Effectiveness of one-to-one feedback methods of teaching with proper metered-dose inhaler technique and correcting errors in chronic obstructive lung disease patients

Abstract

Abstract Objective To determine the most common mistakes made during the use of a metered-dose inhaler (MDI), and the effect of the repeated trainings performed with demonstration method by providing one-to-one feedback on these mistakes. Methods This is a quasi-experimental study with a control group. A total of 100 chronic obstructive pulmonary disease (COPD) patients (50 in the control group and 50 in the experimental group) were included in the research. “Patient Information Form (PIF)” (to determine the descriptive characteristics of patients) through the face-to-face interview method, using “MDI Skill Assessment Form” (MDISAF) (it is composed of 10 skill steps about the use of MDI) through observation method was used. Patients in both the groups were asked to use MDI and their abilities regarding use of MDI were assessed. Then in the intervention group, usage of MDI was explained by a nurse via demonstration and placebo MDI. Trainings were repeated on days 1,3, and 5 as from hospitalization of the patient. In the intervention group, three methods were used in this study: “face-to-face training,” “one-to-one,” and “with feedbacks and repeated.” Routine training regarding use of MDI was given by the nurses in the clinic to patients in the control group. The use of an MDI was assessed using MDISAF before training and after the training on the first, third and fifth days of hospitalization. On the seventh day, the last measurement was performed. Percentage, chi square, and mean were used to assess the data. Results After repetitive training with one-to-one feedback, several differences between the groups in favor of the experimental group were found in 7 of the 10 skill levels of the MDI. There was a significant difference after “training” between the groups in the third, fourth, fifth, sixth, seventh, eighth and ninth MDI steps in posttest measurement (P < 0.05). Evaluating the skills of the groups to use MDI from pretest to posttest, it was determined that while the intervention group made less mistakes in steps in which mistakes were made mostly, the control group continued to make mistakes. Conclusions Inhaler technique intervention with repeated, face to face, and one-to-one feedback trainings can significantly enhance the MDI techniques in COPD patients. The patients in the intervention group made less mistakes during MDI application and their application skills improved. It may be asserted that the training provided to the intervention group was effective for using the device correctly, while the training provided in the clinic for the control group was inadequate.