ANALYSIS OF RESPIRATORY THERAPY:

KNOWLEDGE ABD PRACTICES REGARDING INHALER TECHNIQUES IN

ASTHMATIC PATIENTS

A THESIS

Presented to:

The Faculty of the Department of Respiratory Therapy

In Partial Fulfilment of the Requirement for the Degree of

Bachelor of Science in Respiratory Therapy

Presented by:
Ebbah, Nabeelah A.
Faizal, Fainalyn P.
Guanzon, Trisha
 CHAPTER I

INTRODUCTION

1.1 Background of the Study

Lots of people worldwide suffer from chronic inflammatory lung

disorders such as asthma and chronic obstructive pulmonary disease

(COPD). Nebulizers, pressurized metered-dose inhalers (MDIs), dry powder

inhalers (DPIs), and soft mist inhalers (SMIs) are some of the delivery

methods for inhaled therapy. Research continuously shows that a large

number of COPD and asthma patients do not use their inhalers correctly. (D.B.

Price, M. Roman-Rodriguez, R.B. McQueen, S. Bosnic-Anticevich, V. Carter,

K. Gruffydd-Jones, et al.).

It is true that drugs cannot work if they do not get to the places they are

supposed to. Patients frequently have a poor understanding of the purpose

and proper usage of their inhalation device, which leads to poor inhaler

technique. (F. Lavorini, A. Magnan, J.C. Dubus, T. Voshaar, L. Corbetta, M.

Broeders, et al.). It is common for people with asthma and COPD to have poor

adherence, with at least 50% of them failing to take their inhaled medication

as directed.
 Failure to comply may worsen the condition and result in expensive

exacerbations and deterioration of the technique. Results can be improved

with thorough patient education, which includes device training. But not all

patients can use their inhalers appropriately even after receiving training. (D.

Price, S. Bosnic-Anticevich, A. Briggs, H. Chrystyn, C. Rand, G. Scheuch, et

al.)

It has been suggested that attaining the best possible therapeutic

benefit and controlling asthma significantly depends on receiving the right

instruction and training in precise inhaling technique. The goal of the current

study was to assess inhaler technique and the impact of education on asthma

control suffering from persistent asthma.

1.2 Statement of the Problem

The main objective is to evaluate the knowledge and techniques of

Asthmatic Respiratory Therapies Students in regard to the use of inhaler devices.

Specifically, the study aims to:

1. Compare prescribed inhaler devices that are being used by the

patients;
 2. Assess, using a straightforward interview, the patients' overall ability,

knowledge, and skills in managing and using of inhaled drugs

3. Correlate clinical and anthropometric data with the patients' overall

ability to manage drugs.

1.3 Significance of the Study

The effectiveness of medication can be increased by using an inhaler

correctly, which lowers dosage and side effects. So then, we hypothesized

that if patients have the proper knowledge, and conduct proper techniques in

utilizing their inhaler devices, they may be more likely to be medicated

correctly. Asthmatic RT students’ ability of knowledge for proper usage of their

inhaler devices has not been thoroughly investigated. Our objectives were to

ascertain the knowledge, techniques, and attitude of asthmatic patients

regarding their inhalers and to assess the potential elucidation in providing

better information in proper usage of inhalation method.

1.4 Conceptual Framework

Table 1.1 Conceptual Framework

Asthmatic

RT Student

INHALER
DEVICES

PATIENT’S PROPER
ANALYSIS METHOD AND
ABILITY, TECHNIQUES
KNOWLEDGE

Table 1.1 describes the study's conceptual framework wherein the input is

the following: Number of Asthmatic RT’s students, list of inhaler devices,

patient’s ability and knowledge, clinically proper techniques, and analysis of the

research.

The first input is the numbers of the respondents, then the devices that

the patient’s use, then the evaluation of each respondent to how far is their

knowledge about the inhaler devices they use, next is comparison to the proper

clinical methods of each inhaler devices, and lastly is the analysis of the data

being collected to find out to how far is the knowledge of RT students to inhaler

devices they use.

1.5 Scope and Delimitation of the Study

This study mainly focuses on the analysis of Respiratory Therapist

regarding inhaler devices. This analysis study is only applicable for Asthmatic

Respiratory Students of Universidad de Zamboanga.

1.6 Operational Definition of Terms

The following terms are used in the study.

Asthma - a chronic (long-term) condition that affects the airways in the lungs.

Chronic Obstructive Pulmonary Disease - a group of diseases that cause

airflow blockage and breathing-related problems.

Clinical Methods - the means by which physicians discover facts about the

sick or well patient and enter them into the diagnostic and therapeutic process in

equal partnership with information about disease, pathophysiology, and

technology.

Dosage - the size or frequency of a dose of a medicine or drug.

Dry Powder Inhalers - a device that delivers medication to the lungs in the

form of a dry powder.

Drugs - a medicine or other substance which has a physiological effect when

ingested or otherwise introduced into the body.

 Inhaler - a portable device for administering a drug which is to be breathed in,

used for relieving asthma and other bronchial or nasal congestion.

Medication - a substance used for medical treatment, especially a medicine

or drug.

Nebulizer - a device for producing a fine spray of liquid, used for example for

inhaling a medicinal drug.

Pressurized Metered-Dose Inhalers - a type of MDIs that works based on

the pressurized propellant in the aerosol chamber.

Respiratory Therapy - a certified medical professional who specializes in

providing healthcare for your lungs.

Soft Mist Inhalers - a handheld device for taking medicine that must be

breathed into the lungs (inhaled).

 CHAPTER II
RESEARCH METHODOLOGY

2.1 Research Design

This research aims to evaluate asthmatic respiratory therapists’

students’ understanding and application of inhaler strategies and techniques

regarding with their use of inhaler devices. The study is to investigate

prevalent practices, pinpoint knowledge gaps and strengths, and evaluate the

overall efficacy of their actions.

SAMPLING

DATA COLLECTION

VARIABLES

DATA ANALYSIS

ETHICAL CONSIDERATIONS

RECOMMENDATIONS AND IMPLICATIONS

LIMITATIONS

DISSEMINATION

TIMELINE

FIGURE 3.1 Methodology Flow Diagram

 2.2 Respondent

The respondents in this study are Respiratory therapy students who are

diagnosed with asthma and is currently using inhaler devices The following are

the requirements for participants' inclusion:

1. Educational Background

- Participant must be a bonafide student of Universidad students and

is currently enrolled as BS Respiratory Student.

2. Informed Consent:

- Respondents will be given thorough details about the study's goals,

methods, possible drawbacks, and advantages prior to taking part in

it.

3. Confidentiality:

- Throughout the study, participant identities will be kept private.

Information will be de-identified and safely archived to safeguard

respondents' privacy.

4. Voluntary Participation:

- All participants in the study are free to leave at any time without

penalty, and participation is completely voluntary.

This study attempts to obtain a thorough grasp of respiratory therapy

students' knowledge and practices about inhaler strategies in the context of

controlling their health condition by carefully choosing and including them as

respondents. The research team is dedicated to maintaining ethical norms and

making sure that respondent contributions are essential to the study's success.

2.3 Locale of the Study

The study, which will specifically target respiratory therapy students

diagnosed with asthma and other asthma-related condition and currently enrolled

in the program, will be carried out at the Universidad de Zamboanga. Philippines'

Zamboanga City is home to the Universidad de Zamboanga. Because of its varied

healthcare environment and the university's well-established respiratory therapy

program, Zamboanga City is an excellent location for this research.

In Mindanao, the Philippines, Zamboanga City is a significant urban area

renowned for its commercial and cultural activity. The city's dynamic educational

scene is enhanced by the Universidad de Zamboanga's advantageous location.

The city's medical facilities, social dynamics, and cultural diversity provide a rich

environment in which to study students pursuing respiratory therapy.

Students participating in respiratory therapy programs at Universidad de

Zamboanga at varying program levels will be the focus of the study. Students from

different academic years will be included in the population, enabling a thorough

examination of their knowledge and behaviors throughout their educational

journey. The program will utilize a purposive sample technique to guarantee

representation from various phases.

2.4 Sample Design

Students studying respiratory therapy at Universidad de Zamboanga are

the research's target group. In order to obtain a complete picture of the knowledge

and practices around inhaler strategies throughout multiple program phases,

students from a variety of academic years will be included.

The official roster of respiratory therapy students, which was supplied by

the academic affairs office of the university, will be used to build the sample frame.

The participants will be chosen based on this roster.

The study will utilize a purposive sampling approach to guarantee

representation from various tiers of the respiratory therapy program. Based on

their academic year, participants will be chosen, ensuring a diverse sample that is

representative of all students.

The saturation principles will be used to establish the sample size, with the

goal of include a sufficient number of participants to produce data richness and

depth of insights. The initial goal sample size is 100 respiratory therapy students,

though this could change as the study progresses.

To provide equitable representation at all program phases, the sample will

be divided according to academic year. This will make it easier to comprehend how
information and procedures change as the respiratory therapy program

progresses.

In order to provide a thorough understanding of the knowledge and

practices of Universidad de Zamboanga's respiratory therapy students regarding

inhaler techniques in asthmatic patients, this sample design makes use of a

purposive sampling strategy and takes into account the diversity of academic

levels within the respiratory therapy program.

2.5 Reliability and Validity

2.5.1 Reliability

[Link] Internal Consistency

Instrument Reliability - To evaluate internal consistency, a pilot test

of the survey instrument will be conducted with a limited group of respiratory

therapy students. The reliability of the survey questions will be assessed by

calculating the Cronbach's alpha coefficient. An appropriate coefficient is

one that is higher than 0.70.

Consistency Across Sections - If the survey is broken up into

sections, each section's consistency will be checked to make sure it

measures the desired construct accurately.

[Link] Test-Retest Reliability

 The survey will be sent to a portion of the participants to complete

twice. The Pearson's correlation coefficient will be utilized to examine the

consistency of responses between the two administrations. Strong test-

retest reliability is shown by a high correlation.

2.5.2 Validity

[Link] Content Validity

Expert Review - To make sure the survey questions fully cover the

desired subject, a panel of specialists in respiratory therapy education and

research will examine the instrument. A team of experts in respiratory

therapy education and research will assess the survey instrument to make

sure that the questions fully cover the desired content. Expert feedback will

be incorporated to improve content validity. Expert input will be taken into

consideration to improve the content validity.

Pilot Testing - A pilot study involving a limited cohort of respiratory

therapy students will be carried out to obtain input regarding the lucidity and

pertinence of the survey inquiries. To strengthen the content authenticity,

changes will be made in response to their input.

 [Link] Construct Validity

Factor Analysis - Factor analysis will be performed, if necessary, to

investigate the underlying constructs that the survey measures. This

analysis will assist in verifying that the survey items accurately measure the

intended constructs.

Hypothesis Testing - Based on the body of available literature,

hypotheses on the knowledge and practices of respiratory therapy students

will be developed. Confirmation of these theories by statistical analysis will

bolster the research's construct validity.

[Link] Criterion-Related Validity

Comparison with Existing Measures - The survey results, if

available, will be compared with current assessments of the knowledge and

skills of respiratory therapy students. Criterion-related validity would be

supported if there was a substantial correlation found between the new

instrument and established measures.

[Link] Face Validity

Student Feedback - Following the completion of the survey,

respondents will be asked to comment on the questions' relevancy and

 clarity. This qualitative input will be useful in determining face validity and

pointing out any possible problems with understanding the question.

[Link] Concurrent Validity

Comparison with Practical Assessments - The outcomes of any

practical evaluations that are included will be compared with the survey

replies. Concurrent validity would be supported by a significant correlation

between self-reported practices and observed practical skills.

[Link] Ecological Validity

Application to Real-world Settings - The results of the study will

be examined in light of situations that respiratory therapy trainees may

encounter in the real world. This factor guarantees the ecological validity of

the study and shows how far the conclusions may be used in real-world

scenarios.

This study on the knowledge and practices of respiratory therapy students

at Universidad de Zamboanga intends to generate solid and reliable results that

significantly advance our understanding of inhaler techniques in asthmatic patients

by methodically addressing validity and reliability issues.

2.6 Ethical Consideration

2.6.1 Informed Consent

Clear Information - Prior to their involvement, participants will get thorough

information about the goals, methods, possible dangers, and advantages of the

research. The voluntary nature of involvement will be made abundantly clear

in the permission form.

Consent Process - Before any person is involved in the study, their

informed consent will be sought. The consent forms will be drafted in a way

that is easily comprehensible to all involved.

2.6.2 Confidentiality

Anonymity - All information gathered will be anonymized, and participant

identities will remain private. The responses will be tagged or have personal

identifiers removed to prevent individual participants from being identified.

Secure Data Storage - The study team will be the only ones with access to

the password-protected electronic devices or secured physical storage where

the collected data is kept safe. Only authorized staff will be able to access the

data.

2.6.3 Ethical Approval

Review Board Clearance - Before starting, the research will be subjected

to an ethical evaluation and approved by the ethical review board of

Universidad de Zamboanga. This guarantees that the study conforms to

accepted ethical norms.

 Protocol Adherence: The study team shall closely follow the authorized

research protocol, and shall promptly notify the ethical review board of any

deviations.

The research on respiratory therapy students' knowledge and practices at

Universidad de Zamboanga prioritizes these ethical issues in order to maintain the

study's integrity, transparency, and participant welfare.

2.7 Statistical Tool/Treatment

2.7.1 Descriptive Statistics

To enumerate and characterize the essential elements of the respiratory

therapy students' inhaler technique knowledge and practice.

Tools/Treatments:

- Mean and standard deviation for continuous variables (e.g., overall

knowledge scores).

- Frequency distributions and percentages for categorical variables

(e.g., frequency of specific inhaler techniques practiced).

2.7.2 Factor Analysis

To investigate the relationship between categorical variables, such as the

relationship between a given practice's frequency and particular demographic

traits, such academic year.

 Tools/Treatments:

- Chi-square tests can help identify whether there are significant

associations or dependencies between categorical variables.

2.7.3 Reliability Analysis

To evaluate the survey instrument's internal consistency.

Tools/Treatments:

- The Cronbach's alpha coefficient will be computed in order to assess

the validity of the knowledge and practice survey items.

2.7.4 Validity Analysis

To assess the survey instrument's suitability for measuring the desired

constructs.

Tools/Treatments:

- Expert review will be used to evaluate the content validity, while

component analysis and comparisons with current measures will be

used to investigate the construct validity.

With relation to inhaler strategies for asthmatic patients, these statistical

tools and treatments seek to offer a thorough review of the knowledge and

practices of respiratory therapy students at Universidad de Zamboanga. The

integration of both quantitative and qualitative analyses is expected to enhance

the comprehensive comprehension of the variables impacting respiratory therapy

instruction and procedures within the particular setting of the institution.

2.8 Data Gathering Procedure

2.8.1 Preparation Phase

Approval and Permissions

- Obtain ethical approval from the ethical review board of the

university.

- Request approval to carry out the research from the appropriate

Universidad de Zamboanga authorities.

Participant Recruitment

- Work together with the administrators of the respiratory therapy

program and the academic affairs office to locate and get in touch

with possible participants.

- Share information about the study using outlets that are authorized

by the university.

Informed Consent

- Develop clear and concise informed consent forms outlining the

purpose, procedures, risks, and benefits of participation

- Get each participant's written agreement, stressing that participation

is entirely optional.
 2.8.2 Data Collection

Distribution of Survey Questionnaires

- Depending on the preferences of the participants, provide the survey

questionnaire to them in person or electronically.

- Provide expectations and instructions for filling out the questionnaire

in a clear and concise manner.

Interviews

- To obtain qualitative insights, interview a selection of participants in-

depth.

- To encourage thorough and in-depth answers, use open-ended

questions in a semi-structured approach.