NRS433V Introduction To Nursing Research

Chronic Obstructive Pulmonary Disease

Overview

Chronic Obstructive Pulmonary Disease is a universal term that is usually used to describe an array of diseases that affect the lungs. The particular disease include emphysema, chronic bronchitis and finally the refractory asthma (Gao & Taniguchi, 2014). The underlining characteristic of the disease however is increased breathlessness. It is very unfortunate that the disease is progressive and has no cure. With the correct diagnosis and treatment however, the condition can be managed well to improve breathing (Apps, Mukherjee, Abbas, Minter, & Whitfield, 2016). In Emphysema for example, the alveoli are damaged and inelastic making it difficult for air to move in and out. In chronic bronchitis, the bronchial airways get inflamed and destruction of cilia which sweep mucus and make the airways clean (Apps, Mukherjee, Abbas, Minter, & Whitfield, 2016). Mucus in turn build up and cause difficulties in breathing. In Asthma, the airways tighten and swell. Below is a detailed PICOT statement based on COPD.

Population

The population that is at risk of Chronic Obstructive Pulmonary Disease is the smoking population. However, the population that get exposed to other irritants like chemicals are also likely to suffer from the condition. This may include those people who work in industries that deal with pesticides, fungicides and herbicides. Farmers are also at risk when spraying those chemicals in their farms. This is to simply mean that any population that is exposed to substances that can irritate the airways is at risk of the Chronic Obstructive Pulmonary Disease.

Intervention

Currently, there is no standard method for treating Chronic Obstructive Pulmonary Disease. The only intervention programs available is management to improve on the symptoms and prevent exacerbations of the condition. Changes or effect of the Chronic Obstructive Pulmonary Disease are irreversible as long as the patient continues smoking. This is because the condition cause merging of alveoli to form inelastic sacs which subsequently reduce the surface area of the alveolar membrane leading to impaired gaseous exchange (Pascoe, Locantore, Dransfield, Barnes, & Pavord, 2015). The best intervention that can be utilized is palliative care. Palliative care is a form of service offered to individuals with life threatening conditions and Chronic Obstructive Pulmonary Disease is among them. Chronic Obstructive Pulmonary Disease is regarded as one of the terminal illnesses that only need palliative care. Palliative care is however a big umbrella that include holistic approach. Holistic patient serves to give the patient hope that a supernatural power might come to their rescue someday. It should therefore form part of the care.

Comparison

As stated earlier, there is no current treatment to Chronic Obstructive Pulmonary Disease rather than management to improve symptoms of the disease and exacerbations. Other than palliative care, the other intervention is oxygen therapy (Lange et al., 2015). Chronic Obstructive Pulmonary disease result to the destruction of the alveoli in the lungs rendering them ineffective when it comes to ability to oxygenate blood. This is because the infection causes hypoventilation of the alveoli and renders the patient hypoxic. This therefore necessitates supply of oxygen which is achieved through oxygen therapy. According to the Research conducted by The Nocturnal Oxygen Therapy Trial Group in 1980 as well as the Medical Research Council in 1981, the results indicated that oxygen therapy can prolong the life of the patient.

Expected Outcomes

Since the effect or rather the damage that arise from the Chronic Obstructive Pulmonary Disease is irreversible, the only expected outcome is to prolong life. Chronic Obstructive Pulmonary disease is an array of different conditions with no cure. In this case therefore, we don’t expect the patient to recover from the COPD but we only expect improvements in the symptoms and exacerbations.

Time frame

In the case of palliative care, there is no expected time of recovery rather time it takes for the patient to die. The intervention in this particular case therefore does not have any definite time frame. However, the care has to be provided up to that time the patient will die.

Conclusion

A PICOT statement is an important tool to the nurses as it assists them to get the right protocol in treatment or management of different cases .Besides, it also provides them with the estimated time frame from which the patient can recover and this assists them to effectively plan their schedules. From this case of Chronic Obstructive Pulmonary Disease for example, we expect improvement in the quality of life of the patient. We don’t expect the condition to disappear since it has no treatment rather than management protocols alone.

References

Apps, M., Mukherjee, D., Abbas, S., Minter, J., & Whitfield, J. (2016). Integration of hospital and community COPD services including pulmonary rehabilitation can improve patient care and reduce hospital stays. 1.2 Rehabilitation and Chronic Care. doi:10.1183/13993003.congress-2016.pa3737

Apps, M., Mukherjee, D., Abbas, S., Minter, J., & Whitfield, J. (2016). Integration of hospital and community COPD services including pulmonary rehabilitation can improve patient care and reduce hospital stays. 1.2 Rehabilitation and Chronic Care. doi:10.1183/13993003.congress-2016.pa3737

Gao, C., & Taniguchi, N. (2014). Chronic Obstructive Pulmonary Disease (COPD). Glycoscience: Biology and Medicine, 1267-1274. doi:10.1007/978-4-431-54841-6_175

Lange, P., Celli, B., Agustí, A., Boje Jensen, G., Divo, M., Faner, R., … Vestbo, J. (2015). Lung-Function Trajectories Leading to Chronic Obstructive Pulmonary Disease. New England Journal of Medicine, 373(2), 111-122. doi:10.1056/nejmoa1411532

Pascoe, S., Locantore, N., Dransfield, M. T., Barnes, N. C., & Pavord, I. D. (2015). Blood eosinophil counts, exacerbations, and response to the addition of inhaled fluticasone furoate to vilanterol in patients with chronic obstructive pulmonary disease: a secondary analysis of data from two parallel randomised controlled trials. The Lancet Respiratory Medicine, 3(6), 435-442. doi:10.1016/s2213-2600(15)00106-x