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Scichilone N, Whittamore A, White C, Nudo E, Savella M, Lombardini M. The patient journey in Chronic Obstructive Pulmonary Disease (COPD): a human factors qualitative international study to understand the needs of people living with COPD. BMC Pulm Med 2023; 23:506. [PMID: 38093262 PMCID: PMC10720133 DOI: 10.1186/s12890-023-02796-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/29/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a common condition that causes irreversible airway obstruction. Fatigue and exertional dyspnoea, for example, have a detrimental impact on the patient's daily life. Current research has revealed the need to empower the patient, which can result in not only educated and effective decision-making, but also a considerable improvement in patient satisfaction and treatment compliance. The current study aimed to investigate the perspectives and requirements of people living with COPD to possibly explore new ways to manage their disease. METHODS Adults with COPD from 8 European countries were interviewed by human factor experts to evaluate their disease journey through the gathering of information on the age, performance, length, and impact of diagnosis, symptoms progression, and family and friends' reactions. The assessment of present symptoms, services, and challenges was performed through a 90-min semi-structured interview. To identify possible unmet needs of participants, a generic thematic method was used to explore patterns, themes, linkages, and sequences within the data collected. Flow charts and diagrams were created to communicate the primary findings. Following analysis, the data was consolidated into cohesive insights and conversation themes relevant to determining the patient's unmet needs. RESULTS The 62, who voluntarily accepted to be interviewed, were patients (61% females, aged 32-70 years) with a COPD diagnosis for at least 6 months with stable symptoms of different severity. The main challenges expressed by the patients were the impact on their lifestyle, reduced physical activity, and issues with their mobility. About one-fourth had challenges with their symptoms or medication including difficulty in breathing. Beyond finding a cure for COPD was the primary goal for patients, their main needs were to receive adequate information on the disease and treatments, and to have adequate support to improve physical activity and mobility, helpful both for patients and their families. CONCLUSIONS These results could aid in the creation of new ideas and concepts to improve our patient's quality of life, encouraging a holistic approach to people living with COPD and reinforcing the commitment to understanding their needs.
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Affiliation(s)
- Nicola Scichilone
- Division of Respiratory Medicine, Department PROMISE, "Giaccone" University Hospital, University of Palermo, Palermo, Italy.
| | | | | | - Elena Nudo
- Chiesi Farmaceutici S.P.A, Via Paradigna 131/A - 43122, Parma, Italy
| | - Massimo Savella
- Chiesi Farmaceutici S.P.A, Via Paradigna 131/A - 43122, Parma, Italy
| | - Marta Lombardini
- Chiesi Farmaceutici S.P.A, Via Paradigna 131/A - 43122, Parma, Italy
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Pryce H, Smith SK, Burns-O'Connell G, Knibb R, Greenwood R, Shaw R, Hussain S, Banks J, Hall A, Straus J, Noble S. Protocol for the development and validation of a patient-reported experience measure (PREM) for people with hearing loss: the PREM-HeLP. BMJ Open 2023; 13:e075229. [PMID: 38030247 PMCID: PMC10689349 DOI: 10.1136/bmjopen-2023-075229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 11/14/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Hearing loss is a common chronic health condition and adversely affects communication and social function resulting in loneliness, social isolation and depression. We know little about the patient experience of living with hearing loss and their views on the quality of the audiology service. In this study, we will develop and validate the first patient-reported experience measure (PREM) to understand patients' experiences of living with hearing loss and their healthcare interactions with audiology services. METHODS AND ANALYSIS We will develop the PREM in three phases: (1) development of PREM prototype (items/statements) derived from previous qualitative work and narrative review, (2) cognitive interview testing of the PREM prototype using a 'think aloud' technique to examine the acceptability and comprehensibility of the tool and refine accordingly and (3) psychometric testing of the modified PREM with 300 participants to assess the reliability and validity of the tool using Rasch analyses with sequential item reduction. Eligible participants will be young people and adults aged 16 years and over who have hearing loss. Participants will be recruited from three clinical sites located in England (Bath, Bristol) and Scotland (Tayside) and non-clinical settings (eg, lip-reading classes, residential care settings, national charity links, social media). ETHICS AND DISSEMINATION The study was approved by the West of Scotland Research Ethics Service (approval date: 6 May 2022; ref: 22/WS/0057) and the Health Research Authority and Health and Care Research Wales (HCRW) Approval (approval date: 14 June 2022; IRAS project ID: 308816). Findings will be shared with our patient and public involvement groups, academics, audiology communities and services and local commissioners via publications and presentations. The PREM will be made available to clinicians and researchers without charge.
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Affiliation(s)
- Helen Pryce
- Audiology, School of Optometry, Aston University College of Health and Life Sciences, Birmingham, West Midlands, UK
| | - Sian Karen Smith
- Audiology, School of Optometry, Aston University College of Health and Life Sciences, Birmingham, West Midlands, UK
| | - Georgina Burns-O'Connell
- Audiology, School of Optometry, Aston University College of Health and Life Sciences, Birmingham, West Midlands, UK
| | - Rebecca Knibb
- School of Psychology, Aston University, Birmingham, UK
| | - Rosemary Greenwood
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Rachel Shaw
- School of Psychology, Aston University, Birmingham, UK
| | - Saira Hussain
- Audiology, School of Optometry, Aston University College of Health and Life Sciences, Birmingham, West Midlands, UK
| | - Jonathan Banks
- Social & Community Medicine, University of Bristol, Bristol, UK
| | - Amanda Hall
- Audiology, School of Optometry, Aston University College of Health and Life Sciences, Birmingham, West Midlands, UK
- Children's Hearing Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | | | - Sian Noble
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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Madawala S, Osadnik CR, Warren N, Kasiviswanathan K, Barton C. Healthcare experiences of adults with COPD across community care settings: a meta-ethnography. ERJ Open Res 2023; 9:00581-2022. [PMID: 36755964 PMCID: PMC9900446 DOI: 10.1183/23120541.00581-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/02/2022] [Indexed: 12/24/2022] Open
Abstract
Background Studies investigating lived experiences of patients with COPD raise important concerns about interactions with healthcare professionals. Patients often describe feelings of guilt and shame associated with their COPD and may experience stigma and poor patient experience of care. The aims and objectives of the present study were to systematically scope and synthesise findings from peer-reviewed qualitative studies describing healthcare experiences of patients living with COPD across community care settings. Methods A meta-ethnography was undertaken. Database searches were performed in Ovid MEDLINE, PsychINFO, Ovid Emcare, CINAHL Plus and Sociological Abstracts. Eligible qualitative studies were included. Study screening and data extraction was performed by two independent reviewers. A "line-of-argument" synthesis and deductive and inductive analysis was used to identify key themes, where the deductive element aligned to Wong and Haggerty's six key dimensions of patient experiences. Results Data from 23 studies were included. Experiences and their meaning to patients were explored within the context of six domains of patient experience including access, interpersonal communication, continuity and coordination, comprehensiveness and trust. Inductive coding revealed emotion, stigma, identity and vulnerability shaped healthcare experiences of adults with COPD. Implications Experiences often fell short of what was expected and needed in community settings. Adopting strategies to improve experiences of care in the community can be expected to improve self-management and contribute to improved health outcomes and quality of life. These strategies should take account of vulnerability, stigma and emotions such as guilt and blame that are potent affective drivers of the experience of care for patients with COPD.
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Affiliation(s)
- Sanduni Madawala
- Department of General Practice, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia,Corresponding author: Sanduni Madawala ()
| | - Christian Robert Osadnik
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Narelle Warren
- Department of Sociology, School of Social Sciences, Faculty of Arts, Monash University, Victoria, Australia
| | - Karthika Kasiviswanathan
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Chris Barton
- Department of General Practice, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
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Dattani R, Barwick TD, El Wardany G, Gibbons N, Mason JC, Morgan P, Pusey CD, Tam FWK, Tomlinson JAP. An international patient-centred study of retroperitoneal fibrosis. QJM 2022; 115:148-154. [PMID: 33377941 DOI: 10.1093/qjmed/hcaa327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/17/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The impact that rare chronic disorders, such as retroperitoneal fibrosis (RPF), can have on the physical and psychological aspects of a patient's health is poorly understood. Patient-related outcome measures and experiences provide a unique opportunity to understand the impact rare chronic disorders have on a patient's life as well as allowing healthcare providers to compare and improve performance. AIM To understand the physical and psychosocial impact that RPF has upon peoples' lives. DESIGN An international online questionnaire was therefore created to gain insights into how patients with RPF, a rare fibro-inflammatory condition, viewed their health and experiences. METHODS An international online questionnaire comprising 62 questions/free text options, was designed in collaboration with two patient advocates and the multi-disciplinary Renal Association Rare Disease Registry (RaDaR) RPF Group the questionnaire was anonymous and freely accessible on a GOOGLE Form online platform for 6 months. RESULTS A total of 229 patients from 30 countries across 5 continents responded. Four key issues were identified; (i) pain; (ii) therapy-related side effects; (iii) lack of informed doctors/information about their condition and its management; and (iv) psychological burden. Variations in diagnosis and management are highlighted with 55% undergoing a biopsy to reach a diagnosis of RPF; 75% of patients underwent a further interventional procedure with 60% concurrently treated medically. CONCLUSION This study will guide further development of clinical and academic multi-disciplinary activity and shows the importance of trying to understand the impact of rare chronic disorders on the physical and psychological aspects of a patient's health.
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Affiliation(s)
- R Dattani
- West London Renal and Transplant Centre, Renal Medicine, Du Cane Road, London W12 0HS, UK
| | - T D Barwick
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - G El Wardany
- Retroperitoneal Fibrosis (RPF) Rare Disease Group, Patient Representative London, London, UK
| | - N Gibbons
- Department of Urology, Imperial College Healthcare NHS Trust, London, UK
| | - J C Mason
- Imperial College London, National Heart and Lung Institute London, London, UK
| | - P Morgan
- Retroperitoneal Fibrosis (RPF) Rare Disease Group, Patient Representative London, London, UK
| | - C D Pusey
- West London Renal and Transplant Centre, Renal Medicine, Du Cane Road, London W12 0HS, UK
- Imperial College London, Centre for inflammatory Disease London, London, UK
| | - F W K Tam
- West London Renal and Transplant Centre, Renal Medicine, Du Cane Road, London W12 0HS, UK
- Imperial College London, Centre for inflammatory Disease London, London, UK
| | - J A P Tomlinson
- West London Renal and Transplant Centre, Renal Medicine, Du Cane Road, London W12 0HS, UK
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Schick-Makaroff K, Karimi-Dehkordi M, Cuthbertson L, Dixon D, Cohen SR, Hilliard N, Sawatzky R. Using Patient- and Family-Reported Outcome and Experience Measures Across Transitions of Care for Frail Older Adults Living at Home: A Meta-Narrative Synthesis. THE GERONTOLOGIST 2021; 61:e23-e38. [PMID: 31942997 PMCID: PMC8023359 DOI: 10.1093/geront/gnz162] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Our aim was to create a "storyline" that provides empirical explanation of stakeholders' perspectives underlying the use of patient- and family-reported outcome and experience measures to inform continuity across transitions in care for frail older adults and their family caregivers living at home. RESEARCH DESIGN AND METHODS We conducted a meta-narrative synthesis to explore stakeholder perspectives pertaining to use of patient-reported outcome and experience measures (PROMs and PREMs) across micro (patients, family caregivers, and healthcare providers), meso (organizational managers/executives/programs), and macro (decision-/policy-makers) levels in healthcare. Systematic searches identified 9,942 citations of which 40 were included based on full-text screening. RESULTS PROMs and PREMS (54 PROMs; 4 PREMs; 1 with PROM and PREM elements; 6 unspecified PROMs) were rarely used to inform continuity across transitions of care and were typically used independently, rarely together (n = 3). Two overarching traditions motivated stakeholders' use. The first significant motivation by diverse stakeholders to use PROMs and PREMs was the desire to restore/support independence and care at home, predominantly at a micro-level. The second motivation to using PROMs and PREMs was to evaluate health services, including cost-effectiveness of programs and hospital discharge (planning); this focus was rarely at a macro-level and more often split between micro- and meso-levels of healthcare. DISCUSSION AND IMPLICATIONS The motivations underlying stakeholders' use of these tools were distinct, yet synergistic between the goals of person/family-centered care and healthcare system-level goals aimed at efficient use of health services. There is a missed opportunity here for PROMs and PREMs to be used together to inform continuity across transitions of care.
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Affiliation(s)
| | - Mehri Karimi-Dehkordi
- Department of Medicine and Community Health Sciences, University of Calgary, Vancouver
| | - Lena Cuthbertson
- Office of Patient-Centered Measurement, British Columbia, Ministry of Health, Vancouver
| | - Duncan Dixon
- Norma Marion Alloway Library, Trinity Western University, Langley
| | - S Robin Cohen
- Department of Oncology and Medicine, McGill University, Montréal
- Lady Davis Institute, Palliative Care Research, Montréal
| | | | - Richard Sawatzky
- School of Nursing, Trinity Western University, Langley
- Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital, Vancouver, Canada
- Sahlgrenska Academy, University of Gothenburg, Sweden
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Beckers E, Webers C, Boonen A, Ten Klooster PM, Vonkeman HE, van Tubergen A. Validation and implementation of a patient-reported experience measure for patients with rheumatoid arthritis and spondyloarthritis in the Netherlands. Clin Rheumatol 2020; 39:2889-2897. [PMID: 32318970 PMCID: PMC7497348 DOI: 10.1007/s10067-020-05076-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/24/2020] [Accepted: 04/01/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To test the psychometric properties of the United Kingdom's Commissioning for Quality in Rheumatoid Arthritis Patient-Reported Experience Measure (CQRA-PREM) in patients with spondyloarthritis (SpA) and rheumatoid arthritis (RA) and to implement this questionnaire in daily practice in the Netherlands. METHODS After a forward-backward translation procedure into Dutch, the CQRA-PREM was tested into two quality registries in daily practice. Face validity was assessed with focus group interviews. Feasibility was evaluated through completion times and interpretability of domain scores through floor and ceiling effects. Internal consistency (Cronbach's α coefficients) and homogeneity (corrected item-total correlations) were determined. Divergent validity was assessed by Spearman's rank correlation coefficients (rs) between the average scores of domains and outcome measures. The CQRA-PREM was implemented in daily practice, and the results were used in quality improvement cycles. RESULTS Face validity of the CQRA-PREM was good. The CQRA-PREM was completed by 282 patients with SpA and 376 with RA. Median time to complete the CQRA-PREM was 4.7 min. Ceiling effects were found in three out of seven domains. Internal consistency of nearly all domains was considered good (0.65 ≤ α ≤ 0.95). Thresholds for homogeneity were exceeded within three domains (rp > 0.7), suggesting item redundancy. Divergent validity showed that nearly all domains of the CQRA-PREM were at most weakly correlated with outcomes measures (- 0.3 ≤ rs ≤ 0.3). The CQRA-PREM could identify areas of improvement for providing patient-centered care. CONCLUSION The CQRA-PREM has acceptable psychometric properties and has shown to be a useful tool in evaluating quality of care from the patients' perspective in the Netherlands. TRIAL REGISTRATION SpA-Net is registered in the Netherlands Trial Registry (NTR6740). KEY POINTS • The Commissioning for Quality in Rheumatoid Arthritis Patient-Reported Experience Measure (CQRA-PREM) is a valid measure for assessing patient-centeredness of rheumatology care. • The Dutch version of the CQRA-PREM shows acceptable psychometric properties. • The CQRA-PREM shows to be a useful tool in Plan-Do-Check-Act quality improvement cycles in the Netherlands. • The CQRA-PREM can be used for benchmarking and quality improvement of rheumatology services.
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Affiliation(s)
- Esther Beckers
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands.
| | - Casper Webers
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Annelies Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Peter M Ten Klooster
- Department of Psychology, Health & Technology, University of Twente, Enschede, Netherlands
| | - Harald E Vonkeman
- Department of Rheumatology, Medisch Spectrum Twente, Enschede, Netherlands
| | - Astrid van Tubergen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
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Schmid-Mohler G, Clarenbach C, Brenner G, Kohler M, Horvath E, Spielmanns M, Petry H. Advanced nursing practice in COPD exacerbations: the solution for a gap in Switzerland? ERJ Open Res 2020; 6:00354-2019. [PMID: 32577416 PMCID: PMC7293988 DOI: 10.1183/23120541.00354-2019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 03/24/2020] [Indexed: 02/06/2023] Open
Abstract
AIM This study aimed to address the need for adaptation of the current model of chronic obstructive pulmonary disease (COPD) care in Switzerland, particularly in regard to acute exacerbations, and how far an integrated approach involving advanced nursing practice can meet those needs. METHODS A state analysis guided by the PEPPA framework was initiated by the Pulmonology Clinic of University Hospital Zürich. Literature describing the current provision of COPD care regarding exacerbations in Switzerland and international qualitative studies describing the patient perspective were systematically searched and summarised. The health providers' perspective was investigated in three focus-group interviews. RESULTS A lack of systematic and state-of-the-art support for patient self-management in Switzerland was described in literature and confirmed by the health providers interviewed. While care was assessed as being comprehensive and of good quality in each individual sector, such as inpatient, outpatient, rehabilitation and home settings, it was identified as being highly fragmented across sectors. The interview participants described day-to-day examples in which a lack of support in COPD self-management and fragmentation of care negatively affected the patients' disease management. CONCLUSION The necessity of coordinating the transition between healthcare sectors and self-management support and that these organisational boundaries should be addressed by a multi-professional team were identified. Initial evaluation indicates that advanced practice nurses potentially have the skill set to coordinate the team and address patients' self-management needs in complex patient situations. However, the legal foundation and a reimbursement system to ensure long-term implementation is not yet available.
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Affiliation(s)
- Gabriela Schmid-Mohler
- Centre of Clinical Nursing Science, University Hospital Zürich, Zürich, Switzerland
- Division of Pulmonology, University Hospital Zürich, Zürich, Switzerland
- Medical Dept Heart–Vascular–Thorax, University Hospital Zürich, Zürich, Switzerland
| | - Christian Clarenbach
- Division of Pulmonology, University Hospital Zürich, Zürich, Switzerland
- Medical Dept Heart–Vascular–Thorax, University Hospital Zürich, Zürich, Switzerland
| | - Gabi Brenner
- Directorate of Nursing and Allied Health Professionals, University Hospital Zürich, Zürich, Switzerland
| | - Malcolm Kohler
- Division of Pulmonology, University Hospital Zürich, Zürich, Switzerland
- Medical Dept Heart–Vascular–Thorax, University Hospital Zürich, Zürich, Switzerland
| | - Eva Horvath
- Medical Dept Heart–Vascular–Thorax, University Hospital Zürich, Zürich, Switzerland
| | - Marc Spielmanns
- Pulmonary Medicine, Zürcher RehaZentren Klinik Wald, Zürich, Switzerland
- Dept of Pulmonary Medicine, Faculty of Health, University Witten-Herdecke, Witten, Germany
| | - Heidi Petry
- Centre of Clinical Nursing Science, University Hospital Zürich, Zürich, Switzerland
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Hodson M, Roberts CM, Andrew S, Graham L, Jones PW, Yorke J. Development and first validation of a patient-reported experience measure in chronic obstructive pulmonary disease (PREM-C9). Thorax 2019; 74:600-603. [PMID: 31028236 DOI: 10.1136/thoraxjnl-2018-211732] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 01/18/2019] [Accepted: 01/21/2019] [Indexed: 11/03/2022]
Abstract
We developed a chronic obstructive pulmonary disease (COPD) patient-reported experience measure (PREM-C9). 174 patients with COPD (86 [49%] with a confirmed diagnosis and 88 [51%] with a self-reported diagnosis of COPD) completed a 38-item list, COPD Assessment Test (CAT) and Hospital Anxiety and Depression Scale (HADS). Hierarchical and Rasch analysis produced a 9-item list (PREM-C9). It demonstrated fit to the Rasch model (χ² p=0.33) and correlated moderately with CAT (r=0.42), HAD-anxiety (r=0.30) and HAD-depression (r=0.41) (p<0.05). A substudy confirmed its ability to detect change prepulmonary and postpulmonary rehabilitation. The PREM-C9 is a simple, valid measure of experience of patients living with COPD, validated in this study population with mild to very severe disease; it may be a useful measure in research and clinical audits.
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Affiliation(s)
- Matthew Hodson
- ACERS, Homerton University Hospital NHS Foundation Trust, London, UK
| | - C Michael Roberts
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Sharon Andrew
- Department of Nursing & Midwifery, Victoria University, Melbourne, Victoria, Australia
| | - Laura Graham
- ACERS, Homerton University Hospital NHS Foundation Trust, London, UK
| | - Paul W Jones
- Institute for Infection and Immunity, St Georges, University of London, London, UK
| | - Janelle Yorke
- School of Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK
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Schmid-Mohler G, Caress AL, Spirig R, Yorke J. Introducing a model for emotional distress in respiratory disease: A systematic review and synthesis of symptom management models. J Adv Nurs 2019; 75:1854-1867. [PMID: 30734366 DOI: 10.1111/jan.13968] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 11/12/2018] [Accepted: 11/28/2018] [Indexed: 12/31/2022]
Abstract
AIM To undertake a theoretical systematic review to develop a conceptual model of illness-related emotional distress in the context of symptom management in chronic respiratory disease. DESIGN We performed a systematic search to identify conceptual models. DATA SOURCES Electronic databases MEDLINE, CINAHL, EMBASE and PsycINFO were searched and papers included from inception of the search term until June 2017. REVIEW METHODS The review was conducted following Pound and Campbell's and Turner's theory synthesis. Conceptual models were appraised using Kaplan's criteria. Models were excluded if they referred to a specific condition and/or lacked clarity. RESULTS This synthesis, which includes five models and additional evidence, yielded a new conceptual model describing the processes of regulation and symptom self-management in chronic respiratory disease. Identified sources of illness-related emotional distress are new or increased symptoms, additional treatment, new restrictions in performance of daily life roles and increased unpredictability. People goals and self-efficacy were identified as further drivers of symptom self-management. The regulation process is embedded in contextual factors. CONCLUSION Theory synthesis provided transparent guidance in developing a model to understand of the factors driving self-management decisions. Therefore, the model has the potential to guide development of interventions that support symptom self-management in chronic respiratory disease. IMPACT This newly presented conceptual model of illness-related emotional distress provides an understanding of the factors that drive self-management decisions when peoples experience new or increased symptoms. Such understanding is critical for nursing practice to developing appropriate interventions, especially in support of people decision-making.
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Affiliation(s)
| | - Ann-Louise Caress
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
| | - Rebecca Spirig
- Directorate of Nursing and Allied Health Professionals, University Hospital Zurich, Zurich, Switzerland
| | - Janelle Yorke
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
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