Page 102 - Ebook-Book JCMS 2025

Effectiveness of Teaching Breathing Exercise with Incentive
Spirometry Combined with the Use of Facial Tissue in Elderly
Patients with Hip Fracture
Jitchaya Boonnunn1*, Laddawan Himkhun1, Janya Wongwoon1, Wararat Boonnasa1
,
Theerawoot Tharmviboonsri2, Wilawan Thirapatarapong2
1 Nursing Division Faculty of Medicine, Siriraj Hospital
2 Faculty of Medicine, Siriraj Hospital
*Corresponding Author E-mail: jboonnun@gmail.com
Background: Abstract
Incentive spirometry (IS) is used to prevent postoperative pulmonary complications (PPCs)
in elderly patients with hip fractures. Traditional teaching methods involve explaining the
technique before practicing with the device, which can be difficult for elderly patients.
Using tissue paper to assist in teaching inhalation helps patients understand and correctly
perform the procedure. This study compared IS training outcomes and pulmonary
complications between the traditional method and teaching with tissue paper.
Methods: A randomized experimental design was employed with elderly hip fracture patients
undergoing surgery. Participants were randomly assigned to a control group (40 patients)
taught using traditional methods and an experimental group (40 patients) taught using
tissue paper. Data analysis included descriptive statistics, independent t-tests, Chi-Square
tests, Mann-Whitney U tests, and Fisher’s Exact test.
Results: The average time to correctly teach IS was significantly shorter in the experimental group
compared to the control group (p < .05). No significant differences were found in the
duration the ball floated, the number of balls floated, and average oxygen saturation levels
before surgery, after surgery, and on discharge day between the two groups (p > .05).
The incidence of hypoxemia, atelectasis, and pneumonia showed no significant differences
between the groups (p > .05).
Conclusions and
Recommendations:
Nurses and healthcare teams can use tissue paper to teach patients how to practice
inhaling air into their lungs. This method allows patients to observe, understand, and
practice the breathing technique, leading to increased confidence and correct use of IS with less
instructional time compared to traditional methods. It can also be used for patients who
have not succeeded with traditional teaching method.
100 Joint Conference in Medical Sciences 2025