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Noordman J, Meurs M, Poortvliet R, Rusman T, Orrego-Villagran C, Ballester M, Ninov L, de Guzmán EN, Alonso-Coello P, Groene O, Suñol R, Heijmans M, Wagner C. Contextual factors for the successful implementation of self-management interventions for chronic diseases: A qualitative review of reviews. Chronic Illn 2024; 20:3-22. [PMID: 36744382 DOI: 10.1177/17423953231153337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To identify and describe the most relevant contextual factors (CFs) from the literature that influence the successful implementation of self-management interventions (SMIs) for patients living with type 2 diabetes mellitus, obesity, COPD and/or heart failure. METHODS We conducted a qualitative review of reviews. Four databases were searched, 929 reviews were identified, 460 screened and 61 reviews met the inclusion criteria. CFs in this paper are categorized according to the Tailored Implementation for Chronic Diseases framework. RESULTS A great variety of CFs was identified on several levels, across all four chronic diseases. Most CFs were on the level of the patient, the professional and the interaction level, while less CFs were obtained on the level of the intervention, organization, setting and national level. No differences in main themes of CFs across all four diseases were found. DISCUSSION For the successful implementation of SMIs, it is crucial to take CFs on several levels into account simultaneously. Person-centered care, by tailoring SMIs to patients' needs and circumstances, may increase the successful uptake, application and implementation of SMIs in real-life practice. The next step will be to identify the most important CFs according to various stakeholders through a group consensus process.
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Affiliation(s)
- Janneke Noordman
- Netherlands institute for health services research (Nivel), Utrecht, The Netherlands
| | - Maaike Meurs
- Netherlands institute for health services research (Nivel), Utrecht, The Netherlands
| | - Rune Poortvliet
- Netherlands institute for health services research (Nivel), Utrecht, The Netherlands
| | - Tamara Rusman
- Netherlands institute for health services research (Nivel), Utrecht, The Netherlands
| | - Carola Orrego-Villagran
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
- Health Services Research Network on Chronic Diseases (REDISSEC), Madrid, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
| | - Marta Ballester
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
- Health Services Research Network on Chronic Diseases (REDISSEC), Madrid, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
| | | | - Ena Niño de Guzmán
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | | | - Rosa Suñol
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
- Health Services Research Network on Chronic Diseases (REDISSEC), Madrid, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
| | - Monique Heijmans
- Netherlands institute for health services research (Nivel), Utrecht, The Netherlands
| | - Cordula Wagner
- Netherlands institute for health services research (Nivel), Utrecht, The Netherlands
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Huijten DCM, Hofstede L, Simons SO, Ament SCM, Gunnink-Boonstra N, van den Beuken-van Everdingen MHJ, Janssen DJA. Development of the conversation tool "I-HARP for COPD" for early identification of palliative care needs in patients with chronic obstructive pulmonary disease. Palliat Support Care 2024:1-9. [PMID: 38362720 DOI: 10.1017/s1478951524000191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
OBJECTIVES This study aimed to develop the conversation tool "I-HARP for COPD" for timely identification of palliative care needs in Dutch patients with chronic obstructive pulmonary disease (COPD). METHODS An iterative and participatory research design was used to develop "I-HARP for COPD". There were 2 phases to the development of "I-HARP for COPD": content development and testing. A review of current literature, parallel focus groups, and a questionnaire among experts were used to develop the content of "I-HARP for COPD". "I-HARP for COPD" was then assessed by health-care professionals (HCPs) in clinical practice for understanding, difficulty, and relevance. RESULTS A total of 46 HCPs, 6 patients, 1 informal caregiver, and 1 bereaved informal caregiver participated in this study. "I-HARP for COPD" included 14 screening questions, additional in-depth questions, and recommendations to address identified needs. The content of "I-HARP for COPD" was accepted by 86.2% of the HCPs. SIGNIFICANCE OF RESULTS "I-HARP for COPD" was successfully developed for providing guidance in the palliative care of Dutch patients with COPD and their informal caregivers. By supporting HCPs with "I-HARP for COPD", they are better able to timely identify and direct palliative care needs.
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Affiliation(s)
- Daniël C M Huijten
- Department of Health Services Research and Department of Family medicine, Maastricht University, Care and Public Health Research Institute, Maastricht, The Netherlands
- Department of Nursing Science, Zuyderland, Zuyderland Medical Center, Sittard-Geleen, The Netherlands
| | - Laura Hofstede
- Department of Health Services Research and Department of Family medicine, Maastricht University, Care and Public Health Research Institute, Maastricht, The Netherlands
| | - Sami O Simons
- Department of Respiratory Medicine, Maastricht University, Maastricht, The Netherlands
- Division of Respiratory & Age-related Health, Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - Stephanie C M Ament
- Department of Quality, Innovation, and Research, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | | | | | - Daisy J A Janssen
- Department of Health Services Research and Department of Family medicine, Maastricht University, Care and Public Health Research Institute, Maastricht, The Netherlands
- Department of Research and Development, Ciro Horn, Haelen, The Netherlands
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Steindal SA, Hofsø K, Aagaard H, Mariussen KL, Andresen B, Christensen VL, Heggdal K, Wallander Karlsen MM, Kvande ME, Kynø NM, Langerud AK, Ohnstad MO, Sørensen K, Larsen MH. Non-invasive ventilation in the care of patients with chronic obstructive pulmonary disease with palliative care needs: a scoping review. BMC Palliat Care 2024; 23:27. [PMID: 38287312 PMCID: PMC10823671 DOI: 10.1186/s12904-024-01365-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 01/19/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Patients with severe chronic obstructive pulmonary disease (COPD) could have palliative care (PC) needs because of unmet needs such as dyspnoea. This may lead to anxiety and may have an impact on patients' ability to perform daily activities of living. PC can be started when patients with COPD have unmet needs and can be provided alongside disease-modifying therapies. Non-invasive ventilation (NIV) could be an important measure to manage dyspnoea in patients with COPD in need of PC. A scoping review was conducted to gain an overview of the existing research and to identify knowledge gaps. The aim of this scoping review was to systematically map published studies on the use of NIV in patients with COPD with PC needs, including the perspectives and experiences of patients, families, and healthcare professionals (HCPs). METHODS This review was conducted following the framework of Arksey and O'Malley. The reporting of the review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. The review protocol was published. AMED, CINAHL, Embase, MEDLINE, PEDro, and PsycInfo were searched from inception to November 14, 2022. The included studies had to report the perspectives and experiences of COPD patients, relatives, and HCPs regarding NIV in the care of patients with COPD with PC needs. In pairs, the authors independently assessed studies' eligibility and extracted data. The data were organised thematically. The results were discussed in a consultation exercise. RESULTS This review included 33 papers from 32 studies. Four thematic groupings were identified: preferences and attitudes towards the use of NIV; patient participation in the decision-making process of NIV treatment; conflicting results on the perceived benefits and burdens of treatment; and heterogenous clinical outcomes in experimental studies. Patients perceived NIV as a 'life buoy' to keep them alive. Many patients wanted to take part in the decision-making process regarding NIV treatment but expressed varying degrees of inclusion by HCPs in such decision-making. Conflicting findings were identified regarding the perceived benefits and burdens of NIV treatment. Diversity in heterogeneous clinical outcomes were reported in experimental studies. CONCLUSIONS There is a need for more studies designed to investigate the effectiveness of NIV as a palliative measure for patients with COPD with PC needs using comprehensive outcomes. It is especially important to gain more knowledge on the experiences of all stakeholders in the use of home-based NIV treatment to these patients.
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Affiliation(s)
- Simen A Steindal
- Lovisenberg Diaconal University College, Lovisenberggt 15B, 0456, Oslo, Norway.
- Faculty of Health Sciences, VID Specialized University, Mail Box 184 Vinderen, 0319, Oslo, Norway.
| | - Kristin Hofsø
- Lovisenberg Diaconal University College, Lovisenberggt 15B, 0456, Oslo, Norway
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Hanne Aagaard
- Lovisenberg Diaconal University College, Lovisenberggt 15B, 0456, Oslo, Norway
| | - Kari L Mariussen
- Lovisenberg Diaconal University College, Lovisenberggt 15B, 0456, Oslo, Norway
| | - Brith Andresen
- Lovisenberg Diaconal University College, Lovisenberggt 15B, 0456, Oslo, Norway
- The Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
| | | | - Kristin Heggdal
- Faculty of Health Sciences, VID Specialized University, Mail Box 184 Vinderen, 0319, Oslo, Norway
| | | | - Monica E Kvande
- Lovisenberg Diaconal University College, Lovisenberggt 15B, 0456, Oslo, Norway
| | - Nina M Kynø
- Department of Nursing and Health Promotion, Acute and Critical Illness, Oslo Metropolitan University, Oslo, Norway
- Department of Pediatric and Adolescent Medicine, Division of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway
| | - Anne Kathrine Langerud
- Department of Nursing and Health Promotion, Acute and Critical Illness, Oslo Metropolitan University, Oslo, Norway
- Department of Post-Operative and Critical Care, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Mari Oma Ohnstad
- Lovisenberg Diaconal University College, Lovisenberggt 15B, 0456, Oslo, Norway
| | - Kari Sørensen
- Lovisenberg Diaconal University College, Lovisenberggt 15B, 0456, Oslo, Norway
- Department of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
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Ora L, Wilkes L, Mannix J, Gregory L, Luck L. Embedding nurse-led supportive care in an outpatient service for patients with Chronic Obstructive Pulmonary Disease. J Adv Nurs 2023; 79:3274-3285. [PMID: 36807924 DOI: 10.1111/jan.15605] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 01/13/2023] [Accepted: 02/10/2023] [Indexed: 02/23/2023]
Abstract
AIM To describe a small multidisciplinary team's experience of the process of embedding nurse-led supportive care into an existing Chronic Obstructive Pulmonary Disease outpatient service. DESIGN Case study methodology METHODS: Data were collected from multiple sources including key documents and semi-structured interviews with healthcare professionals (n = 6) conducted between June and July 2021. A purposive sampling strategy was used. Content analysis was applied to key documents. Interviews were transcribed verbatim and analysed using an inductive approach. RESULTS Subcategories under the four-stage process were identified from the data. ASSESSMENT evidence of needs of patients with Chronic Obstructive Pulmonary Disease; gaps in care and evidence of other models of supportive care. Planning: setting the supportive care service structure and intention; resources and funding; leadership, specialization and respiratory/palliative care roles. IMPLEMENTATION relationships and trust; embedding supportive care and communication. EVALUATION benefits and positive outcomes for staff and patients, and, improvements and future considerations for supportive care in the COPD service. CONCLUSION A collaboration between respiratory and palliative care services resulted in successfully embedding nurse-led supportive care in a small outpatient service for patients with Chronic Obstructive Pulmonary Disease. Nurses are well placed to lead new models of care that aim to address unmet biopsychosocial-spiritual needs of patients. More research is needed to evaluate nurse-led supportive care in Chronic Obstructive Pulmonary Disease and other chronic illness settings; the effectiveness of nurse-led supportive care from the perspective of patients and caregivers and the impact of nurse-led supportive care on health service usage. PATIENT OR PUBLIC CONTRIBUTION The development of the model of care is informed by ongoing discussions with patients with COPD and their caregivers. Data availability statement: Research data are not shared (due to ethical restrictions). IMPACT Embedding nurse-led supportive care in an existing Chronic Obstructive Pulmonary Disease outpatient service is achievable. Nurses with clinical expertise can lead innovative models of care that address the unmet biopsychosocial-spiritual needs of patients with conditions such as Chronic Obstructive Pulmonary Disease. Nurse-led supportive care may have utility and relevance in other chronic disease contexts.
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Affiliation(s)
- Linda Ora
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
- Nepean Blue Mountains Local Health District, Penrith, New South Wales, Australia
| | - Lesley Wilkes
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
| | - Judy Mannix
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
| | - Linda Gregory
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
| | - Lauretta Luck
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
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Kalaitzaki A, Rovithis M, Dimitropoulos A, Koukouli S, Linardakis M, Katsiri E, Rikos N, Vasilopoulos G, Tsolas G, Papachristou A, Dimitrantzou A, Katsiris D, Stavropoulou A. Promoting Self-Management and Independent Living of Older Individuals with Chronic Diseases through Technology: A Study of Self-Reported Needs, Priorities, and Preferences. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1493. [PMID: 37629783 PMCID: PMC10456648 DOI: 10.3390/medicina59081493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/27/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023]
Abstract
Background and Objectives: Older patients' needs are rarely examined beforehand, and thus, although technology-based tools can enhance self-management, acceptability rates are still low. This study aimed to examine and compare self-reported needs, priorities, and preferences of older patients with heart failure (HF), diabetes mellitus type II (DM2), and chronic obstructive pulmonary disease (COPD) toward technology use to enhance self-management. Materials and Methods: A convenience sample of 473 participants over 60 s (60.5% females), diagnosed with HF (n= 156), DM2 (n = 164), or COPD (n = 153) was recruited. They were administered a questionnaire about the usefulness of technology in general and in specific areas of disease management. Results: Most participants (84.7%) admitted that technology is needed for better disease management. This was equally recognized across the three groups both for the overall and specific areas of disease management (in order of priority: "Information", "Communication with Physicians and Caregivers", and "Quality of Life and Wellbeing"). Sociodemographic differences were found. Cell phones and PCs were the devices of preference. The four common features prioritized by all three groups were related to 'information about disease management' (i.e., monitoring symptoms, reminders for medication intake, management and prevention of complications), whereas the fifth one was related to 'communication with physicians and caregivers (i.e., in case of abnormal or critical signs). The top disease-specific feature was also monitoring systems (of respiratory rate or blood sugar or blood pressure, and oxygen), whereas other disease-specific features followed (i.e., maintaining normal weight for HF patients, adjusting insulin dose for DM2 patients, and training on breathing exercises for COPD patients). Conclusions: Older individuals in these three groups seem receptive to technology in disease management. mHealth tools, incorporating both common and disease-specific features and addressing different chronic patients, and also being personalized at the same time, could be cost-saving and useful adjuncts in routine clinical care to improve self-management.
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Affiliation(s)
- Argyroula Kalaitzaki
- Department of Social Work, School of Health Sciences, Hellenic Mediterranean University, Gianni Kornarou, Estavromenos 1, 71410 Heraklion, Greece (S.K.)
- Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life (QoLab), 71410 Heraklion, Greece; (N.R.); (A.S.)
| | - Michael Rovithis
- Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life (QoLab), 71410 Heraklion, Greece; (N.R.); (A.S.)
- Department of Business Administration and Tourism, School of Management and Economics Sciences, Hellenic Mediterranean University, Gianni Kornarou, Estavromenos 1, 71410 Heraklion, Greece
| | | | - Sofia Koukouli
- Department of Social Work, School of Health Sciences, Hellenic Mediterranean University, Gianni Kornarou, Estavromenos 1, 71410 Heraklion, Greece (S.K.)
- Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life (QoLab), 71410 Heraklion, Greece; (N.R.); (A.S.)
| | - Manolis Linardakis
- Department of Social Medicine, Faculty of Medicine, University of Crete, Andrea Kalokerinou 13, Giofirakia, 71500 Heraklion, Greece;
| | - Elli Katsiri
- Innosense ΙΚΕ, 18 Esperidon Str., 13674 Athens, Greece; (E.K.); (D.K.)
| | - Nikos Rikos
- Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life (QoLab), 71410 Heraklion, Greece; (N.R.); (A.S.)
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, Gianni Kornarou, Estavromenos 1, 71410 Heraklion, Greece
| | - George Vasilopoulos
- Department of Nursing, Faculty of Health and Care Sciences, University of West Attica, Ag. Spyridonos Str., 12243 Athens, Greece;
| | - George Tsolas
- Institute of Nursing Research and Health Policy, 73 Aristotelous Str., 10434 Athens, Greece; (G.T.); (A.P.)
| | - Aikaterini Papachristou
- Institute of Nursing Research and Health Policy, 73 Aristotelous Str., 10434 Athens, Greece; (G.T.); (A.P.)
| | | | | | - Areti Stavropoulou
- Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life (QoLab), 71410 Heraklion, Greece; (N.R.); (A.S.)
- Department of Nursing, Faculty of Health and Care Sciences, University of West Attica, Ag. Spyridonos Str., 12243 Athens, Greece;
- Faculty of Health, Science, Social Care and Education, Kingston University, KT2 7LB London, UK
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Jamil N, Zainal ZA, Alias SH, Chong LY, Hashim R. A systematic review of behaviour change techniques in pharmacist-delivered self-management interventions towards patients with chronic obstructive pulmonary disease. Res Social Adm Pharm 2023:S1551-7411(23)00256-5. [PMID: 37202279 DOI: 10.1016/j.sapharm.2023.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/11/2023] [Accepted: 05/08/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Self-management interventions often employ behaviour change techniques in order to produce desired target behaviours that are necessary for day-to-day living with a chronic disease. Despite the large number of self-management interventions for patients with chronic obstructive pulmonary disease (COPD), previously reported interventions have been typically delivered by healthcare providers other than the pharmacist. OBJECTIVE This systematic review examined the components of pharmacists-delivered COPD self-management interventions according to an established taxonomy of behaviour change techniques (BCTs). METHODS A systematic search was conducted on PubMed, ScienceDirect, OVID, and Google Scholar from January 2011 to December 2021 for studies of pharmacist-delivered self-management interventions in COPD patients. RESULTS A total of seventeen studies of intervention were eligible for inclusion in the narrative review. Interventions were educational and were delivered individually and face-to-face for the first session. Across studies, pharmacists spent an average of 35 min on the first meeting and had an average of 6 follow-up sessions. Recurrent BCTs in pharmacist interventions were "Information on the health consequence", "Feedback on behaviour", "Instruction on how to perform a behaviour", "Demonstration of the behaviour" and "Behavioural practice/rehearsal". CONCLUSIONS Pharmacists have provided interventions towards improving health behaviours, especially on adherence and usage of inhaler devices for patients with COPD. Future self-management interventions should be designed using the identified BCTs for the improvement of COPD self-management and disease outcomes.
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Affiliation(s)
- Nurdiana Jamil
- Faculty of Pharmacy, University of Cyberjaya, Persiaran Bestari, 63000, Cyberjaya, Selangor, Malaysia.
| | - Zainol Akbar Zainal
- Faculty of Pharmacy, University of Cyberjaya, Persiaran Bestari, 63000, Cyberjaya, Selangor, Malaysia.
| | - Siti Hazlina Alias
- Faculty of Psychology and Social Sciences, University of Cyberjaya, Persiaran Bestari, 63000, Cyberjaya, Selangor, Malaysia.
| | - Li Yin Chong
- Serdang Hospital, Ministry of Health Malaysia, Jalan Puchong, 43000, Kajang, Selangor, Malaysia.
| | - Rosnani Hashim
- Faculty of Pharmacy, University of Cyberjaya, Persiaran Bestari, 63000, Cyberjaya, Selangor, Malaysia.
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Zanolari D, Händler-Schuster D, Clarenbach C, Schmid-Mohler G. A qualitative study of the sources of chronic obstructive pulmonary disease-related emotional distress. Chron Respir Dis 2023; 20:14799731231163873. [PMID: 36898089 PMCID: PMC10009049 DOI: 10.1177/14799731231163873] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
OBJECTIVE The aim of this study is to identify the sources of illness-related emotional distress from the perspective of individuals living with mild to severe chronic obstructive pulmonary disease (COPD). METHODS A qualitative study design with purposive sampling was applied at a Swiss University Hospital. Eleven interviews were conducted with individuals who suffered from COPD. To analyze data, framework analysis was used, guided by the recently presented model of illness-related emotional distress. RESULTS Six main sources for COPD-related emotional distress were identified: physical symptoms, treatment, restricted mobility, restricted social participation, unpredictability of disease course and COPD as stigmatizing disease. Additionally, life events, multimorbidity and living situation were found to be sources of non-COPD-related distress. Negative emotions ranged from anger, sadness, and frustration to desperation giving rise to the desire to die. Although most patients experience emotional distress regardless of the severity of COPD, the sources of distress appear to have an individual manifestation. DISCUSSION There is a need for a careful assessment of emotional distress among patients with COPD at all stages of the disease to provide patient-tailored interventions.
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Affiliation(s)
- Diana Zanolari
- School of Health Sciences, Institute of Nursing, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Daniela Händler-Schuster
- School of Health Sciences, Institute of Nursing, Zurich University of Applied Sciences, Winterthur, Switzerland.,Department Nursing Science and Gerontology, Institute of Nursing, Private University of Health Sciences Medical Informatics and Technology, Hall in Tyrol, Austria.,Te Kura Tapuhi Hauora, The School of Nursing, Midwifery, and Health Practice at Victoria University of Wellington Te Herenga Waka, Victoria University of Wellington, Wellington, New Zealand
| | | | - Gabriela Schmid-Mohler
- Department of Pulmonology, 27243University Hospital Zurich, Zurich, Switzerland.,Centre of Clinical Nursing Science, 27243University Hospital Zurich, Zurich, Switzerland
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Skerry L, Kervin E, Freeze TA, Brillant A, Woodland J, Hanson N. "It's a lonely battle": A qualitative study of older adult Canadians' experiences with chronic obstructive pulmonary disease medication adherence and support. Can Pharm J (Ott) 2022; 156:32-41. [PMID: 36686315 PMCID: PMC9849920 DOI: 10.1177/17151635221140412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Medication adherence is critical for optimal management of chronic obstructive pulmonary disease (COPD) and is influenced by patient, treatment and societal factors. Currently, little is known about the patient perspectives of older adult Canadians with COPD regarding medication adherence. Therefore, the purpose of this study was to explore the lived experiences of older Canadian adults with COPD regarding medication adherence and management. Methods Semi-structured interviews were conducted with 20 community-dwelling older adults with COPD, and iterative thematic analysis was performed. Results Six themes emerged from these data: (1) continuity of care, (2) importance of pharmacy for information and care, (3) medication self-management, (4) "there needs to be more information," (5) drug costs a concern and (6) "it's a lonely battle." Conclusion Findings suggested a need for improved continuity of care, disease-related information provision and means of addressing psychosocial needs. Holistic approaches to patient education and self-management, with consideration for varying health literacy, are needed.
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Affiliation(s)
- Leanne Skerry
- Horizon Health Network, Research Services,
Saint Joseph’s Hospital, Saint John, New Brunswick
| | - Emily Kervin
- Horizon Health Network, Research Services,
Saint Joseph’s Hospital, Saint John, New Brunswick
| | - Tracy A. Freeze
- Horizon Health Network, Research Services,
Saint Joseph’s Hospital, Saint John, New Brunswick
| | - Andrew Brillant
- Pharmacy Services, Saint Joseph’s Hospital,
Saint John, New Brunswick
| | - Jennifer Woodland
- Horizon Health Network, Research Services,
Saint Joseph’s Hospital, Saint John, New Brunswick
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Laranjeira C, Dourado M. "Dignity as a Small Candle Flame That Doesn't Go Out!": An Interpretative Phenomenological Study with Patients Living with Advanced Chronic Obstructive Pulmonary Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:17029. [PMID: 36554911 PMCID: PMC9778832 DOI: 10.3390/ijerph192417029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/10/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
Long-term illness, such as chronic obstructive pulmonary disease (COPD), can expose people to existential suffering that threatens their dignity. This qualitative study explored the lived experiences of patients with advanced COPD in relation to dignity. An interpretative phenomenological approach based on lifeworld existentials was conducted to explore and understand the world of the lived experience. Twenty individuals with advanced COPD (GOLD [Global Initiative for Chronic Obstructive Lung Disease] stages III and IV) were selected using a purposive sampling strategy. In-depth interviews were used to collect data, which were then analysed using Van Manen's phenomenology of practice. The existential experience of dignity was understood, in essence, as "a small candle flame that doesn't go out!". Four intertwined constituents illuminated the phenomenon: "Lived body-balancing between sick body and willingness to continue"; "Lived relations-balancing between self-control and belongingness"; "Lived Time-balancing between past, present and a limited future"; and "Lived space-balancing between safe places and non-compassionate places". This study explains how existential life phenomena are experienced during the final phases of the COPD trajectory and provides ethical awareness of how dignity is lived. More research is needed to investigate innovative approaches to manage complex care in advanced COPD, in order to assist patients in discovering their inner resources to develop and promote dignity.
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Affiliation(s)
- Carlos Laranjeira
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena–Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Rua de Santo André—66–68, Campus 5, 2410-541 Leiria, Portugal
- Research in Education and Community Intervention (RECI I&D), Piaget Institute, 3515-776 Viseu, Portugal
- Center for Studies and Development of Continuous and Palliative Care (CEDCCP), Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal
| | - Marília Dourado
- Center for Studies and Development of Continuous and Palliative Care (CEDCCP), Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, R. Larga, 3004-504 Coimbra, Portugal
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Social dimensions of chronic respiratory disease: stigma, isolation, and loneliness. Curr Opin Support Palliat Care 2022; 16:195-202. [PMID: 36102929 DOI: 10.1097/spc.0000000000000616] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
PURPOSE OF REVIEW Social wellbeing is a core component of heath. However, people with chronic respiratory disease report unmet social needs, particularly in relation to stigma, social isolation, and loneliness. This review considers recent advances in understanding these social concepts within the context of chronic respiratory disease. RECENT FINDINGS A growing body of qualitative work illustrates the detrimental impacts of stigma in chronic respiratory disease, contributing towards poorer psychological health and self-management, and reduced engagement with professional support. Stigma, alongside physical limitations stemming from respiratory symptoms, can also contribute to social isolation and loneliness. Social isolation and loneliness are associated with poorer mental health and quality of life, declines in function, and in some cases, increased hospital admissions. Although close or cohabiting relationships can ameliorate some social challenges, isolation and loneliness can also impact informal carers of people with chronic respiratory disease. SUMMARY Increasing evidence illustrates the direct and indirect influences of social dimensions on health outcomes for people living with chronic respiratory disease. Although there is increased understanding of the lived experiences of stigma, less is understood about the complexities of social isolation and loneliness in chronic respiratory disease, and optimal interventions to address social challenges.
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11
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Borge CR, Larsen MH, Osborne RH, Engebretsen E, Andersen MH, Holter IA, Leine M, Wahl AK. Exploring patients' and health professionals' perspectives on health literacy needs in the context of chronic obstructive pulmonary disease. Chronic Illn 2022; 18:549-561. [PMID: 33705224 DOI: 10.1177/1742395321999441] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Persons with chronic obstructive pulmonary disease (COPD) require complex follow-up by healthcare professionals (HCPs) and may experience several health literacy (HL) needs. This study aimed to explore such needs in people with COPD and the HCPs who care for them. METHODS From October 2016 to August 2017 a qualitative study with four focus groups (FG) were performed in people with COPD (n = 14) and three in multidisciplinary HCPs (n = 21). An inductive thematic analysis was used to investigate HL needs. RESULTS Four HL needs emerged: 1) strengthening the feeling of security; 2) combating the burden of insufficient knowledge on COPD and lack of informational flow; 3) supporting motivation for endurance and self-management; and 4) strengthening dignity. DISCUSSION This study highlights a gap between people with COPD who express important HL needs and HCPs' capabilities to care for these needs. For HCPs to increase HL in such cases, HCPs need to improve their own HL. It is essential to find solutions on how to improve HL in HCPs who care for people with COPD and to increase the availability of interventions that increase HL in COPD. Education programs, health organizations, and governments should be aware of HL needs in such situations.
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Affiliation(s)
- Christine R Borge
- Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway.,Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Marie H Larsen
- Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway.,Lovisenberg Diaconal University College, Oslo, Norway
| | - Richard H Osborne
- Centre of Global Health and Equity, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Australia
| | - Eivind Engebretsen
- Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
| | - Marit H Andersen
- Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway.,Oslo University Hospital, Oslo, Norway
| | | | | | - Astrid K Wahl
- Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
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12
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Waller A, Hobden B, Fakes K, Clark K. A Systematic Review of the Development and Implementation of Needs-Based Palliative Care Tools in Heart Failure and Chronic Respiratory Disease. Front Cardiovasc Med 2022; 9:878428. [PMID: 35498028 PMCID: PMC9043454 DOI: 10.3389/fcvm.2022.878428] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 03/25/2022] [Indexed: 11/19/2022] Open
Abstract
Background The impetus to develop and implement tools for non-malignant patient groups is reflected in the increasing number of instruments being developed for heart failure and chronic respiratory diseases. Evidence syntheses of psychometric quality and clinical utility of these tools is required to inform research and clinical practice. Aims This systematic review examined palliative care needs tools for people diagnosed with advanced heart failure or chronic respiratory diseases, to determine their: (1) psychometric quality; and (2) acceptability, feasibility and clinical utility when implemented in clinical practice. Methods Systematic searches of MEDLINE, CINAHL, Embase, Cochrane and PsycINFO from database inception until June 2021 were undertaken. Additionally, the reference lists of included studies were searched for relevant articles. Psychometric properties of identified measures were evaluated against pre-determined and standard criteria. Results Eighteen tools met inclusion criteria: 11 were developed to assess unmet patient palliative care needs. Of those, 6 were generic, 4 were developed for heart failure and 1 was developed for interstitial lung disease. Seven tools identified those who may benefit from palliative care and include general and disease-specific indicators. The psychometric qualities of the tools varied. None met all of the accepted criteria for psychometric rigor in heart failure or respiratory disease populations. There is limited implementation of needs assessment tools in practice. Conclusion Several tools were identified, however further validation studies in heart failure and respiratory disease populations are required. Rigorous evaluation to determine the impact of adopting a systematic needs-based approach for heart failure and lung disease on the physical and psychosocial outcomes of patients and carers, as well as the economic costs and benefits to the healthcare system, is required.
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Affiliation(s)
- Amy Waller
- Health Behaviour Research Collaborative, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- *Correspondence: Amy Waller
| | - Breanne Hobden
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Kristy Fakes
- Health Behaviour Research Collaborative, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Katherine Clark
- Northern Sydney Local Health District (NSLHD) Supportive and Palliative Care Network, St Leonards, NSW, Australia
- Northern Clinical School, The University of Sydney, Darlington, NSW, Australia
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, NSW, Australia
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13
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Niño de Guzmán Quispe E, Martínez García L, Orrego Villagrán C, Heijmans M, Sunol R, Fraile-Navarro D, Pérez-Bracchiglione J, Ninov L, Salas-Gama K, Viteri García A, Alonso-Coello P. The Perspectives of Patients with Chronic Diseases and Their Caregivers on Self-Management Interventions: A Scoping Review of Reviews. THE PATIENT 2021; 14:719-740. [PMID: 33871808 PMCID: PMC8563562 DOI: 10.1007/s40271-021-00514-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/26/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND Self-management (SM) interventions are supportive interventions systematically provided by healthcare professionals, peers, or laypersons to increase the skills and confidence of patients in their ability to manage chronic diseases. We had two objectives: (1) to summarise the preferences and experiences of patients and their caregivers (informal caregivers and healthcare professionals) with SM in four chronic diseases and (2) to identify and describe the relevant outcomes for SM interventions from these perspectives. METHODS We conducted a mixed-methods scoping review of reviews. We searched three databases until December 2020 for quantitative, qualitative, or mixed-methods reviews exploring patients' and caregivers' preferences or experiences with SM in type 2 diabetes mellitus (T2DM), obesity, chronic obstructive pulmonary disease (COPD), and heart failure (HF). Quantitative data were narratively synthesised, and qualitative data followed a three-step descriptive thematic synthesis. Identified themes were categorised into outcomes or modifiable factors of SM interventions. RESULTS We included 148 reviews covering T2DM (n = 53 [35.8%]), obesity (n = 20 [13.5%]), COPD (n = 32 [21.6%]), HF (n = 38 [25.7%]), and those with more than one disease (n = 5 [3.4%]). We identified 12 main themes. Eight described the process of SM (disease progression, SM behaviours, social support, interaction with healthcare professionals, access to healthcare, costs for patients, culturally defined roles and perceptions, and health knowledge), and four described their experiences with SM interventions (the perceived benefit of the intervention, individualised care, sense of community with peers, and usability of equipment). Most themes and subthemes were categorised as outcomes of SM interventions. CONCLUSION The process of SM shaped the perspectives of patients and their caregivers on SM interventions. Their perspectives were influenced by the perceived benefit of the intervention, the sense of community with peers, the intervention's usability, and the level of individualised care. Our findings can inform the selection of patient-important outcomes, decision-making processes, including the formulation of recommendations, and the design and implementation of SM interventions.
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Affiliation(s)
- Ena Niño de Guzmán Quispe
- Iberoamerican Cochrane Centre (IbCC)-Sant Pau Biomedical Research Institute (IIB-Sant Pau), C/ Sant Antoni Maria Claret 167. Pabellón 18, Planta 0, 08025, Barcelona, Spain.
| | - Laura Martínez García
- Iberoamerican Cochrane Centre (IbCC)-Sant Pau Biomedical Research Institute (IIB-Sant Pau), C/ Sant Antoni Maria Claret 167. Pabellón 18, Planta 0, 08025, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Carola Orrego Villagrán
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Monique Heijmans
- Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands
| | - Rosa Sunol
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - David Fraile-Navarro
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
- Madrid Primary Health Care Service, Madrid, Spain
| | | | | | - Karla Salas-Gama
- Health Services Research Group, Institut de Recerca Vall d'Hebron Hospital, Barcelona, Spain
- Vall d'Hebron University Hospital, Barcelona, Spain
| | - Andrés Viteri García
- Centro de Investigación de Salud Pública y Epidemiología Clínica (CISPEC), Universidad UTE, Quito, Ecuador
- Centro Asociado Cochrane de Ecuador, Universidad UTE, Quito, Ecuador
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre (IbCC)-Sant Pau Biomedical Research Institute (IIB-Sant Pau), C/ Sant Antoni Maria Claret 167. Pabellón 18, Planta 0, 08025, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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14
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Bugajski A, Szalacha L, Rechenberg K, Johnson A, Beckie T, Morgan H. Psychometric Evaluation of the Self-Care in Chronic Obstructive Pulmonary Disease Inventory in the United States. Heart Lung 2021; 51:1-8. [PMID: 34731690 DOI: 10.1016/j.hrtlng.2021.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/30/2021] [Accepted: 07/11/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND High quality self-care among individuals with chronic obstructive pulmonary disease (COPD) promotes better outcomes, however, there are few validated self-care measures that are psychometrically sound to be used in research. OBJECTIVES The purpose of this study is to examine the psychometric properties of the Self-Care in Chronic Obstructive Pulmonary Disease Inventory (SC-COPDI) in an English-speaking population in the United States. METHODS Factorial validity, construct validity and reliability of the SCCOPDI were examined using components analysis via principal components analysis, hypothesis testing via multivariate linear regression, Cronbach's alpha, and split-half reliability. RESULTS The SCCOPDI demonstrated strong evidence of validity and reliability on par with the SCCOPDI's original construction. Component analysis produced item loadings consistent with the theoretical underpinnings of the instrument. Reliability metrics yielded good internal consistency across all subscales of the SCCOPDI. CONCLUSIONS The SCCOPDI is a valid and reliable instrument to measure self-care in people with COPD.
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Affiliation(s)
- Andrew Bugajski
- Lakeland Regional Health, 1324 Lakeland Hills Blvd, Lakeland, FL, 33805.
| | - Laura Szalacha
- University of South Florida College of Nursing, 12901 Bruce B. Downs Blvd, MDC 22, Tampa, FL 33612, United States.
| | - Kaitlyn Rechenberg
- University of South Florida College of Nursing, 12901 Bruce B. Downs Blvd, MDC 22, Tampa, FL 33612, United States.
| | - Ayesha Johnson
- University of South Florida College of Nursing, 12901 Bruce B. Downs Blvd, MDC 22, Tampa, FL 33612, United States.
| | - Theresa Beckie
- University of South Florida College of Nursing, 12901 Bruce B. Downs Blvd, MDC 22, Tampa, FL 33612, United States.
| | - Hailey Morgan
- University of South Florida College of Nursing, 12901 Bruce B. Downs Blvd, MDC 22, Tampa, FL 33612, United States.
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15
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Siltanen H, Aine T, Huhtala H, Kaunonen M, Paavilainen E. The information needs of people with COPD-The holistic approach with special reference to gender and time since diagnosis. Nurs Open 2021; 8:2498-2508. [PMID: 33755324 PMCID: PMC8363367 DOI: 10.1002/nop2.773] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 12/07/2020] [Accepted: 12/18/2020] [Indexed: 12/12/2022] Open
Abstract
AIMS The aim of this study was to determine what kinds of unmet information needs people with COPD have and whether there are differences in information needs between genders or based on the time since COPD diagnosis. DESIGN A descriptive cross-sectional study. METHODS Data on people with COPD (N = 169) were collected from a two-part questionnaire distributed via website. On the first part, information needs concerning the medical aspects of self-management were measured by the Lung Information Needs Questionnaire (LINQ). On the second part, which was developed specifically for this study, a more holistic view of self-management counselling was sought. Statistical methods were used to analyse the data. RESULTS The respondents had wide-ranging information needs in many areas of COPD self-management. The most often reported areas of unmet information needs included exacerbations, diet, fatigue, stress and anxiety, palliative care and sexual life. The information needs varied by gender and time since COPD diagnosis.
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Affiliation(s)
- Hannele Siltanen
- Department of Health SciencesFaculty of Social SciencesTampere UniversityTampereFinland
| | - Tiina Aine
- Faculty of Medicine and Health TechnologyTampere UniversityTampereFinland
| | - Heini Huhtala
- Department of Health SciencesFaculty of Social SciencesTampere UniversityTampereFinland
| | - Marja Kaunonen
- Department of Health SciencesFaculty of Social SciencesTampere UniversityTampereFinland
- Pirkanmaa Hospital DistrictTampereFinland
| | - Eija Paavilainen
- Department of Health SciencesFaculty of Social SciencesTampere UniversityTampereFinland
- Etelä‐Pohjanmaa Hospital DistrictSeinäjokiFinland
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16
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Kuntz AA, Holden TR. A supportive framework for the care of older adults with COPD. J Am Geriatr Soc 2021; 69:3003-3008. [PMID: 34159581 DOI: 10.1111/jgs.17330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Aaron A Kuntz
- Advanced Geriatrics Fellow, Geriatrics Research, Education, and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA
| | - Timothy R Holden
- Assistant Professor of Medicine, John T. Milliken Department of Medicine, Division of Geriatrics and Nutritional Science, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
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17
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Simonÿ C, Højfeld CR, Clausen B, Birkelund R, Bodtger U. Experiences in responders and non-responders to pulmonary rehabilitation among people with chronic obstructive pulmonary disease: a clinical study with convergent mixed analysis. Disabil Rehabil 2021; 44:4389-4397. [PMID: 33832393 DOI: 10.1080/09638288.2021.1907455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE This study aims to investigate the experienced and measured development in physical capacity in people with Chronic Obstructive Pulmonary Disease (COPD) undergoing a standard pulmonary rehabilitation programme with a focus on the diverging experiences of responders and non-responders. METHODS Twenty-one participants in standard pulmonary rehabilitation were included in the study. We measured the participants' change in the six-minute walk test (6MWT) during rehabilitation participation. We investigated their experiences of the changes in their physical capacity by combined participant observations and interviews. A convergent mixed analysis was conducted of the coherent data. RESULTS Standard pulmonary rehabilitation had a different physical impact on people with COPD. Responders were delighted by a positive physical change, which improved their daily functioning and capability of fulfilling personal priorities. However, non-responders experienced decreased capacity and a lack of trust in their future. All participants found it challenging to exercise and achieve sustainable exercise habits. CONCLUSION In this qualitative study, we found that absence of expected improvement to pulmonary rehabilitation seems to confer distress and feelings of hopelessness. The achievement of sustainable change in daily exercise behaviour appears yet to be insufficient. Thus, new and more individualized models of physiotherapists' guidance in exercise are imperative.Implications for rehabilitationIt is vital to acknowledge differential response to people with the chronic obstructive pulmonary disease following eight-week standard pulmonary rehabilitation.Especially noteworthy feelings of distress and hopelessness are prominent to non-responders because of the absence of the promised improvements.Both responders and non-responders require intensive physiotherapist guidance to exercise.It is recommended to ensure individualised support to people with chronic obstructive pulmonary disease in rehabilitation programmes.
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Affiliation(s)
- Charlotte Simonÿ
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark.,Institute of The Regional Health University of Southern Denmark, Odense, Denmark
| | - Claus Riber Højfeld
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
| | - Brian Clausen
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
| | - Regner Birkelund
- Institute of The Regional Health University of Southern Denmark, Odense, Denmark.,Department of Health Research, Vejle Sygehus, Vejle, Denmark
| | - Uffe Bodtger
- Institute of The Regional Health University of Southern Denmark, Odense, Denmark.,Department of Respiratory Medicine, Naestved Hospital, Naestved, Denmark.,Department of Internal Medicine, Zealand University Hospital Roskilde, Roskilde, Denmark
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18
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Camus-García E, González-González AI, Heijmans M, Niño de Guzmán E, Valli C, Beltran J, Pardo-Hernández H, Ninov L, Strammiello V, Immonen K, Mavridis D, Ballester M, Suñol R, Orrego C. Self-management interventions for adults living with Chronic Obstructive Pulmonary Disease (COPD): The development of a Core Outcome Set for COMPAR-EU project. PLoS One 2021; 16:e0247522. [PMID: 33647039 PMCID: PMC7920347 DOI: 10.1371/journal.pone.0247522] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 02/09/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND A large body of evidence suggests that self-management interventions (SMIs) may improve outcomes in chronic obstructive pulmonary disease (COPD). However, accurate comparisons of the relative effectiveness of SMIs are challenging, partly due to heterogeneity of outcomes across trials and uncertainty about the importance of these outcomes for patients. We aimed to develop a core set of patient-relevant outcomes (COS) for SMIs trials to enhance comparability of interventions and ensure person-centred care. METHODS We undertook an innovative approach consisting of four interlinked stages: i) Development of an initial catalogue of outcomes from previous EU-funded projects and/or published studies, ii) Scoping review of reviews on patients and caregivers' perspectives to identify outcomes of interest, iii) Two-round Delphi online survey with patients and patient representatives to rate the importance of outcomes, and iv) Face-to-face consensus workshop with patients, patient representatives, health professionals and researchers to develop the COS. RESULTS From an initial list of 79 potential outcomes, 16 were included in the COS plus one supplementary outcome relevant to all participants. These were related to patient and caregiver knowledge/competence, self-efficacy, patient activation, self-monitoring, adherence, smoking cessation, COPD symptoms, physical activity, sleep quality, caregiver quality of life, activities of daily living, coping with the disease, participation and decision-making, emergency room visits/admissions and cost effectiveness. CONCLUSION The development of the COPD COS for the evaluation of SMIs will increase consistency in the measurement and reporting of outcomes across trials. It will also contribute to more personalized health care and more informed health decisions in clinical practice as patients' preferences regarding COPD outcomes are more systematically included.
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Affiliation(s)
- Estela Camus-García
- Avedis Donabedian Research Institute (FAD), Universitat Autonòma de Barcelona, Barcelona, Spain
| | - Ana Isabel González-González
- Avedis Donabedian Research Institute (FAD), Universitat Autonòma de Barcelona, Barcelona, Spain
- Institute of General Practice, Goethe University, Frankfurt, Germany
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Spain
| | - Monique Heijmans
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Ena Niño de Guzmán
- Iberoamerican Cochrane Centre Barcelona, Department of Clinical Epidemiology and Public Health, Biomedical Research Institute San Pau (IIB Sant Pau), Barcelona, Spain
| | - Claudia Valli
- Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine, Universidad Atónoma de Barcelona, Barcelona, Spain
- Iberoamerican Cochrane Centre Barcelona, Biomedical Research Institute San Pau (IIB Sant Pau), Barcelona, Spain
| | - Jessica Beltran
- Iberoamerican Cochrane Centre Barcelona, Biomedical Research Institute San Pau (IIB Sant Pau), Barcelona, Spain
| | - Hector Pardo-Hernández
- Iberoamerican Cochrane Centre Barcelona, Biomedical Research Institute San Pau (IIB Sant Pau) - CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | | | | | | | - Dimitris Mavridis
- Department of Primary Education, University of Ioannina, Ioannina, Greece
| | - Marta Ballester
- Avedis Donabedian Research Institute (FAD), Universitat Autonòma de Barcelona, Barcelona, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Spain
| | - Rosa Suñol
- Avedis Donabedian Research Institute (FAD), Universitat Autonòma de Barcelona, Barcelona, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Spain
| | - Carola Orrego
- Avedis Donabedian Research Institute (FAD), Universitat Autonòma de Barcelona, Barcelona, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Spain
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19
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Pison C, Shah PL, Slebos DJ, Ninane V, Janssens W, Perez T, Kessler R, Deslee G, Garner JL, Hartman JE, Degano B, Mayr A, Mayse M, Peterson AD, Valipour A. Safety of denervation following targeted lung denervation therapy for COPD: AIRFLOW-1 3-year outcomes. Respir Res 2021; 22:62. [PMID: 33608007 PMCID: PMC7893728 DOI: 10.1186/s12931-021-01664-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 02/11/2021] [Indexed: 01/09/2023] Open
Abstract
Background Targeted lung denervation (TLD) is a novel bronchoscopic therapy that disrupts parasympathetic pulmonary nerve input to the lung reducing clinical consequences of cholinergic hyperactivity. The AIRFLOW-1 study assessed safety and TLD dose in patients with moderate-to-severe, symptomatic COPD. This analysis evaluated the long-term impact of TLD on COPD exacerbations, pulmonary function, and quality of life over 3 years of follow up. Methods TLD was performed in a prospective, energy-level randomized (29 W vs 32 W power), multicenter study (NCT02058459). Additional patients were enrolled in an open label confirmation phase to confirm improved gastrointestinal safety after procedural modifications. Durability of TLD was evaluated at 1, 2, and 3 years post-treatment and assessed through analysis of COPD exacerbations, pulmonary lung function, and quality of life. Results Three-year follow-up data were available for 73.9% of patients (n = 34). The annualized rate of moderate to severe COPD exacerbations remained stable over the duration of the study. Lung function (FEV1, FVC, RV, and TLC) and quality of life (SGRQ-C and CAT) remained stable over 3 years of follow-up. No new gastrointestinal adverse events and no unexpected serious adverse events were observed. Conclusion TLD in COPD patients demonstrated a positive safety profile out to 3 years, with no late-onset serious adverse events related to denervation therapy. Clinical stability in lung function, quality of life, and exacerbations were observed in TLD treated patients over 3 years of follow up.
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Affiliation(s)
- Christophe Pison
- Service Hospitalier Universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, CS10217, 38043, Grenoble Cedex 9, France. .,Université Grenoble Alpes, Grenoble, France.
| | - Pallav L Shah
- Royal Brompton & Harefield NHS Trust, Chelsea & Westminster Hospital and Imperial College, London, UK
| | - Dirk-Jan Slebos
- Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Vincent Ninane
- CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Wim Janssens
- Department of Respiratory Diseases, KU Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Thierry Perez
- CHU Lille, Center for Infection and Immunity of Lille, INSERM U1019-UMR9017, Univ Lille Nord de France, Lille, France
| | - Romain Kessler
- Service de Pneumologie, Nouvel Hôpital Civil, Université de Strasbourg, Strasbourg, France
| | - Gaetan Deslee
- Service de Pneumologie, INSERM UMRS-1250, CHU de Reims, Hôpital Maison Blanche, Reims, France
| | - Justin L Garner
- Royal Brompton & Harefield NHS Trust, Chelsea & Westminster Hospital and Imperial College, London, UK
| | - Jorine E Hartman
- Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Bruno Degano
- Service Hospitalier Universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, CS10217, 38043, Grenoble Cedex 9, France.,Université Grenoble Alpes, Grenoble, France
| | - Anna Mayr
- Department of Respiratory and Critical Care Medicine, Karl-Landsteiner-Institute for Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna, Austria
| | | | | | - Arschang Valipour
- Department of Respiratory and Critical Care Medicine, Karl-Landsteiner-Institute for Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna, Austria
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20
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Hirakawa Y, Hirahara S, Yamaguchi Y, Yamanaka T, Arai H, Miura H. Improving the quality of community primary palliative care in COPD: A qualitative study of health-care providers. Home Health Care Serv Q 2020; 40:39-53. [PMID: 33156734 DOI: 10.1080/01621424.2020.1845272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Primary palliative care is essential for the continuity of care in severe COPD. This study aimed to identify essential factors and aspects to enhance the quality of primary palliative care for adults with severe COPD living in the community. Interviews with medical professionals from six institutions located in two major metropolitan areas in Japan were conducted, and these interviews were analyzed by using a qualitative content analysis approach. Results indicate that effective collaborative communication among team members, long-term care insurance system and related services, and palliative care techniques were the primary themes.
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Affiliation(s)
| | - Satoshi Hirahara
- Tokyo Fureai Medical Co-op Research & Education Center , Tokyo, Japan
| | - Yasuhiro Yamaguchi
- Department of Pulmonary Medicine, Saitama Medical Center, Jichi Medical University , Saitama, Japan
| | - Takashi Yamanaka
- Department of Home Care Medicine, Graduate School of Medicine, The University of Tokyo , Tokyo, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology , Obu, Japan
| | - Hisayuki Miura
- Department of Home Care and Regional Liaison Promotion, National Center for Geriatrics and Gerontology , Obu, Japan
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21
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Rajnoveanu RM, Rajnoveanu AG, Fildan AP, Todea DA, Man MA, Motoc NS, Mosoiu D. Palliative Care Initiation in Chronic Obstructive Pulmonary Disease: Prognosis-Based, Symptoms-Based or Needs-Based? Int J Chron Obstruct Pulmon Dis 2020; 15:1591-1600. [PMID: 32694913 PMCID: PMC7340370 DOI: 10.2147/copd.s254104] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 06/12/2020] [Indexed: 12/13/2022] Open
Abstract
The absence or late initiation of palliative care (PC) in chronic obstructive pulmonary disease (COPD) is multidimensional. To provide palliative care from the moment of COPD diagnosis remains utopic. Even the advanced forms or the end-of-life stages benefit late or never from these services. In this context, the research questions for the present systematic review were focused on the prognosis variables or multicomponent indices in COPD patients alongside the symptoms and unmet needs, which may be useful for the palliative care initiation. The aim was to help clinicians to identify not only the tools reliable to predict poor survival in COPD patients but also to identify the criteria for appropriateness for early palliative care onset. The search included systematic reviews and reviews published in English in the PUBMED database from Jan 1, 2015 to Jan 6, 2020. From a total of 202 findings, after applying filters, using additional sources, and eliminating duplicates, the search strategy screened 16 articles, out of which 10 were selected and included. A Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) flow diagram was constructed. The main domains identified as barriers in providing palliative care in COPD patients were complex: from the prognosis difficulties to the prognostic variables and scores proposed for initiating PC; from the troublesome symptoms or the unidimensional symptom tools to the unmet needs of COPD patients. The review concluded that none of the existing prognostic variables and multicomponent indices are reliable enough to exclusively predict poor survival in COPD patients and the decision to initiate PC should be rather based on the presence of refractory symptoms and patients’ unmet needs and preferences. Despite the current advances, the ideal model to initiate palliative care from the moment COPD is diagnosed is a goal for clinicians trained in, and capable of providing palliative care in any COPD patient.
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Affiliation(s)
| | - Armand-Gabriel Rajnoveanu
- Occupational Medicine Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - Doina Adina Todea
- Pneumology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Milena Adina Man
- Pneumology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Nicoleta Stefania Motoc
- Pneumology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Daniela Mosoiu
- Hospice Casa Sperantei Brasov, Transilvania University, Brasov, Romania
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22
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Pozzar M, Volpato E, Valota C, Pagnini F, Banfi PI. How people with chronic obstructive pulmonary disease perceive their illness: a qualitative study between mind and body. BMC Pulm Med 2020; 20:120. [PMID: 32366300 PMCID: PMC7199319 DOI: 10.1186/s12890-020-1157-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 04/20/2020] [Indexed: 12/12/2022] Open
Abstract
Background Although many studies on people with Chronic Obstructive Pulmonary Disease (COPD) have examined the mutual impact of physical status and emotional experience, there is limited knowledge about the way COPD people first-hand perceive their condition. This study was designed to investigate the illness perceptions of the patients and, secondarily, to explore their beliefs about the mind-body relationship. Methods This qualitative study has exploited an ad-hoc semi-structured interview to collect personal perspectives of participants on their illness. Twenty-seven patients (15 males and 12 females), with a mild to severe COPD, were recruited within the Respiratory Rehabilitation Unit of Don Carlo Gnocchi Foundation, in Milan. The thematic analysis of the interviews’ content was facilitated by NVivo (12th version, QSR International®). Results The thematic analysis of the corpus resulted in four master themes. Illness experience has been considered the primary one. Indeed, dealing with COPD every day allows these people to portray a specific representation of the mind-body relationship, to gain a certain degree of expertise and to develop a perspective on the future. Conclusions Individual perceptions of the illness vary among people with COPD, but some common experiences characterize them. Many patients share a profound belief that their mental state and their physical symptoms are highly interrelated.
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Affiliation(s)
- Marta Pozzar
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.
| | - Eleonora Volpato
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.,IRCCS Fondazione Don Carlo Gnocchi, Milan, 20148, Italy
| | - Chiara Valota
- IRCCS Fondazione Don Carlo Gnocchi, Milan, 20148, Italy
| | - Francesco Pagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.,Department of Psychology, Harvard University, Cambridge, MA, USA
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23
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Pawlow PC, Doherty CL, Blumenthal NP, Matura LA, Christie JD, Ersek M. An Integrative Review of the Role of Palliative Care in Lung Transplantation. Prog Transplant 2020; 30:147-154. [DOI: 10.1177/1526924820913512] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Lung transplant patients experience significant physical symptoms and psychological stress that affect their quality of life. Palliative care is an interdisciplinary specialty associated with improved symptom management and enhanced quality of life. Little, however, is known about the palliative care needs of lung transplant patients and the role it plays in their care. Aim: The aim of this integrative review was to synthesize the literature describing the palliative care needs, the current role, and factors influencing the integration of palliative care in the care of lung transplant patients. Design/Data Sources: We searched PubMed, Scopus, CINAHL, and Embase to identify English-language, primary studies focused on palliative care in adult lung transplantation. Study quality was evaluated using Strengthening the Report of Observational studies in Epidemiology and Consolidated Criteria for Reporting Qualitative Research criteria. Results: Seven articles were included in the review. Most were single-center, descriptive studies. Two studies used qualitative and 5 used quantitative methodologies. Collectively, these studies suggest that palliative care is typically consulted for physical and psychological symptom management, although consultation is uncommon and often occurs late in the lung transplant process. We found no studies that systematically assessed palliative needs. Misperceptions about palliative care, communication challenges, and unrealistic patient/family expectations are identified barriers to the integration. While limited, evidence suggests that palliative care can be successfully integrated into lung transplant patient management. Conclusions: Empirical literature about palliative care in lung transplantation is sparse. Further research is needed to define the needs and opportunities for integration into the care of these patients.
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Affiliation(s)
| | | | | | - Lea Ann Matura
- University of Pennsylvania School of Nursing Philadelphia, PA, USA
| | - Jason D. Christie
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mary Ersek
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Veterans Affairs, Corporal Michael J. Crescenz VA Medical Center, PA, USA
- School of Nursing, Perelman School of Medicine, University of Pennsylvania, PA, USA
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24
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Spitzer KA, Stefan MS, Drake AA, Pack QR, Lagu T, Mazor KM, Pinto-Plata V, Lindenauer PK. "You Leave There Feeling Part of Something": A Qualitative Study of Hospitalized COPD Patients' Perceptions of Pulmonary Rehabilitation. Int J Chron Obstruct Pulmon Dis 2020; 15:575-583. [PMID: 32231430 PMCID: PMC7085332 DOI: 10.2147/copd.s234833] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 01/24/2020] [Indexed: 11/30/2022] Open
Abstract
Rationale Current guidelines recommend that patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease (COPD) initiate pulmonary rehabilitation (PR) shortly after discharge from the hospital. However, fewer than 2 percent of Medicare beneficiaries do so. Few studies have examined hospitalized patients’ perceptions of the barriers and facilitators to enroll in PR. The aim of this study was to develop an understanding of these factors by interviewing patients. Methods We conducted semi-structured interviews with patients during a hospitalization for COPD exacerbation in a large teaching hospital. Directed content analysis was used to code and analyze interview transcripts. Results Of the 15 patients we interviewed, 9 had participated in PR prior to their hospitalization, 10 were women; 4 were black, and 1 was Hispanic. Facilitators of enrollment included a desire to learn more about the disease, social support, and trust in the health-care provider recommending PR. Barriers to enrollment included lack of awareness, family obligations, lack of motivation, and transportation. For those who had previous experience with PR, but who did not complete the program, another barrier was not feeling well enough. Facilitators to adherence included the educational component of the program; feeling better through exercise; and a social connection with both participants and staff. For some patients. PR contributed to a renewed sense of hope or meaning. Most interviewees expressed interest in a peer coaching program. Conclusion Our results highlight the importance of increasing awareness of PR and building trust between the provider and patients to facilitate initial enrollment. Future interventions to improve enrollment and adherence should address the need for education about the benefits of PR and the value of social support. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/RzDULZbriWQ
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Affiliation(s)
- Kerry A Spitzer
- Institute for Healthcare Delivery and Population Science, University of Massachusetts Medical School-Baystate, Springfield, MA, USA
| | - Mihaela S Stefan
- Institute for Healthcare Delivery and Population Science, University of Massachusetts Medical School-Baystate, Springfield, MA, USA.,Department of Internal Medicine, Baystate Medical Center, Springfield, MA, USA.,Department of Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, USA
| | - Aubri A Drake
- Institute for Healthcare Delivery and Population Science, University of Massachusetts Medical School-Baystate, Springfield, MA, USA
| | - Quinn R Pack
- Institute for Healthcare Delivery and Population Science, University of Massachusetts Medical School-Baystate, Springfield, MA, USA.,Department of Internal Medicine, Baystate Medical Center, Springfield, MA, USA.,Department of Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, USA.,Division of Cardiovascular Medicine, Baystate Medical Center, Springfield, MA, USA
| | - Tara Lagu
- Institute for Healthcare Delivery and Population Science, University of Massachusetts Medical School-Baystate, Springfield, MA, USA.,Department of Internal Medicine, Baystate Medical Center, Springfield, MA, USA
| | - Kathleen M Mazor
- Meyers Primary Care Institute, a Joint Endeavor of the University of Massachusetts Medical School, Reliant Medical Group, and Fallon Health, Worcester, MA, USA
| | - Victor Pinto-Plata
- Pulmonary and Critical Care Medicine Division, Baystate Medical Center, Springfield, MA, USA
| | - Peter K Lindenauer
- Institute for Healthcare Delivery and Population Science, University of Massachusetts Medical School-Baystate, Springfield, MA, USA.,Department of Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, USA.,Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
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25
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Gaveikaite V, Grundstrom C, Lourida K, Winter S, Priori R, Chouvarda I, Maglaveras N. Developing a strategic understanding of telehealth service adoption for COPD care management: A causal loop analysis of healthcare professionals. PLoS One 2020; 15:e0229619. [PMID: 32134958 PMCID: PMC7058286 DOI: 10.1371/journal.pone.0229619] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 02/10/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Telehealth services can improve the quality of health services for chronic obstructive pulmonary disease (COPD) management, but the clinical benefits for patients yet not clear. It is crucial to develop a strategy that supports the engagement of healthcare professionals to promote the sustainable adoption of telehealth services further. The aim of the study was to show how variables related to the perception of telehealth services for COPD by different healthcare professionals interact to influence its adoption and to generate advice for future telehealth service implementation. METHODS Data was thematically synthesized from published qualitative studies to create causal loop diagrams, further validated by expert interviews. These diagrams visualize dependencies and their polarity between different variables. RESULTS Adoption of telehealth services from the nurse's perspective is directly affected by change management and autonomous decision making. From the physician's perspective, perceived value is the most important variable. Physical activity management and positive user experience are considered affecting perceived value for physiotherapists. There is no consensus where self-management services should be positioned in the COPD care pathway. CONCLUSION Our results indicate how complex interactions between multiple variables influence the adoption of telehealth services. Consequently, there is a need for multidimensional interventions to achieve adoption. Moreover, key variables were identified that require attention to ensure success of telehealth services. Furthermore, it is necessary to explore where self-management services are best positioned in the care pathway of COPD patients.
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Affiliation(s)
- Violeta Gaveikaite
- Laboratory of Computing, Medical Informatics and Biomedical Imaging Technologies, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Department of Chronic Disease Management, Philips Research, Eindhoven, The Netherlands
| | - Casandra Grundstrom
- M3S, Faculty of Information Technology and Electrical Engineering, University of Oulu, Oulu, Finland
| | - Katerina Lourida
- Laboratory of Computing, Medical Informatics and Biomedical Imaging Technologies, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stefan Winter
- Department of Chronic Disease Management, Philips Research, Aachen, Germany
| | - Rita Priori
- Department of Chronic Disease Management, Philips Research, Eindhoven, The Netherlands
| | - Ioanna Chouvarda
- Laboratory of Computing, Medical Informatics and Biomedical Imaging Technologies, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nicos Maglaveras
- Laboratory of Computing, Medical Informatics and Biomedical Imaging Technologies, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Department of IEMS, McCormick School of Engineering, Northwestern University, Evanston, Illinois, United States of America
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26
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Psychosocial Interventions for Patients with Severe COPD-An Up-to-Date Literature Review. ACTA ACUST UNITED AC 2019; 55:medicina55090597. [PMID: 31527553 PMCID: PMC6780939 DOI: 10.3390/medicina55090597] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/31/2019] [Accepted: 09/09/2019] [Indexed: 12/26/2022]
Abstract
Background and Objectives: Chronic obstructive pulmonary disease (COPD) is a life limiting condition with a long list of serious psychosocial consequences, aggravating with illness progression. In advanced stages, chronic respiratory failure often develops, which might undermine mental health and reduce activity. The study objective was to review the recent studies concerning psychosocial interventions dedicated to patients with severe COPD. Materials and Methods: The PubMed database was searched for terms, such as ‘COPD and long-term oxygen therapy, non-invasive ventilation, severe or respiratory failure’ and ‘psychological or psychosocial or mental health and intervention.’ Studies were included that described patients with stable, severe COPD and the outcomes of psychosocial interventions. Results and Conclusions: Thirty-four studies were identified and divided into four thematic groups: home medical support, exercise, self-management and mental health. The number of studies that focused on mental health preservation in severe COPD was very limited; i.e., none refer directly to those treated with respiratory failure. Improving patients’ self-efficacy gave promising effects to the acceptance of palliative care, pulmonary rehabilitation completion and mental health. Physical activity might be recommended to be included in interventions for mental health enhancement, although little is known about the role of the particular forms of exercise. An increasing beneficial use of new technologies for psychosocial interventions was noted. Psychosocial interventions applied in advanced COPD underline the roles of self-efficacy, telehealth and physical activity in physical and mental health preservation. However, all of the above elements need to be independently tested on more homogenous groups of patients and have the possible modes of their treatment analysed.
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27
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Blonshine J, Cruz J, Sajnic A, De Brandt J. European Respiratory Society International Congress best abstract preview from the allied respiratory professionals from assembly 9. J Thorac Dis 2018; 10:S3010-S3016. [PMID: 30310691 DOI: 10.21037/jtd.2018.08.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - Joana Cruz
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic Institute of Leiria, Leiria, Portugal.,Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Andreja Sajnic
- Department for Respiratory Diseases "Jordanovac", University Hospital Center, Zagreb, Croatia
| | - Jana De Brandt
- REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
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28
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Halding AG, Aarsheim EI, Dolmen NM, Jensen AJ, Stavøstrand S, Grov EK. COPD transitions in health and self-management: service users' experiences from everyday life. Int J Chron Obstruct Pulmon Dis 2018; 13:2075-2088. [PMID: 30013335 PMCID: PMC6037402 DOI: 10.2147/copd.s158058] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Purpose To explore how persons living with COPD experience transitions related to health, self-management, and follow-up from the healthcare services. Patients and methods This study is part of a participatory research project. Six males and five females living with COPD, with a COPD assessment test score of 21–29, participated; all the participants were living at home. Data were collected in qualitative research interviews and analyzed using qualitative content analysis highlighting the participants’ experiences. Results The findings showed two main themes: “The struggle to keep going” and “The need for continuity and competent facilitation”. The participants reported complex health transitions, with changes in roles and function, demanding exacerbations and critical events, and challenges with learning needed self-management. They expressed a great need for and had great benefit from, education, rehabilitation, and follow-up in their management of everyday life. Not all received offers in line with current guidelines. Conclusion In-depth knowledge of patients’ experienced COPD transitions offers clinicians guidance for the timing and quality of follow-up services. Life with COPD entails challenging transitions in health and self-management. Good rehabilitation and follow-up from the healthcare services are needed throughout the disease trajectory. Participation in self-management education and rehabilitation that include psychosocial aspects may facilitate health-enhancing transitions and improve self-management skills. Experienced lack of competence and flexibility among healthcare providers hinders trust and collaboration. Access to stable and competent follow-up in the primary health services may facilitate cohesive services and collaborative self-management.
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Affiliation(s)
- Anne-Grethe Halding
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Førde, Norway,
| | | | | | | | | | - Ellen Karine Grov
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Førde, Norway,
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