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      Coaching patients during pulmonary function testing: A practical guide

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          Abstract

          Pulmonary function testing is a cornerstone in the diagnosis and management of individuals with respiratory disease. However, correct interpretation of pulmonary function data relies heavily on acceptable test quality, which in turn is dependent on several factors including equipment, trained personnel, and patient cooperation and effort. This article briefly reviews key principles of patient instruction and several aspects of pulmonary function testing, and discusses factors that hamper performance. The authors also offer several coaching suggestions and examples readers may find useful in their practice.

          Abstract

          Pulmonary function tests are an important tool to assist in the diagnosis and management of patients with respiratory disease. Ensuring that the tests are of acceptable quality is vital. Acceptable pulmonary function test quality requires, among others, optimal patient performance. Optimal patient performance, in turn, requires adequate coaching from registered respiratory therapists (RRTs) and other pulmonary function laboratory personnel. The present article provides techniques and tips to help RRTs coach patients during testing. The authors briefly review the components of pulmonary function testing, then describe factors that may hinder a patient’s performance, list common mistakes that patients make during testing, and provide tips that RRTs can use to help patients optimize their performance.

          Translated abstract

          L’exploration fonctionnelle pulmonaire est un outil important pour contribuer au diagnostic et à la prise en charge des patients atteints d’une maladie respiratoire. Il est essentiel de s’assurer que les tests sont d’une qualité acceptable. Pour parvenir à une analyse des explorations fonctionnelles respiratoires de qualité acceptable, il faut, entre autres, obtenir le rendement optimal du patient. Pour ce faire, l’inhalothérapeute et le reste du personnel du laboratoire de fonction pulmonaire doivent donner des conseils pertinents. Le présent article présente des techniques et des trucs pour aider les inhalothérapeutes à conseiller les patients pendant les tests. Les auteurs analysent brièvement les éléments de l’exploration fonctionnelle pulmonaire, décrivent les facteurs qui nuisent au rendement du patient, énumèrent les erreurs courantes que font les patients pendant les tests et donnent des conseils que les inhalothérapeutes peuvent utiliser pour aider les patients à optimiser leur rendement.

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          Most cited references37

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          Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper.

          W MacNee, , B Celli (2004)
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            Cystic fibrosis pulmonary guidelines: chronic medications for maintenance of lung health.

            Cystic fibrosis is a recessive genetic disease characterized by dehydration of the airway surface liquid and impaired mucociliary clearance. As a result, individuals with the disease have difficulty clearing pathogens from the lung and experience chronic pulmonary infections and inflammation. Death is usually a result of respiratory failure. Newly introduced therapies and aggressive management of the lung disease have resulted in great improvements in length and quality of life, with the result that the median expected survival age has reached 36 years. However, as the number of treatments expands, the medical regimen becomes increasingly burdensome in time, money, and health resources. Hence, it is important that treatments should be recommended on the basis of available evidence of efficacy and safety. The Cystic Fibrosis Foundation therefore established a committee to examine the clinical evidence for each therapy and to provide guidance for the prescription of these therapies. The committee members developed and refined a series of questions related to drug therapies used in the maintenance of pulmonary function. We addressed the questions in one of three ways, based on available evidence: (1) commissioned systematic review, (2) modified systematic review, or (3) summary of existing Cochrane reviews. It is hoped that the guidelines provided in this article will facilitate the appropriate application of these treatments to improve and extend the lives of all individuals with cystic fibrosis.
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              Pulmonary Function Tests

              Pulmonary function tests are valuable investigations in the management of patients with suspected or previously diagnosed respiratory disease. They aid diagnosis, help monitor response to treatment and can guide decisions regarding further treatment and intervention. The interpretation of pulmonary functions tests requires knowledge of respiratory physiology. In this review we describe investigations routinely used and discuss their clinical implications.
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                Author and article information

                Journal
                Can J Respir Ther
                Can J Respir Ther
                Canadian Journal of Respiratory Therapy: CJRT = Revue Canadienne de la Thérapie Respiratoire : RCTR
                Pulsus Group Inc
                1205-9838
                2368-6820
                Summer 2015
                : 51
                : 3
                : 65-68
                Affiliations
                [1 ]Pulmonary Function Laboratory, Kaye Edmonton Clinic, University of Alberta Hospital;
                [2 ]Department of Medicine, University of Alberta, Edmonton, Alberta
                Author notes
                Correspondence: Ms Heidi J Cheung, Pulmonary Function Laboratory, Kaye Edmonton Clinic, University of Alberta Hospital, 11400 University Avenue, Edmonton, Alberta T6G 1Z1. Telephone 780-407-5416, fax 780-407-5710, e-mail heidi.cheung@ 123456albertahealthservices.ca
                Article
                cjrt-51-65
                10.1016/j.chest.2020.06.065
                4530837
                26283871
                8d169c03-7ac1-4c60-85e1-480c3877b3dd
                © 2015 Canadian Society of Respiratory Therapists. All rights reserved

                This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License (CC BY-NC) ( http://creativecommons.org/licenses/by-nc/4.0/), which permits reuse, distribution and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes. For commercial reuse, contact support@ 123456pulsus.com

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                Categories
                Review

                diffusion capacity,flow volume loops,nitrogen washout,plethysmography,quality control,slow vital capacity

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