1
|
Rafaelli de Carvalho D, Araújo de Castro L, Morita AA, Loyola WS, Fujisawa DS, Probst VS. The impact of chronic obstructive pulmonary disease in patients' lives: The perception of the health professionals. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2020; 26:e1886. [PMID: 33164269 DOI: 10.1002/pri.1886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 09/15/2020] [Accepted: 10/12/2020] [Indexed: 11/11/2022]
Abstract
INTRODUCTION The perception of health professionals about chronic obstructive pulmonary disease (COPD) has not been thoroughly investigated. OBJECTIVE To analyze the perception of health professionals about the impact of COPD on the lives of affected individuals. MATERIALS AND METHODS Qualitative and cross-sectional study with five health professionals: two nurses, two physiotherapists, and one medical doctor. They participated in a focus group (FG) session, with semistructured questions covering: definition of COPD, activities of daily living (ADL), and physical activity of daily living (PADL), as well as the importance of these outcomes in the lives of individuals with COPD. DATA ANALYSIS The FG was recorded, transcribed, and analyzed according to the content analysis. RESULTS The FG highlighted four main themes: physical-functional and emotional impairment of individuals, the importance of patient-health professional contact, repercussions of COPD on the patients' physical activity, and strategies for promoting physical activity. Based on the four themes exposed, the health professionals reported that there is a progression in the lives of individuals' with COPD, which is divided into three phases: adaptation, reluctance, and dependence. CONCLUSION There was a negative perception of the health professionals regarding the functionality and emotion of patients with COPD. Emotional aspects, family support, and architectural structure can positively or negatively influence patients' ADL and PADL. Finally, there was a perception of progression in the life of patients with COPD, since their initial adaptation, evolving to physical and emotional dependence.
Collapse
Affiliation(s)
- Débora Rafaelli de Carvalho
- Centre of Research and Post-Graduation in Health Sciences, Londrina State University, Londrina, Brazil.,Physiotherapy Department, Masters and Doctoral Programme in Rehabilitation Sciences, Londrina State University and University of North Parana, Londrina, Brazil
| | - Larissa Araújo de Castro
- Centre of Research and Post-Graduation in Health Sciences, Londrina State University, Londrina, Brazil.,Physiotherapy Department, Masters and Doctoral Programme in Rehabilitation Sciences, Londrina State University and University of North Parana, Londrina, Brazil
| | - Andrea Akemi Morita
- Centre of Research and Post-Graduation in Health Sciences, Londrina State University, Londrina, Brazil.,Physiotherapy Department, Masters and Doctoral Programme in Rehabilitation Sciences, Londrina State University and University of North Parana, Londrina, Brazil
| | - Walter Sepúlveda Loyola
- Centre of Research and Post-Graduation in Health Sciences, Londrina State University, Londrina, Brazil.,Physiotherapy Department, Masters and Doctoral Programme in Rehabilitation Sciences, Londrina State University and University of North Parana, Londrina, Brazil
| | - Dirce Shizuko Fujisawa
- Centre of Research and Post-Graduation in Health Sciences, Londrina State University, Londrina, Brazil.,Physiotherapy Department, Masters and Doctoral Programme in Rehabilitation Sciences, Londrina State University and University of North Parana, Londrina, Brazil
| | - Vanessa Suziane Probst
- Centre of Research and Post-Graduation in Health Sciences, Londrina State University, Londrina, Brazil.,Physiotherapy Department, Masters and Doctoral Programme in Rehabilitation Sciences, Londrina State University and University of North Parana, Londrina, Brazil
| |
Collapse
|
2
|
Simonÿ C, Riber C, Bodtger U, Birkelund R. Striving for Confidence and Satisfaction in Everyday Life with Chronic Obstructive Pulmonary Disease: Rationale and Content of the Tele-Rehabilitation Programme >C☺PD-Life>>. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183320. [PMID: 31505861 PMCID: PMC6766220 DOI: 10.3390/ijerph16183320] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/29/2019] [Accepted: 09/03/2019] [Indexed: 12/31/2022]
Abstract
Background: More feasible rehabilitation programmes for patients with chronic obstructive pulmonary disease (COPD) are warranted. Even so, still in its infancy, telerehabilitation to COPD patients reveals promising results, wherefore it is anticipated to contribute significant value to the current challenges of rehabilitation to these patients. To expand useful knowledge in the field, more sophisticated telerehabilitation interventions must be developed and appraised, but first and foremost, thoroughly described. Aims and methods: The aim of this article is to give a detailed description of the rationale and content of the >C☺PD-Life>> programme, within the bounds of the checklist of Template for Intervention Description and Replication (TIDieR). Approach:>C☺PD-Life>> is a telerehabilitation programme for COPD patients delivered as a study intervention by an interprofessional team of clinicians collaborating from both the hospital and the municipal healthcare system. Making use of two-way audio and visual communication software, 15 patients participated in the intervention via a tablet computer from their private setting. The programme was a six-month-long empowerment-based rehabilitation that aimed to support COPD patients in leading a satisfactory and confident life with appropriate physical activity and high disease management. Conclusions: A long-term interprofessional cross-sectoral telerehabilitation programme has been justified and described. The intervention was tested in 2017–2018 and the qualitative appraisal, along with an analysis of case-based measurements of development in physical capacity, COPD Assesment Test, and health management, is currently under production.
Collapse
Affiliation(s)
- Charlotte Simonÿ
- Department of Physiotherapy and Occupational Therapy, Slagelse Hospital, Faelledvej 7, 4200 Slagelse, Denmark.
- Institute of the Regional Health Services Research, University of Southern Denmark, 5230 Odense, Denmark.
| | - Claus Riber
- Department of Physiotherapy and Occupational Therapy, Slagelse Hospital, Faelledvej 7, 4200 Slagelse, Denmark.
| | - Uffe Bodtger
- Institute of the Regional Health Services Research, University of Southern Denmark, 5230 Odense, Denmark.
- Department of Respiratory Medicine, Naestved Hospital, Ringstedgade 61, 4700 Naestved, Denmark.
- Department of Respiratory Medicine, Zealand University Hospital, Sygehusvej 10, 4000 Roskilde, Denmark.
| | - Regner Birkelund
- Institute of the Regional Health Services Research, University of Southern Denmark, 5230 Odense, Denmark.
- Department of Health Research, Lillebaelt Hospital, University Hospital of Southern Denmark, Beriderbakken 4, 7100 Vejle, Denmark.
| |
Collapse
|
3
|
Fotokian Z, Mohammadi Shahboulaghi F, Fallahi-Khoshknab M, Pourhabib A. The empowerment of elderly patients with chronic obstructive pulmonary disease: Managing life with the disease. PLoS One 2017; 12:e0174028. [PMID: 28369069 PMCID: PMC5378379 DOI: 10.1371/journal.pone.0174028] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 03/02/2017] [Indexed: 02/03/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a serious health problem that has significant effects on the life status of elderly persons. Use of the empowerment approach is necessary for health promotion in older people with COPD, but little attention has so far been paid to all the dimensions of empowerment in the management of COPD, which would provide useful knowledge regarding elders with COPD. This article reports on a study exploring people's experiences of the empowerment of older people with COPD. This study adopted an exploratory qualitative design and was carried out using grounded theory methodology. Grounded theory was considered appropriate for this study because of its focus on how people respond to and act on the problems that they encounter. We collected data by conducting in-depth semi-structured interviews and taking field notes. Twenty-four participants were selected through purposive sampling. The results showed that in encountering the complexity of disease and in response to difficulties induced by COPD, three strategies were applied. Elderly persons with COPD, their family caregivers, and professional team members engaged in "managing life with COPD," "striving to keep abreast of life," "preparing for battle with disease," and "helping to stabilize the elder's life." The outcome of these strategies was "co-existence with disease." The potential of "managing life with COPD" was influenced by the following factors: "co-existence with ageing," "personal potential," "a challenged health system," and "weak social support." "Managing life with COPD" enables the elder to feel in control and live optimally. This is a fragile balance, however, and the unpredictability of COPD can tip the elder into "self-efficacy." Understanding the experiences of the empowerment process of older people with COPD can help health professionals provide more focused elderly care.
Collapse
Affiliation(s)
- Zahra Fotokian
- Department of Nursing, Ramsar Nursing Care Research Center, School of Nursing and Midwifery, Babol University of Medical Sciences, Babol, Mazandaran, Iran
| | - Farahnaz Mohammadi Shahboulaghi
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran
| | - Masoud Fallahi-Khoshknab
- Department of Nursing, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran
| | - Ali Pourhabib
- Department of Nursing, School of Nursing and Midwifery, Babol University of Medical Sciences, Babol, Mazandaran, Iran
| |
Collapse
|
4
|
Schäfer J, Carvalho LL, Miranda NADF, Vitiello IP, Paiva DN, Silva ALGD. Use of audiovisual media for education and self-management of patients with Chronic Obstructive Pulmonary Disease – COPD. FISIOTERAPIA EM MOVIMENTO 2015. [DOI: 10.1590/0103-5150.028.001.ao10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction Chronic Obstructive Pulmonary Disease (COPD) is considered a disease with high morbidity and mortality, even though it is a preventable and treatable disease. Objective To assess the effectiveness of an audiovisual educational material about the knowledge and self-management in COPD. Methods Quasi-experimental design and convenience sample was composed of COPD patients of Pulmonary Rehabilitation (PR) (n = 42), in advanced stage of the disease, adults of both genders, and with low education. All subjects answered a specific questionnaire before and post-education audiovisual session, to assess their acquired knowledge about COPD. Results Positive results were obtained in the topics: COPD and its consequences, first symptom identified when the disease is aggravated and physical exercise practice. Regarding the second and third symptoms, it was observed that the education session did not improve this learning, as well as the decision facing the worsening of COPD. Conclusion COPD patients showed reasonable knowledge about the disease, its implications and symptomatology. Important aspects should be emphasized, such as identification of exacerbations of COPD and decision facing this exacerbation.
Collapse
|
5
|
Verbrugge R, de Boer F, Georges JJ. Strategies used by respiratory nurses to stimulate self-management in patients with COPD. J Clin Nurs 2013; 22:2787-99. [PMID: 23834504 DOI: 10.1111/jocn.12048] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2012] [Indexed: 01/17/2023]
Abstract
AIMS AND OBJECTIVES To gain an insight into strategies, adopted by Dutch respiratory nurses during clinic sessions, to improve self-management of patients with chronic obstructive pulmonary disease. BACKGROUND Chronic obstructive pulmonary disease is highly prevalent and a significant cause of morbidity and mortality, impacting on quality of life and healthcare expenditure. Health promotion is therefore an important consideration. By applying specific strategies, respiratory nurses can play a major role in the promotion of self-management. Research has shown that respiratory nurses, who run clinics, have insufficient knowledge of evidence-based strategies that can be adopted to promote self-management among chronic obstructive pulmonary disease patients. It appears that respiratory nurses adopt their own strategies during clinic sessions. DESIGN A qualitative research study was carried out using Grounded Theory method. METHODS Data were collected during open interviews conducted by an external researcher with a nursing background. The interviews were analysed through coding after which categories were developed. RESULTS Fourteen respiratory nurses were interviewed. The results show that respiratory nurses emphasise quitting smoking during the consult. Attention is also paid to inhalation medication and techniques. Other self-management strategies that respiratory nurses use are: application of specific interviewing techniques, referring to other healthcare professionals and providing tools for coping with the illness in everyday life. CONCLUSION AND RELEVANCE TO CLINICAL PRACTICE The main emphasis during the clinic session is directed at quitting smoking. Other self-management strategies such as providing information regarding nutrition and exercise, instilling confidence and becoming an equal discussion partner, gain less attention. During the clinic session, respiratory nurses should also focus on these self-management strategies in addition to quitting smoking. Further research should be directed at self-management strategies used by respiratory nurses in relation to different characteristics of patients. In this way, a more patient-oriented form of consultation could be developed for chronic obstructive pulmonary disease patients.
Collapse
Affiliation(s)
- Remco Verbrugge
- St. Antonius Hospital Nieuwegein, Utrecht and Graduate Student, Faculty of Medicine, Department of Nursing Science, Utrecht, The Netherlands
| | | | | |
Collapse
|
6
|
The potential for integrated care programmes to improve quality of care as assessed by patients with COPD: early results from a real-world implementation study in The Netherlands. Int J Integr Care 2012; 12:e191. [PMID: 23593052 PMCID: PMC3601538 DOI: 10.5334/ijic.836] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Revised: 07/21/2012] [Accepted: 07/23/2012] [Indexed: 11/22/2022] Open
Abstract
Objective We investigated whether patients with chronic obstructive pulmonary disease (COPD) who were enrolled in disease-management programmes (DMPs) felt that they received a better quality of care than non-enrolled COPD patients. Methods Our cross-sectional study was performed among patients (n=665) enrolled in four DMPs in the Netherlands. We also evaluated COPD patients (n=227) not enrolled in such programmes. Patients’ assessment of chronic-illness care (PACIC) was measured with a 20-item questionnaire. The instrument had five pre-defined domains: patient activation (three items), delivery-system/practice design (three items), goal setting/tailoring (five items), problem solving/contextual (four items), and follow-up/coordination (five items). Results The mean overall PACIC score (scale: 1–5) of enrolled DMP patients was 2.94, and that of non-enrolled DMP patients was 2.73 (p≤0.01). Differences in the same direction were found in the subscales of patient activation (p≤0.01), delivery-system/practice design (p≤0.001), and problem solving/contextual (p≤0.001). Conclusions Our results suggest that even in the early stages of implementation, DMPs for COPD may significantly improve care.
Collapse
|
7
|
Thomas MJ, Simpson J, Riley R, Grant E. The impact of home-based physiotherapy interventions on breathlessness during activities of daily living in severe COPD: A systematic review. Physiotherapy 2010; 96:108-19. [DOI: 10.1016/j.physio.2009.09.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2008] [Accepted: 09/09/2009] [Indexed: 12/14/2022]
|
8
|
McKinstry A, Tranter M, Sweeney J. Outcomes of dysphagia intervention in a pulmonary rehabilitation program. Dysphagia 2009; 25:104-11. [PMID: 19618132 DOI: 10.1007/s00455-009-9230-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2008] [Accepted: 05/02/2009] [Indexed: 01/29/2023]
Abstract
People with chronic obstructive pulmonary disease (COPD) or chronic respiratory disease demonstrate an increased prevalence of oropharyngeal dysphagia as a consequence of impaired coordination between respiration and swallowing function. To date, the effect of patient education and intervention on the management of oropharyngeal dysphagia within pulmonary rehabilitation programs has not been reported or evaluated. Data were collected on participants who were enrolled in the Outpatient Pulmonary Rehabilitation Program and who received dysphagia intervention. Intervention consisted of some or all of the following: (1) a 1-hour dysphagia education program, (2) screening for oropharyngeal dysphagia, and (3) individual comprehensive oropharyngeal dysphagia assessment and management if a screening assessment was failed. A statistically significant improvement was found in participants' knowledge of dysphagia and COPD (P < 0.001). Participants' retention of this knowledge 4 days post education remained statistically significant (P < 0.001). Twenty-seven percent of participants who were screened had symptoms of oropharyngeal dysphagia. Fifty-five (53%) participants receiving further individual dysphagia assessment/management correctly completed pre/post swallowing-related quality-of-life surveys (SWAL-QOL). Statistically significant improvement was found in the following subscales: Burden of Dysphagia (P < 0.009), Physical Problems of Dysphagia (P < 0.012) and Managing Diet Options/Food Selection (P < 0.016). Dysphagia education, screening, and management in a pulmonary rehabilitation program improved participants' swallowing-related quality of life and overall self-management of chronic respiratory disease and dysphagia.
Collapse
Affiliation(s)
- Anita McKinstry
- Department of Speech Pathology, Austin Hospital, 145 Studley Road, Heidelberg, Victoria 3084, Australia.
| | | | | |
Collapse
|
9
|
Callens SFJ, Kitetele F, Lelo P, Shabani N, Lusiama J, Wemakoy O, Colebunders R, Behets F, Van Rie A. Pulmonary cystic disease in HIV positive individuals in the Democratic Republic of Congo: three case reports. J Med Case Rep 2007; 1:101. [PMID: 17888170 PMCID: PMC2082036 DOI: 10.1186/1752-1947-1-101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2007] [Accepted: 09/22/2007] [Indexed: 11/20/2022] Open
Abstract
Pulmonary emphysema and bronchiectasis in HIV seropositive patients has been described in the presence of injection drug use, malnutrition, repeated opportunistic infections, such as Pneumocytis jirovici pneumonia and Mycobacterium tuberculosis infection, and has been linked to the presence of HIV virus in lung tissue. Given the high burden of pulmonary infections and malnutrition among people living with HIV in resource poor settings, these individuals may be at increased risk of developing pulmonary emphysema, potentially reducing the long term benefit of antiretroviral therapy (ART) if initiated late in the course of HIV infection. In this report, we describe three HIV-infected individuals (one woman and two children) presenting with extensive pulmonary cystic disease.
Collapse
Affiliation(s)
- Steven FJ Callens
- School of Public Health, University of North Carolina at Chapel Hill, USA
| | - Faustin Kitetele
- Pediatric Hospital Kalembe Lembe, Lingwala, Kinshasa, Democratic Republic of Congo
| | - Patricia Lelo
- School of Public Health, University of Kinshasa, Democratic Republic of Congo
| | - Nicole Shabani
- School of Public Health, University of Kinshasa, Democratic Republic of Congo
| | - Jean Lusiama
- School of Public Health, University of Kinshasa, Democratic Republic of Congo
| | - Okitolanda Wemakoy
- School of Public Health, University of Kinshasa, Democratic Republic of Congo
| | - Robert Colebunders
- University of Antwerp, Belgium and Institute of Tropical Medicine, Antwerp, Belgium
| | - Frieda Behets
- School of Public Health, University of North Carolina at Chapel Hill, USA
| | - Annelies Van Rie
- School of Public Health, University of North Carolina at Chapel Hill, USA
| |
Collapse
|
10
|
van der Palen J, Monninkhof E, van der Valk P, Visser A. Managing COPD: no more nihilism! PATIENT EDUCATION AND COUNSELING 2004; 52:221-223. [PMID: 14998589 DOI: 10.1016/s0738-3991(03)00094-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
This special issue of Patient Education and Counseling is long overdue. During most of the last two decades asthma, and notably asthma self-management has been in the spotlight, while COPD has had to endure a nihilistic approach. The first sign that interest was shifting to the treatment of COPD came from a few large randomized trials on the use of inhaled corticosteroids (ICS) in COPD. Although these studies demonstrated a moderate effect of ICS in COPD, it has become clear that true improvements in the management of this chronic disease will have to come from behavioral interventions. This special issue of Patient Education and Counseling is dedicated solely to the non-pharmaceutical management of COPD. It addresses many issues related to behavioral therapy, such as smoking cessation, exercise training, nutritional aspects, and self-management programs, including action plans to self-treat exacerbations. With the availability of all the treatment and management options, described in this special issue, a nihilistic attitude toward the patient with COPD is no longer justified.
Collapse
|