerous patients experience cachexia. Patients with COPD should try to eat healthy so that they avoid adding weight. Carrying extra weight can cause breathlessness or even worse effects. Individuals in Korea who suffer from COPD and asthma should be educated on how to keep a healthy diet to improve their health status.
Watch What You Breathe
Patients suffering from COPD and asthma in Korea should be careful with what surrounds them. There are certain things that should be avoided so as to reduce the symptoms of these chronic illnesses. Patients suffering from COPD should avoid dusty places, places with a lot of smoke as well as car exhausts. They should also avoid strong smelling cleaning products and perfumes.
Counseling and Therapy
Among the 73 participants 85% suggested that Individual counseling was an effective way that helped them cope with asthma and COPD. The participants said that behavioral therapy was necessary as it helped the chronically ill individuals cope with their illness. During counseling, patients are taught on the relaxation techniques and breathing exercises among other activities that are a benefit to the patient. (Minsu et al., 2016) Group counseling and support groups are known to assist the asthma and COPD patients as they make them feel loved and also reduces loneliness as the patients are able to socialize with each other.
Implication for Nursing Practice and Research
The findings that were observed in this study give medical practitioners a better understanding and more knowledge about the Korean patients and the measures that they undertake to cope with dyspnea. The coping methods that the Korean participants use could significantly be of help to medical practitioners as the nurses are able to understand the Korean patients and the things that the pass through. The nurses are thus able to define the kind of life that the people live, why they use the traditional medicines and how well they cope with home remedies. Furthermore, the medical practitioners are able to care for the chronically ill as well as educate them on the best coping strategies. However, the 73 participants could not provide accurate data, therefore more research is needed so as to come up with more coping strategies as well as help the medics come out with enough information so that they can be ale to assess the patients.
Discussion
The study at hand attempted at examining the coping strategies that asthma and COPD patients in Korea should use. After data collection and an in-depth study of the chronic illness, it was found that individuals who were suffering from asthma experiences more stress in comparison with COPD patient. Research indicated also that an intense negative life occasion tends to increase the risks involved in the illness. According to investigations in earlier surveys as well as the current study, it can be concluded that mental stressors and patients response in confronting them has a striking part in the development and strengthening of COPD and asthma. The proposal is accordingly made that in addition to medical therapeutic intercessions, psychological interferences like teaching coping strategies and emotional control are necessary among other strategies.
These articles can enhance the present and future clinical practice in wide areas. The practitioner or the reader gets the knowledge on how to treat COPD and Asthma patients. The study also helps healthcare providers to appreciate the efforts by Korean immigration in trying to overcome dyspnea. Moreover, this will help health care practitioners while controlling approaches their patients use for coping.
The knowledge that one is considered to live with a chronic illness throughout his or her life has a psychological consequences for families, the patient, the community and even the way of living for the patient. The support to patients living with a chronic illness is therefore crucial as it gives the patient and their families hope to continue living. The practitioners of Korea should among others use the coping strategies as discussed in this study to help the Korean patients. It is also evident from the research that Korean immigrants use parallel coping strategies as those of other ethnic groups. The only difference observed is that their coping strategies integrate features of Asian medical herbs and practice.
References
Foo, J., Landis, S. H., Maskell, J., Oh, Y., van der Molen, T., Han, M. K., & ... Punekar, Y. (2016). Continuing to Confront COPD International Patient Survey: Economic Impact of COPD in 12 Countries. Plos ONE, 11 (4), 1-15.
Kim, S., Kim, J., Kim, K., Kim, Y., Park, Y., Baek, S., & . Moon, H. (2013). Healthcare use and prescription patterns associated with adult asthma in Korea: analysis of the NHI claims database. Allergy, 68 (11), 1435-1442.
Minsu, O., Min-Woo, J., Young-hoon, G., Hyeon-Jeong, L., Jiho, L., Chang Sun, S., & ... Sim, C. S. (2016). Estimating the severity distribution of disease in South Korea using EQ-5D-3L: a cross-sectional study. BMC Public Health, 161-9.
Soo-Kyung, P., Nancy A. Stotts, Marilyn K. Douglas, DorAnne Donesky-Cuenco, and Virginia Carrieri-Kohlman (2014). Dyspnea Coping Strategies in Korean Immigrants with Asthma or Chronic Obstructive Pulmonary Disease. Journal Transculture Nursing, 25: 60-69.
WHO,. (2015). Chronic obstructive pulmonary disease (COPD) . World Health Organization . Retrieved from http://www.who.int/mediacentre/factsheets/fs315/en/.
