R e fe re n c e s 1. B a n n is te r, O. M . (1980). T h e effectiveness o f n e b u - ' Iised s a lb u ta m o l in th e m a n a g e m e n t o f a c u te a s th m a in c h ild re n . P h y s io th e r. 66, 144-146. 5. ' 2. K u z e m k o , J. A . (1977). A s th m a in c h ild re n . P itm a n M e d ica l. B a th . p p . 73 - 75. 3. M u lle r, N . C. a n d B ry a n , A . C . (1979). C h e st wall m e c h a n ic s a n d r e s p ira to ry m u sc le s in in fa n ts. Pae- 102 DESEMBER 1980 d ia tric clinics o f N o r th A m e ric a , 26, 509 - 514. S u p e r, M . (1979). C y stic fibrosis — w ith special re fe re n c e to S o u th e rn A fric a . S .A . J o u rn . o f H o s p . \ M e d ., 2, 104 - 109. W a rin g , W . W . (1972). D ia g n o stic & th e ra p e u tic p r o ­ c ed u re s, E d . K e n d ig . E . L ., in P u lm o n a r y D is o r d e r s ,1 V ol. 1 o f D iso rd e rs o f th e R e s p ira to ry T r a c t in C h ild re n , 2 nd E d itio n . W . B. S a u n d e rs C o ., P h ila ­ d e lp h ia , p p . 114 - 128. F I S I O T E R A P I E A STUDY O F T H E P A T IE N T S A TT EN D IN G T H E ASTHMA ROOM AT G R O O T E SCHUUR H O S P ITA L R e n £ M e y e rs, B.Sc. (P h y s io th e ra p y ), U .C .T .* O n re v ie w in g th e l ite r a tu r e o n a s th m a tic p a tie n ts , a g e n e ra l p r o b le m o f p a ti e n t e d u c a tio n b e c a m e e v id e n t ( W e ste rm a n e t a l , 1978; P r in s lo o , 1978). G r o o te S c h u u r H o s p ita l w a s th o u g h t to b e a n id e a l p la c e to stu d y s u c h p a tie n ts a n d find o u t ju s t h o w m u c h th e y do k n o w . T he. A s th m a R o o m is p a r t o f t h e M e d ic a l C a su a lty D e p a r tm e n t a n d serv es as a s h o r t s ta y w a rd f o r p a tie n ts w ith a c u te a tta c k s o f a sth m a . T h e r o o m is s u p p lie d w ith p ip e d o x y g e n w h ic h is u se d to a d m in is te r n e b u ­ liz e d b r o n c h o d ila to r s . T h e p a tie n ts a re a c c o m m o d a te d in a r m c h a irs. - A c c o rd in g to th e E m e rg e n c y U n i t re g is te r, 1 005 p a tie n ts w e re a d m itte d to th e A s th m a R o o m o v e r a 1 0 -m o n th p e r io d f r o m O c to b e r 1977 to A u g u s t 1978 (P rin s lo o , 1978). T h e a v e ra g e n u m b e r o f a d m iss io n s p e r p a tie n t w as a lso e x tre m e ly h ig h . T h is s tu d y , b y m e a n s o f a q u e s tio n n a ir e (F ig. 1), in te rv ie w e d 82 p a tie n ts in th e A s th m a R o o m d u r in g th e p e r io d 2 - 2 7 A p r il 1979. T h e q u e s tio n s c o v e re d a sp e c ts o f th e p a tie n ts ’ c o n d i­ tio n , a n d fre q u e n c y o f a tta c k s . T h e r e w e re q u e s tio n s o n th e k n o w le d g e o f th e ir m e d ic a tio n a n d p h y s io th e r a p y te c h n iq u e s. A d e m o n s tr a tio n o f th e u s e o f th e in h a le r b y th e p a t i e n t w a s r e q u ir e d . B r o a d e r q u e s tio n s w e re in c lu d e d to give th e p a tie n t th e o p p o r tu n ity ^ to a d v ise fe llo w -a s th m a tic s a n d to g a u g e th e i r o p in io n o f th e a tm o s p h e re in th e A s th m a R o o m . S o m e o f th e re su lts o b ta in e d a re d isc u sse d b e lo w . T h e to ta l n u m b e r o f a d m is s io n s o f th e 82 p a tie n ts s tu d ie d , a m o u n te d to 801. T h e m a j o r i ty o f th e p a tie n ts h a d v e ry lit tle in s ig h t in to th e “ m e c h a n ic s o f a s th m a ” . M o s t e x p la in e d t h e i r c o n d itio n as b e in g tig h tn e s s o f th e c h e s t o r s h o rtn e s s o f b re a th . O n ly 9 ,8 % m e n tio n e d b ro n c h i o r “ lu n g p ip e s ” a n d n o n e o f th e s e c o u ld e x p a n d a n y f u r th e r . A lth o u g h a h ig h p e rc e n ta g e fe lt th e y k n e w , a n d s ta te d , th e trig g e r f a c to r f o r th e p r e s e n t a tta c k , th e m a jo r ity d id n o t se e m to a sso c ia te a v o id in g th e tr ig g e r f a c to r w ith p re v e n tin g a n a tta c k . O v e r 75% o f th e p a tie n ts w e re b r e a th in g a p ic a lly . O n ly 37% w e re a w a re th a t t h e i r b r e a th in g p a tte r n c o u ld b e m o re effective. T h o s e p a tie n ts w ho k n e w h o w to b r e a th e d ia p h ra g m a tic a lly , a n d re a liz e d its im p o rta n c e , h a d p re v io u s ly b e e n a d m itte d to a n o th e r w a rd w h e re th e y h a d re c e iv e d p h y s io th e r a p y tre a tm e n t a n d th u s b r e a th in g r e e d u c a tio n . O n ly 7,3% u s e d p h y s io th e r a p y te c h n iq u e s s u c h as re la x a tio n , re s tin g p o s itio n s a n d * P h y s io th e r a p is t, G r o o te S c h u u r H o s p ita l, C a p e T o w n , t S u m m a ry o f u n d e r g ra d u a te p r o je c t p re s e n te d to w a rd s B.Sc, ( P h y s io th e ra p y ) in 1979. b r e a th in g c o n tro l, to p re v e n t th e p r e s e n t a tta c k f r o m b e c o m in g w orse. M e d ic a tio n p ro v e d to b e a p ro b le m . A ll b u t 3,7% fo u n d t h a t th e m e d ic a tio n re q u ir e d w a s e a s ily o b ta in ­ a b le , a n d th e p la c e f r o m w hich th e y re c e iv e d it, w as' e a s ily a cc essib le . Y e t a t th e tim e o f a d m is s io n , 46% h a d “r u n o u t ” o f so m e o f t h e ir m e d ic a tio n a n d 16% h a d n o m e d ic in e le f t a t all. A d e m o n s tr a tio n b y th e p a tie n ts o n th e u s e o f th e in h a le r re v e a le d t h a t 40% u s e d t h e ir in h a le r effectively. M a n y h a d b e e n u sin g a n in h a le r f o r s e v e ra l y e a rs. J u d g in g f r o m th e d e m o n ­ s tr a tio n , th e y h a d p r o b a b ly n e v e r b e e n ta u g h t h o w to u s e i t a n d d id n o t b e n efit f u lly f r o m th e in h a la tio n . A la rg e v a r ie ty o f d ru g s w e re p re s c rib e d f o r these p a tie n ts w ith a n a v e ra g e o f 3 p e r p a tie n t. A s m a n y o f th e p a tie n ts in te rv ie w e d d id n o t u n d e r s ta n d th e v a lu e o f p r o p h y la c tic m e d ic in e , it w a s c le a r t h a t m o r e tim e sh o u ld b e s p e n t e x p la in in g th e d o sa g e o f e a c h d ru g a n d im p o rta n c e o f r e g u la r a n d c o rre c t u se . D u r in g th e in te rv ie w p a tie n ts w e re e n c o u ra g e d to e x p re ss th e ir v iew s a n d th o u g h t th e y c o u ld h e lp o t h e r a sth m a p a tie n ts b y a d v ic e m a in ly o n h o m e re m e d ie s. T h e re s u lts o b ta in e d r e in f o r c e d th e o r ig in a l h y p o ­ th e s is , n a m e ly t h a t i f th e p a ti e n t h a d a b e tt e r k n o w ­ led g e o f th e ir d ise a s e a n d o f th e i r p a r tic u la r trig g e r fa c to rs , th e y c o u ld a v o id p re c ip ita tin g a tta c k s . W ith th e a d d e d k n o w le d g e o f p h y s io th e r a p y te c h n iq u e s a n q th e c o rre c t u s a g e o f m e d ic a tio n , th e y c o u ld in s titu te im m e d ia te a n d m o r e e ffective “ s e lf-tre a tm e n t” a t h o m e. I n th is w a y th e y s h o u ld b e a b le to a b o r t an a tta c k o r p re v e n t it f r o m r e a c h in g th e sta g e w h e re p r o f e s ­ s io n a l h e lp is re q u ire d . T h e A s th m a R o o m w o u ld b e a n id e a l p la c e to in s titu te a g r o u p e d u c a tio n p ro g ra m m e , in c lu d in g in ­ f o r m a l d isc u ssio n s w ith th e p h y s io th e ra p is t. A m o re m e a n in g fu l r o le f o r p h y s io th e r a p is ts in th e e d ucation, o f a ll a s th m a p a tie n ts c o u ld e v o lv e a n d c o v e r asp e cts su c h as re s tin g p o s itio n s , b r e a th in g c o n tro l, rela x atio n ,; a n d th e c o rre c t u s e o f m e d ic a tio n , e s p e c ia lly in h a le rs . T h is c o u ld g r e a tly a s sist p a tie n ts to a b e tt e r u n d e r ­ s ta n d in g o f t h e ir d ise a s e a s a w h o le . R e fe re n c e s 1. P r in s lo o , F . R . (1978). D e p a r tm e n t o f C o m m unity M e d ic in e , U n iv e r s ity o f C a p e T o w n (p e rs o n a a ssig n m e n t). 2. W e s te rm a n n , D . E ., B a te m a n , E . D ., A le x a n d e r, M . G ., B e n a ta r, S. R . (1978). T h e m a g n itu d e o f the a s th m a p ro b le m in C a p e T o w n . S .A . M e d . J., 53 544 - 547. R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. )