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Tornu E, Jordan PJ, McCaul M. Nurses' experiences of self-management support for adults with tuberculosis and human immunodeficiency virus coinfection. Health SA 2024; 29:2546. [PMID: 38726065 PMCID: PMC11079328 DOI: 10.4102/hsag.v29i0.2546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/01/2024] [Indexed: 05/12/2024] Open
Abstract
Background Professional nurses provide self-management support to adults (18 years and older) living with tuberculosis (TB) and human immunodeficiency virus (HIV) coinfection to enable them to mitigate its impact on their lives. However, the experiences of professional nurses providing self-management support to adults with TB-HIV coinfection remain unclear. Aim This study explored and described the experiences of professional nurses on the provision of self-management support to adults living with TB-HIV coinfection in Greater Accra, Ghana. Setting Three public primary health facilities in Greater Accra, Ghana. Methods An exploratory, descriptive qualitative design was used. Twenty-two purposively sampled professional nurses were interviewed face-to-face individually using an interview guide. Interviews were recorded with participants' permission, transcribed and analysed thematically using MAXQDA software. Results The three themes generated revealed that the: (1) self-management problems of adults living with TB-HIV coinfection included their recurring physical, mental and social problems, (2) the support provided to adults with TB-HIV coinfection included symptom, nutritional, medication and psychosocial self-management support, (3) the factors related to providing self-management support showed that self-management support was influenced by patient, nurse and health facility-related factors but was feasible, equitable and acceptable to patients and stakeholders. Conclusion Professional nurses' self-management support practice entailed improvising limited resources to address the recurring problems of adults living with TB-HIV coinfection. Nurses require adequate resources to provide comprehensive self-management support. Contribution The contextual evidence provides insight into the self-management problems of adults with TB-HIV coinfection and the factors influencing professional nurses' self-management support.
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Affiliation(s)
- Eric Tornu
- Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Portia J. Jordan
- Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Michael McCaul
- Department of Global Health, Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Stellenbosch University, Cape Town, South Africa
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Hamzeh H, Kelly C, Spencer S. Outcomes of physiotherapy for people living with bronchiectasis: qualitative study to inform development of a core outcome set. Physiotherapy 2023; 121:37-45. [PMID: 37812851 DOI: 10.1016/j.physio.2023.07.001] [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: 09/26/2022] [Revised: 06/17/2023] [Accepted: 07/05/2023] [Indexed: 10/11/2023]
Abstract
INTRODUCTION Evidence of the effectiveness of physiotherapy for bronchiectasis is inconsistent, partly due to variation in the selection and reporting of outcomes in clinical trials. This qualitative study is a component of the development of a core outcome set (COS). The COS will identify a minimum group of outcomes for use in clinical trials of physiotherapy considering the views of researchers, patients, and clinicians. OBJECTIVES To identify outcomes for use in physiotherapy research that are important to patients and physiotherapists and to explain their significance. METHODS Semi-structured interviews were conducted with adult patients with bronchiectasis who received physiotherapy, in addition to physiotherapists clinically involved in bronchiectasis care. Interviews were audio recorded and transcribed verbatim. Thematic analysis was used to identify, classify, and explain the significance of outcomes. Outcomes were mapped into the list created from literature review and classified into domains. RESULTS We interviewed 18 participants from four countries covering a range of experiences in different settings. Seventy outcomes were identified and grouped into 15 domains. Thirty-three outcomes were not previously reported in the literature. Thematic analysis revealed exacerbations, quality of life, use of healthcare resources, patient-reported symptoms, physical functioning, and sputum as the prominent themes reported by both patients and physiotherapists. CONCLUSIONS This qualitative study highlighted the importance of considering stakeholder perspectives when planning research trials. Outcomes identified will be used to inform the next phase of COS development. REGISTRATION This study is part of the COS development project registered with the Core Outcome Measures in Effectiveness Trials initiative (COMET) https://www.comet-initiative.org/Studies/Details/1931 CONTRIBUTION OF THE PAPER.
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Affiliation(s)
- Hayat Hamzeh
- Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK.
| | - Carol Kelly
- Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK; Cardio-Respiratory Research Centre, Edge Hill University, Ormskirk, Lancashire, UK
| | - Sally Spencer
- Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK; Cardio-Respiratory Research Centre, Edge Hill University, Ormskirk, Lancashire, UK; Health Research Institute, Edge Hill University, Ormskirk, Lancashire, UK
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Bhat A, Lee AL, Maiya GA, Vaishali K. Measurement properties of physical activity in adults with bronchiectasis: A systematic review protocol. F1000Res 2023; 12:801. [PMID: 37600906 PMCID: PMC10439356 DOI: 10.12688/f1000research.138593.1] [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] [Accepted: 06/30/2023] [Indexed: 08/22/2023] Open
Abstract
People with bronchiectasis reduce their physical activity (PA) due to muscle weakness, dyspnea, fatigue, reduced exercise capacity and frequent cough with expectoration. Patient-reported and objective physical assessment methods have been used to evaluate PA in people with bronchiectasis. In the literature, significant differences in the PA measured using patient-reported outcome measures when compared with the objective methods. Given the availability of many PA assessment tools, it is tedious for the clinician or researcher to choose an outcome measure for clinical practice or research. The evidence on validity and reliability in bronchiectasis are unclear. Objectives: To identify the PA assessment tools, describe and evaluate the literature on psychometric properties of instruments measuring and analyzing PA. Methods: The search will be conducted in PubMed/Medline, Cochrane Central Register of Controlled Studies, Scopus and EMBASE databases. The keywords, index terms and synonyms of the following words will be used: bronchiectasis, physical activity, and outcome measures. Published studies of adult with clinical and/ or radiologically diagnosed bronchiectasis, aged >18 years, any gender and studies that assessed PA and/or if there are reports on measurement properties of PA will be included in the review. Studies using qualitative research methods, narrative reviews, letters to editors and editorials will be excluded. The quality of the study will be assessed and data will be extracted. Any disagreement will be resolved in the presence of an author not involved in the screening or selecting studies. Discussion: By assessing the quality of studies on measurement properties, this review will help researchers choose the outcome measure to evaluate the effects of interventions on PA. This review will identify the suite of outcome measures of PA for people with bronchiectasis that can be used for research and clinical purpose.
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Affiliation(s)
- Anup Bhat
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Annemarie L Lee
- Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Clayton, Frankston, Victoria, 3199, Australia
| | - G Arun Maiya
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - K Vaishali
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
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Lee AL, Smith R, Burr L, Chang AB, Holmes‐Liew C, King P, Middleton P, Morgan L, Smith D, Thomson R, Waterer G, Wong C, McAleer R. 'Teach me how to look after myself': What people with bronchiectasis want from education in a pulmonary rehabilitation setting. THE CLINICAL RESPIRATORY JOURNAL 2022; 17:59-69. [PMID: 36404576 PMCID: PMC9829624 DOI: 10.1111/crj.13563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 10/05/2022] [Accepted: 11/07/2022] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Pulmonary rehabilitation is recommended for people with bronchiectasis. Various education topics are included in these programmes, but the content is largely guided by the needs of people with other respiratory conditions. OBJECTIVES With the education topics applicable to people with bronchiectasis unclear, we aimed to explore the perspective of adults with this condition on relevant educational topics in a pulmonary rehabilitation context. METHODS Participants from the Australian Bronchiectasis Registry were invited to undertake a semi-structured interview. Interview transcripts were coded independently, with themes established by consensus (two researchers). RESULTS Twenty-one people participated. The major themes were greater clarity on the underlying cause of bronchiectasis and prognosis. Most sought knowledge about self-management strategies and treatments to address extra-pulmonary symptoms. Participants requested more information on physiotherapy options and the role of exercise and physical activity outside of pulmonary rehabilitation. Preferences were mixed for the education delivery model. CONCLUSIONS We have identified unmet educational topics of interest for people with bronchiectasis. Our study provides a framework for education topics desired by adults with bronchiectasis within a pulmonary rehabilitation setting. The topics identified will guide development of an education curriculum for pulmonary rehabilitation that is more fit-for-purpose for people with bronchiectasis.
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Affiliation(s)
- Annemarie L. Lee
- Department of PhysiotherapyMonash UniversityFrankstonVictoriaAustralia,Monash Lung and SleepMonash HealthClaytonVictoriaAustralia,Institute for Breathing and SleepAustin HealthHeidelbergVictoriaAustralia,Department of Allied Health ResearchCabrini HealthMalvernVictoriaAustralia
| | - Rebecca Smith
- Department of PhysiotherapyMonash UniversityFrankstonVictoriaAustralia,Physiotheraphy DepartmentLaunceston General HospitalLauncestonTasmaniaAustralia
| | - Lucy Burr
- Australian Bronchiectasis RegistryLung Foundation AustraliaMiltonQueenslandAustralia,Department of Respiratory and Sleep MedicineMater Hospital BrisbaneBrisbaneQueenslandAustralia,University of QueenslandBrisbaneQueenslandAustralia
| | - Anne B. Chang
- Australian Bronchiectasis RegistryLung Foundation AustraliaMiltonQueenslandAustralia,NHMRC Centre for Research Excellence in Paediatric Bronchiectasis (AusBREATHE), Australian Centre for Health Services Innovation, Queensland University of Technology, and Menzies School of Health ResearchCharles Darwin UniversityDarwinNorthern TerritoryAustralia
| | - Chien‐Li Holmes‐Liew
- Australian Bronchiectasis RegistryLung Foundation AustraliaMiltonQueenslandAustralia
| | - Paul King
- Australian Bronchiectasis RegistryLung Foundation AustraliaMiltonQueenslandAustralia
| | - Peter Middleton
- Australian Bronchiectasis RegistryLung Foundation AustraliaMiltonQueenslandAustralia
| | - Lucy Morgan
- Australian Bronchiectasis RegistryLung Foundation AustraliaMiltonQueenslandAustralia,Department of Respiratory MedicineConcord Repatriation General HospitalConcordNew South WalesAustralia,Sydney School of MedicineThe University of SydneyCamperdownNew South WalesAustralia
| | - Daniel Smith
- Australian Bronchiectasis RegistryLung Foundation AustraliaMiltonQueenslandAustralia
| | - Rachel Thomson
- Australian Bronchiectasis RegistryLung Foundation AustraliaMiltonQueenslandAustralia,University of QueenslandBrisbaneQueenslandAustralia,Gallipoli Medical Research InstituteGreenslopes Private HospitalGreenslopesQueenslandAustralia
| | - Grant Waterer
- Australian Bronchiectasis RegistryLung Foundation AustraliaMiltonQueenslandAustralia
| | - Conroy Wong
- Australian Bronchiectasis RegistryLung Foundation AustraliaMiltonQueenslandAustralia,Middlemore HospitalUniversity of AucklandAucklandNew Zealand
| | - Rachael McAleer
- La Trobe Rural Health SchoolLa Trobe UniversityBendigoVictoriaAustralia
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Tsang A, Lynes D, McKenzie H, Spencer S, Kelly C. Self-management programmes for adult patients with bronchiectasis: a systematic review and realist synthesis. Disabil Rehabil 2022; 44:6939-6948. [PMID: 34658309 DOI: 10.1080/09638288.2021.1978563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE Self-management for patients with bronchiectasis has been identified as an important component that could potentially empower patients to manage their condition and improve their quality of life. Evidence was reviewed to investigate what self-management programmes work, why and in what circumstances. METHODS A systematic review and realist synthesis were conducted. A comprehensive database search was performed on seven databases for evidence published up to July 2021. Leading candidate self-management programmes identified from the systematic review became the focus of the realist synthesis. A realist logic of analysis was applied to produce explanatory context-mechanism-outcome configurations. These explanations were consolidated into programme theories drawing on health behaviour change theory. RESULTS By synthesising the data from eight eligible articles, programme theories articulated how three different self-management programmes work that included: (i) education and action planning, (ii) education and airway clearance techniques (ACT) and, (iii) education, exercise and ACT. Patient characteristics and collaborative partnership between healthcare professionals and patients were identified as important contexts that influenced the improvement in self-efficacy, health-related quality of life, and exercise capacity. CONCLUSIONS This review contributes to a better understanding of how the complex interaction between contexts and mechanisms can improve outcomes of clinical interest.IMPLICATIONS FOR REHABILITATIONThis evidence synthesis has identified potentially important combinations of interventions to be considered in self-management programmes for adults with bronchiectasis.Collaborative partnership between patient and healthcare professionals should be considered to improve short-term self-efficacy.Targeting self-management programmes to increase short-term health-related quality of life and exercise capacity should consider the context of patient characteristics.
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Affiliation(s)
- Anthony Tsang
- Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK.,Department of Nursing, Faculty of Health, Psychology & Social Care, Manchester Metropolitan University, Manchester, UK
| | - Dave Lynes
- Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK
| | - Hayley McKenzie
- Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK
| | - Sally Spencer
- Faculty of Health & Social Care, Health Research Institute, Edge Hill University, Ormskirk, UK
| | - Carol Kelly
- Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK.,Faculty of Health & Social Care, Health Research Institute, Edge Hill University, Ormskirk, UK
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Kelly C, Heslop-Marshall K, Jones S, Roberts NJ. Self-management in chronic lung disease: what is missing? Breathe (Sheff) 2022; 18:210179. [PMID: 36338256 PMCID: PMC9584548 DOI: 10.1183/20734735.0179-2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 03/22/2022] [Indexed: 11/17/2022] Open
Abstract
Self-management, as a strategy to support those living with chronic respiratory conditions such as asthma and COPD, has been widely advocated in guidelines and adopted in practice. However, there can be a disconnect between the goals of patients and healthcare professionals. Goals and barriers to self-management are often compounded by the complex social, emotional and medical needs of patients. People living with chronic respiratory conditions also often have symptoms of anxiety and depression, which can impact on self-management. Self-management therefore requires patients and healthcare professionals to work together and it is essential to involve patients when designing, implementing and evaluating self-management interventions. Patient preferences are clearly important and goal setting needs an individual, flexible and responsive approach from healthcare professionals, which aligns to a more personalised approach to management of treatable traits and the burden of disease. To achieve these goals, healthcare professionals need education to support patients in self-management and behaviour change. This approach should lead to shared decision-making and partnership working that puts the patient right at the centre of their care. Self-management is often effective in chronic respiratory disease and can improve symptoms and reduce healthcare burden. Yet patients rarely feature in the design or implementation of interventions; are patients as active partners the missing ingredient?https://bit.ly/3LiqhVg
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Marchant JM, Cook AL, Roberts J, Yerkovich ST, Goyal V, Arnold D, O’Farrell HE, Chang AB. Burden of Care for Children with Bronchiectasis from Parents/Carers Perspective. J Clin Med 2021; 10:jcm10245856. [PMID: 34945152 PMCID: PMC8707334 DOI: 10.3390/jcm10245856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/09/2021] [Accepted: 12/11/2021] [Indexed: 11/16/2022] Open
Abstract
Bronchiectasis is a neglected chronic respiratory condition. In children optimal appropriate management can halt the disease process, and in some cases reverse the radiological abnormality. This requires many facets, including parental/carer bronchiectasis-specific knowledge, for which there is currently no such published data. Further, the importance of patient voices in guiding clinical research is becoming increasingly appreciated. To address these issues, we aimed to describe the voices of parents of children with bronchiectasis relating to (a) burden of illness and quality of life (QoL), (b) their major worries/concerns and (c) understanding/management of exacerbations. The parents of 152 children with bronchiectasis (median age = 5.8 years, range 3.5-8.4) recruited from the Queensland Children's Hospital (Australia) completed questionnaires, including a parent-proxy cough-specific QoL. We found that parents of children with bronchiectasis had impaired QoL (median 4.38, range 3.13-5.63) and a high disease burden with median 7.0 (range 4.0-10.0) doctor visits in 12-months. Parental knowledge varied with only 41% understanding appropriate management of an exacerbation. The highest worry/concern expressed were long-term effects (n = 42, 29.8%) and perceived declining health (n = 36, 25.5%). Our study has highlighted the need for improved education, high parental burden and areas of concern/worry which may inform development of a bronchiectasis-specific paediatric QoL tool.
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Affiliation(s)
- Julie M. Marchant
- Australian Centre for Health Services Innovation @ Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD 4059, Australia; (A.L.C.); (J.R.); (S.T.Y.); (V.G.); (D.A.); (H.E.O.); (A.B.C.)
- NHMRC Centre for Research Excellence in Paediatric Bronchiectasis (AusBREATHE), Queensland Children’s Hospital, Brisbane, QLD 4101, Australia
- Department of Respiratory and Sleep Medicine, Queensland Children’s Hospital, Brisbane, QLD 4101, Australia
- Correspondence:
| | - Anne L. Cook
- Australian Centre for Health Services Innovation @ Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD 4059, Australia; (A.L.C.); (J.R.); (S.T.Y.); (V.G.); (D.A.); (H.E.O.); (A.B.C.)
- NHMRC Centre for Research Excellence in Paediatric Bronchiectasis (AusBREATHE), Queensland Children’s Hospital, Brisbane, QLD 4101, Australia
- Department of Respiratory and Sleep Medicine, Queensland Children’s Hospital, Brisbane, QLD 4101, Australia
| | - Jack Roberts
- Australian Centre for Health Services Innovation @ Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD 4059, Australia; (A.L.C.); (J.R.); (S.T.Y.); (V.G.); (D.A.); (H.E.O.); (A.B.C.)
- NHMRC Centre for Research Excellence in Paediatric Bronchiectasis (AusBREATHE), Queensland Children’s Hospital, Brisbane, QLD 4101, Australia
- Department of Respiratory and Sleep Medicine, Queensland Children’s Hospital, Brisbane, QLD 4101, Australia
| | - Stephanie T. Yerkovich
- Australian Centre for Health Services Innovation @ Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD 4059, Australia; (A.L.C.); (J.R.); (S.T.Y.); (V.G.); (D.A.); (H.E.O.); (A.B.C.)
- NHMRC Centre for Research Excellence in Paediatric Bronchiectasis (AusBREATHE), Queensland Children’s Hospital, Brisbane, QLD 4101, Australia
- Department of Respiratory and Sleep Medicine, Queensland Children’s Hospital, Brisbane, QLD 4101, Australia
- Menzies School of Health Research, Charles Darwin University, Darwin, NT 0810, Australia
| | - Vikas Goyal
- Australian Centre for Health Services Innovation @ Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD 4059, Australia; (A.L.C.); (J.R.); (S.T.Y.); (V.G.); (D.A.); (H.E.O.); (A.B.C.)
- NHMRC Centre for Research Excellence in Paediatric Bronchiectasis (AusBREATHE), Queensland Children’s Hospital, Brisbane, QLD 4101, Australia
- Department of Respiratory and Sleep Medicine, Queensland Children’s Hospital, Brisbane, QLD 4101, Australia
| | - Daniel Arnold
- Australian Centre for Health Services Innovation @ Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD 4059, Australia; (A.L.C.); (J.R.); (S.T.Y.); (V.G.); (D.A.); (H.E.O.); (A.B.C.)
- Menzies School of Health Research, Charles Darwin University, Darwin, NT 0810, Australia
| | - Hannah E. O’Farrell
- Australian Centre for Health Services Innovation @ Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD 4059, Australia; (A.L.C.); (J.R.); (S.T.Y.); (V.G.); (D.A.); (H.E.O.); (A.B.C.)
- Menzies School of Health Research, Charles Darwin University, Darwin, NT 0810, Australia
| | - Anne B. Chang
- Australian Centre for Health Services Innovation @ Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD 4059, Australia; (A.L.C.); (J.R.); (S.T.Y.); (V.G.); (D.A.); (H.E.O.); (A.B.C.)
- NHMRC Centre for Research Excellence in Paediatric Bronchiectasis (AusBREATHE), Queensland Children’s Hospital, Brisbane, QLD 4101, Australia
- Department of Respiratory and Sleep Medicine, Queensland Children’s Hospital, Brisbane, QLD 4101, Australia
- Menzies School of Health Research, Charles Darwin University, Darwin, NT 0810, Australia
- School of Medicine, University of Queensland, Brisbane, QLD 4072, Australia
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Chapman SJ, Doble E, Fulton O. Patient and public partnership at BMJ Open Respiratory Research. BMJ Open Respir Res 2021; 8:8/1/e001140. [PMID: 34876481 PMCID: PMC8655522 DOI: 10.1136/bmjresp-2021-001140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 11/23/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Stephen J Chapman
- Consultant in Respiratory Medicine, Adult Cystic Fibrosis Centre, Oxford University Hospitals, Oxford, UK
| | - Emma Doble
- Patient Editor (Education and Strategy), BMJ, BMA House, London, UK
| | - Olivia Fulton
- Patient Advisory Representative, BMJ Open Respiratory Research, Edinburgh, UK
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