Te Whakaora Tinana hei Whakahaere i ngā Raru Manawa
He amuamu noa ngā raruraru manawa i waenga i ngā tāngata o ngā reanga katoa, mai i ngā tamariki ki ngā kaumātua. Ko ngā mate pēnei i te mate huango, te mate pūkahukahu aukati mau tonu (COPD), te niumōnia, te bronchiectasis, me ngā mate manawa i muri i te pokanga ka taea te whakaiti i te kounga o te oranga. Haunga te maimoatanga hauora, he mea nui te whakaora tinana ki te āwhina i te whakapai ake i te mahi a ngā pūkahukahu, te whakaiti i te poto o te manawa, te whakahaere i te pupuhi, me te whakapai ake i te manawanui ki ngā mahi. E matapakihia ana e tēnei tuhinga te whai wāhi a te whakaora tinana ki te whakahaere i ngā raruraru manawa, ngā tikanga e whakamahia ana, me ōna painga mō ngā tūroro.
Te tūranga o te whakaora tinana i roto i te pūnaha manawa
Ko te whakaora manawa o te ngākau he peka o te whakaora manawa e aro ana ki te aromatawai me ngā wawaotanga hei whakapai ake i te mahi a te ngākau me te pukahukahu. I roto i te horopaki o ngā raruraru manawa, ka āwhina ngā kaiwhakaora manawa i ngā tūroro mā roto i ngā kaupapa kua whakaritea kia rite ki ō rātou ake āhuatanga. Ko ngā whāinga ko: te whakapai ake i te hau o te pukahukahu, te arotau i te whakawhiti hāora me te hauhā waro, te pupuri i te whakawātea o te ara manawa, te whakapai ake i te kaha o ngā uaua manawa, me te āwhina i ngā tūroro kia hoki haumaru ki ā rātou mahi o ia rā.
He maha ngā wā ka haere tahi ngā raruraru manawa me te ngoikore o te uaua, te iti o te nekehanga o te uma, te kohikohinga o ngā wai (huka), me ngā tauira manawa koretake. He mahi tā te whakaora tinana hei whakatika i ēnei āhuatanga. Ina koa i roto i ngā mate mau tonu pēnei i te COPD, ehara i te mea ka āwhina noa te whakaora tinana i te wā e puta ai ngā mate engari he mahi nui anō hoki hei ārai i te hokinga mai mā te whakakori tinana me te mātauranga.
Ngā āhuatanga e āwhinahia ana e te whakaora tinana
Ko ētahi o ngā mate manawa noa e whai hua ana mai i te whakaora tinana ko:
1. COPD (Mate Pūkahukahu Ārai Mau)
He maha ngā wā ka pāngia ngā tūroro COPD e te poto o te manawa, te nui o te whakaputanga huware, me te ngoikore o te manawanui ki ngā mahi. Ka āwhina te whakaora tinana ki te whakangungu i ngā tauira manawa whai hua me te whakapai ake i te kaha mahi.
2. Te mate huango
Mō te mate huango, ka taea e te whakaora tinana te āwhina i te whakahaere manawa, te whakangā, me te whakapakari tinana. Ahakoa me aro tonu te hauora ki ngā whakaekenga ohorere, ka taea e ngā mahi manawa te āwhina i te whakaiti i te mataku me te whakapai ake i te pai o te manawa.
3. Ngā mate pūkahukahu me ngā mate manawa
Mō ngā tūroro he matotoru, he uaua rānei ki te whakaputa huware, he mea nui ngā tikanga whakawātea i te ara manawa hei āwhina i te whakaora.
4. Te mate pukupuku pūkahukahu me te mate pukupuku pūkahukahu
He maha ngā wā ka hua ake te nui rawa o te whakaputanga o te huware me ngā mate urutā anō hoki i tēnei āhuatanga. Mā te whakaora tinana ka taea te whakawātea i ngā ara manawa i ia wā, i ia wā.
5. Whai muri i te pokanga (ina koa ko te pokanga uma/puku)
I muri i te pokanga, ka pāpaku te manawa o ngā tūroro nā te mamae, ka tūpono rātou ki te atelectasis (te hinganga o tētahi wāhanga o te pukahukahu). Mā ngā mahi manawa me te whakaoho wawe ka āwhina i te ārai i ngā raruraru.
6. Ngā mate pūnaha io (hei tauira, te whiu, te whara o te taurakira, te ALS)
Ka uaua te tango a ngā tūroro i ngā waikura nā te ngoikore o ngā uaua manawa me te koretake o te maremare. Ka āwhina te whakaora tinana ki te whakapai ake i te maremare me te manawa.
Ngā tikanga whakaora tinana i whakamahia
1. Ngā mahi manawa
Ko te whāinga o ngā mahi manawa he whakapai ake i ngā tauira manawa me te whakapiki i te whai huatanga o ngā uaua manawa. Ko ngā tikanga e rua e whakamahia whānuitia ana ko:
– Te manawa ngutu-puru: ka āwhina i te whakaroa i te manawa, ka whakaiti i te mau o te hau i roto i te COPD, ā, ka whakaiti i te poto o te manawa.
– Manawa diaphragmatic (manawa diaphragmatic): ka whakangungu i te whakamahinga o te diaphragm kia hohonu ake ai, kia marino ake ai hoki te manawa, ka whakaiti i te whakamahinga o ngā uaua manawa tāpiri e tere ai te ngenge o ngā tūroro.
2. Ngā tikanga whakawātea ara manawa
Ki te nui haere ngā waikura, ka pāngia pea ngā tūroro e te maremare tonu, te poto o te manawa, me te piki ake o te mōrearea o te mate. Ko ngā tikanga ka taea te whakamahi ko:
– Te pupuhi me te maremare whai hua: ko te pupuhi he tukunga manawa kaha me te kore e kati i te korokoro, he mea whai hua mō te neke i te huware mai i ngā ara manawa iti ki ngā ara manawa nui kia ngāwari ai te whakaputa.
– Te whakaheke i te wai i roto i te tinana: te whakanoho i te tinana ki ētahi huarahi hei whakamahi i te kaha ā-papa hei āwhina i te pana i te huware.
– Patupatu me te wiri: he pā mārie me te wiri o te pakitara o te uma hei āwhina i te wetewete i ngā hinu.
– Ngā āwhina pēnei i te PEP (Positive Expiratory Pressure): ka whakarato i te pēhanga i te wā e hemo ana kia tuwhera tonu ai ngā ara manawa, kia ngāwari ake ai te nekeneke o ngā mea huna.
3. Ngā mahi whakapakari uaua manawa
Mō ētahi tūroro, ka ngoikore ngā uaua manawa me ngā uaua manawa. Mā te whakamahi i tētahi taputapu whakangungu uaua manawa ka taea te whakapai ake i te kaha o ngā uaua manawa, te āwhina i ngā tūroro ki te whakaiti i te poto o te manawa i te wā e mahi ana, me te whakanui ake i te kaha o te mahi whakakori tinana.
4. Te whakakorikori tinana me te whakangungu tinana kua whakaritea
He maha ngā wā ka mataku ngā tūroro ki te neke i te manawa poto, ka heke te hauora: ko te kore mahi, ko te ngoikore, ā, ko te tūponotanga ka pāngia rātou e te manawa poto. Mā te kaupapa whakakori tinana haumaru—pērā i te hikoi, te eke pahikara tū, te whakangungu kaha māmā rānei—ka āwhina i te whakapai ake i te manawanui ki ngā mahi me te mahi o te ngākau. I roto i ngā kaupapa whakaora pūkahukahu, he wāhanga matua te whakakori tinana, e tautokona ana e te mātauranga me ngā rautaki whakahaere tohu.
5. Te mātauranga me te whakahaere pūngao
Ka whakaratohia hoki e ngā kaiwhakaora tinana te mātauranga e pā ana ki:
– me pēhea te kite i ngā tohu o te hokinga mai o te mate,
– ngā tikanga manawa i te piki arawhata, i te hikoi rānei,
– ngā tūnga tinana hei āwhina i te whakaiti i te poto o te manawa (hei tauira, te piko whakamua me te tautoko mai i ngā ringa),
– rautaki tere (te whakahaere i te auau o ngā mahi) kia kore ai e tere te pau o te pūngao.
He mea nui tēnei mātauranga nā te mea he nui te awe o te angitū o te whakaora tinana i te korikori tinana takitahi me ngā panonitanga o ngā tikanga o ia rā.
Te tukanga arotake me te whakatau i te kaupapa
I mua i te whakahaere i tētahi wawaotanga, ka whakahaerehia e te kaiwhakaora tinana he aromatawai whānui. Kei roto pea i te whakamātautau te tere manawa, te tauira manawa, te mākū o te hāora, te kaha maremare, te nui me ngā āhuatanga o te huware, te nekehanga o te pakitara o te uma, te manawanui ki ngā mahi, me ngā aromatawai i te mate manawa pēnei i te Tauine Borg. I runga i ēnei hua, ka whakawhanakehia e te kaiwhakaora tinana he kaupapa e hāngai ana ki ngā whāinga a te tūroro—hei tauira, te whakaiti i te mate manawa i te hikoi, te whakapai ake i te kaha ki te mahi i ngā mahi o te whare, te whakaiti rānei i te auau o ngā whakaekenga COPD.
Ngā painga o te whakaora tinana mō ngā raruraru manawa
Ko ngā painga whānui o te whakaora tinana mō ngā mate manawa ko:
– ka whakaiti i te kikī o te manawa, ka whakapai ake hoki i te whakamarie o te manawa,
– ka āwhina ki te pana i te huware kia ma ake ai te ara manawa,
– te whakanui ake i te kaha mahi me ngā āheinga mahi o ia rā,
– te whakaiti i te mōrearea o ngā raruraru pēnei i te atelectasis me ngā mate urutā anō,
– te whakapai ake i te tū me te nekenekehanga o te uma,
– te whakapai ake i te kounga o te oranga me te whakapono ki a ia anō o ngā tūroro.
I ngā āhuatanga mau tonu, ka āwhina hoki te whakaora tinana i ngā tūroro kia pai ake te whakahaere i ō rātou mate mā roto i ngā tikanga whakakori tinana, te aroturuki i ngā tohu, me te piri ki te kaupapa.
Āhea koe me toro atu ki tētahi kaiwhakaora tinana?
Tērā pea ka whakaarohia te kōrero ki te rata tinana mēnā he maha ngā wā ka pāngia te tangata e te poto o te manawa i a ia e mahi ana i ngā mahi māmā, he maremare tonu me te huware, he ngoikore te manawanui e mau tonu ana, kei te ora rānei i te mate pūkahukahu, i te pokanga rānei. Heoi, he mea nui kia mōhio ki ngā tohu ohorere pēnei i te poto ohorere o te manawa, te kikorangi o ngā ngutu, te mamae nui o te uma, te ngoikore rānei o te māramatanga—me aro tonu ki te hauora ēnei āhuatanga.
Whakamutunga
He mea nui te mahi whakaora tinana i roto i te whakahaere i ngā raruraru manawa, ahakoa he mea whakapeka, he mea mau tonu hoki. Mā roto i ngā mahi manawa, ngā tikanga whakawātea manawa, te whakapakari uaua manawa, te mahi whakakori tinana kua whakaritea, me te mātauranga, ka āwhina te whakaora tinana i ngā tūroro kia pai ake te manawa me te mahi i ngā mahi me te kounga pai ake o te oranga. Ko te mahi tahi i waenga i ngā tūroro, ngā kaiwhakaora tinana, me ētahi atu tohunga hauora te mea nui ki te angitu, nā te mea ko te maimoatanga o ngā mate manawa me whai huarahi pumau, whai kiko, mō te wā roa.
