LEARNING OBJECTIVES
After studying this chapter you should be able to:
• define asthma and chronic obstructive pulmonary disease (COPD), identify the pathophysiological differences, risk factors, and presentations, and explain the principles of nursing care
• provide education to clients and their families on health promotion and prevention strategies regarding asthma and COPD
• discuss the nurse's role in a variety of health care settings
• describe advanced nursing practice in the management of clients and their carers with asthma and COPD.
Introduction
Two chronic conditions affecting the respiratory system discussed in this chapter are asthma and chronic obstructive pulmonary disease (COPD). Both of these conditions are serious chronic health problems in Australia and New Zealand, and while the symptoms experienced by clients can be similar, the aetiology, pathophysiology and treatments vary between the two conditions. The important role that nurses have in the management of these conditions is discussed in this chapter.
Asthma is Australia's most widespread chronic health problem, affecting one in six children and one in nine adults (Andrews, Jones & Mullan, 2014, p. 34). Asthma has a 9.9 per cent prevalence rate in Australia, which is high by international standards. The rate of asthma among Indigenous Australians is almost twice as high as the rate for non-Indigenous Australians. The difference in prevalence exists across all age groups but is more marked for older Indigenous peoples (ABS, 2013a). People living in inner regional areas experience the highest incidence of asthma – 12.4 per cent compared to 9.7 per cent for those living in major cities and 9.4 per cent for outer regional and remote area residents (ABS, 2012). New Zealand has the second-highest prevalence of asthma in the world, with one in seven children aged 2–14 years (14 per cent) requiring asthma medication and one in nine adults (11 per cent) diagnosed with asthma. Māori and Pacific Island people and people from lower socioeconomic groups are disproportionately affected by asthma (Asthma Foundation, 2012).
In Australia, COPD is the fifth leading cause of death (AIHW, 2015). COPD is the fourth leading cause of death in New Zealand, ranked second in men and seventh in women for years lost to disability (Lawes et al., 2012).