Asthma school organization in the Republic of Uzbekistan Alikulova D. , Mamatkulov B. , Urazalieva I. (Republic of Uzbekistan) Организация работы «Астма школы» в Республике Узбекистан Аликулова Д. Я. , Маматкулов Б. М. , Уразалиева И. Р. (Руспублика Узбекистан)
1Аликулова Дилърабо Якшибаевна / Alikulova Dilrabo - магистр;
2Маматкулов Бахромжон Маматкулович /Mamatkulov Bahromjon - доктор медицинских наук, профессор, директор;
3Уразалиева Ильмира Равкатовна / Urazalieva Ilmira - ассистент,
Школа общественного здравоохранения,
Ташкентская медицинская академия, г. Ташкент, Республика Узбекистан
Abstract: the study of risk factors leading to the development of asthma, conducted in the form of a survey and interviews. 52 % of patients with a diagnosis of asthma noted the presence of the disease among close relatives. Among the risk factors that lead to bronchial asthma, the most common are pollen, tobacco (49.1 %). 59.2 % of patients diagnosed with asthma do not follow the diet. 27.3 % of them are abused bitter, salty and high cholesterol food. 44 % do not get enough fruits and vegetables, protein-rich foods.
Аннотация: изучение факторов риска, приводящих к развитию бронхиальной астмы, проводится в виде опроса и интервью. 52 % пациентов с диагнозом бронхиальной астмы отметили наличие этого заболевания среди близких родственников. Среди факторов риска, которые приводят к бронхиальной астме, наиболее частыми являются пыльца растений, табак (49,1 %). 59,2 % больных с диагнозом бронхиальная астма режим питания не соблюдают. 27,3 % из них злоупотребляли горькой, соленой и богатой холестерином пищей. 44 % опрошенных не получали достаточное количество фруктов и овощей, богатых белком продуктов.
Keywords: asthma, nurses, primary health care, prevention, risk factors.
Ключевые слова: бронхиальная астма, медицинские сестры, первичное звено здравоохранения,
профилактика, факторы риска.
Despite improvements in diagnosis and treatment, prevalence and mortality as a consequence of bronchial asthma (BA) in the world is increasing every year [2, с 105]. In many cases, risk factors for the disease are severe and long lasting, resistant to therapy, asthma attacks, respiratory failure strongly expressed. Until now it meets death from status asthmaticus. In this regard, asthma is not only medical, but also an important socio-economic problem [1, с. 255-259]. Purpose of the study. The study of risk factors leading to the development of asthma.
Materials and methods. The object of study - patients with bronchial asthma (BA). Assessment of the quality of life of patients with asthma, conducted in the form of a survey and interviews. In conducting the survey focuses on physical activity, general health, sensitivity to pain, mental and physical stress, the viability of patients. The study of life and quality of life of patients with asthma. The study of life and quality of life study was conducted in family polyclinics № 16 and № 18 of Olmazor district of Tashkent city. Interviewed 100 patients with bronchial asthma (the study group) and 100 people without asthma, but living in similar conditions (control group).
There are 70 women in the main group and 30 men in the control group, respectively, 51 and 49.
Results. Among the examined patients 20.7 % were aged 20-39 years, 34.4 % - 40-49 years old, 44.5 % - over 50 years. The family of 1-3 people is 11.9 %, 4-6 persons - 67.4 %, 7 and more persons - 20 %. Among surveyed 12.7 % of patients had completed higher education, incomplete higher -2.8 %, average - 46.0 % -28.8 % Secondary, primary education - 9.7 %. In this area more than 5 years, 86.9 % of the patients lived. After interviewing the patients with bronchial asthma among close relatives were detected in 52.0% of patients studied among relatives identified asthma. In 48 % of cases among close relatives were found.
The occurrence of asthma plays an important role for acute respiratory infection (ARI), upper respiratory tract. Patients who had undergone during the year SARS 4 times or more accounted for 22.7 %, 2.3 times - 53.7 %, 1 time - 23.6 %.
Among patients with asthma work of industrial enterprises accounted for 34 % of rural workers - 28 % of workers employed in construction - 5.1 %, transport workers - 6 % related to food production - 11 %. In 52 % of patients overall work experience in the specialty I was 9 years and more, 20 % - 6-8 years, 28 % - 4-5 years. By increasing the working time increases the risk of disease.
As a result of the survey, it was found that most of the patients were in contact with the allergen in the textile mills, spinning and weaving factory, shoe factories, brick kilns. These enterprises allergens affect the mucosa of the upper respiratory tract, in this moment working with long-term exposure to allergens occurred outbreak.
Analysis of living conditions showed that 26.2 % of the patients live in their homes, the rest in multi-storey prefabricated houses. 4.4 % - rated their housing as a dark, respectively, 16.7 % mentioned the dampness, that is the fifth part of the living conditions of patients with asthma did not meet sanitary and hygienic standards.
On the severity of the disease directly affects the nature of the diet and the origin of the disease. Our own survey showed that 59.2 % of the patients participating in the study as a whole, does not stick to the diet, 16.9 % consume -foods rich in cholesterol, 19.9 % - fried foods.
Asthma often creates difficulties in the life of the patient. The presence of asthma in the family of the patient, requires all restrictions on the number of life-style. Adverse outcomes of patients with asthma are often associated with low levels of interaction between the patient and the doctor, with limited knowledge about the disease of the patient. The «Asthma School» at the National Center allergist. Classes in «Asthma School» held 3-4 times a week, in the afternoon.
After training at the «Asthma-school» doctors, allergists say, changing habitual behavior is a difficult task, so in school should be directed not only to studying certain knowledge, but also on developing the necessary skills to improve the quality of life of persons with the changing opportunities. Raising awareness helps the conscious active participation of the patient and his family members in the process of rehabilitation. About 61 % of patients follow the recommendations of doctors. As a result, a significant number of asthma listeners turned into a lighter form. FIRST AID and techniques of self-regulation in a fit of choking, «drug», Physiotherapy treatment techniques and breathing exercises with asthma. The use of modern methods of presentation would lead to a better assimilation of knowledge. The information necessary to identify the most important moments, it must be compact.
Thus, our studies led to the following conclusions: 46 % of patients in the study, have a secondary education. Most of the patients lived in rural areas more than 5 years. 52 % of patients with a diagnosis of asthma noted the presence of the disease among close relatives. Among the risk factors that lead to bronchial asthma, the most common are pollen, tobacco 49.1 %. 59.2 % of patients diagnosed with asthma diet are not observed at all. When planning the classes you need to take into account the age characteristics of the audience.
At the workshops, conducted by the medical staff middle managers, patients self-teaching method of breathing, keeping a diary, using modern methods of color zones, the tactics of the first aid in a fit, physical therapy techniques and various methods of breathing exercises, the use of different types of nebulizers. Once a year after the end of «Asthma-school» carried out a survey, check the state of health in order to assess the impact of training on the quality of life for the patient and the underlying disease. It is necessary to conduct regular monitoring of vital statistics.
References 1
1. Архипов В. В., Цой А. Н. GINA 2006: Новые рекомендации по фармакотерапии бронхиальной астмы // Рус. Мед. журн. - 2007. - Т. 15, № 4. - с. 255-259.
2. Григорьева Н. О., Морозько П. Н., Абумуслимова Е. А., Гоголева М. Н., Варжель Ю. В., Козырев А. Г. Оценка влияния «Астма-школы» на качество жизни больных бронхиальной астмой. Организационные, клинические и экономические аспекты восстановительной медицины / Под. ред. акад. РАМН А. В. Шаброва. СПб.: СПбГМА им. И. И. Мечникова Росздрава. 2006. 105 с.