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1
Bashir, Ayisha. "Commentary and Reflection Related to the Perspectives of Nurses Toward Telehealth Efficacy and Quality of Health Care." Health Services Research and Managerial Epidemiology 5 (January 1, 2018): 233339281880054. http://dx.doi.org/10.1177/2333392818800549.
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Telehealth nursing enabling communication with chronic disease patients has shown to improve medical outcomes for patients suffering from diabetes mellitus, chronic obstructive pulmonary disease (COPD), and chronic heart disease. Studies have been conducted to examine whether telehealth technology impacts the perceived level of internal service quality (SQ) delivered by nurses within a telehealth organization. Overall, the perspectives toward telehealth SQ researched through case studies showed positive results. The innovative role of telehealth nursing and related technology toward patient care was highlighted. Literature establishes how telehealth provides daily monitoring of patient health, which has the benefits of peace of mind, immediate feedback for patients, family, and caregivers, as well as the convenience of scheduling. This commentary not only reflects but also aims to analyze the effectiveness of the telehealth nursing interventions and reasons for the delayed implementation across United States. Improving and implementing telehealth methods in the case of chronic patients suffering from diabetes, COPD, and heart disease can lead to reductions in health-care errors and readmissions. Telehealth nursing has the potential of decreasing the length of hospital stay, at the same time improving satisfaction of care teams, while the patient management continues at home.
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Rørth, Rasmus, Marianne F. Clausen, Emil L. Fosbøl, Ulrik M. Mogensen, Kristian Kragholm, Pardeep S. Jhund, Mark C. Petrie, et al. "Initiation of domiciliary care and nursing home admission following first hospitalization for heart failure, stroke, chronic obstructive pulmonary disease or cancer." PLOS ONE 16, no. 8 (August 4, 2021): e0255364. http://dx.doi.org/10.1371/journal.pone.0255364.
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Background Patients with chronic diseases are at higher risk of requiring domiciliary and nursing home care, but how different chronic diseases compare in terms of risk is not known. We examined initiation of domiciliary care and nursing home admission among patients with heart failure (HF), stroke, COPD and cancer. Methods Patients with a first-time hospitalization for HF, stroke, COPD or cancer from 2008–2016 were identified. Patients were matched on age and sex and followed for five years. Results 111,144 patients, 27,786 with each disease, were identified. The median age was 69 years and two thirds of the patients were men. The 5-year risk of receiving domiciliary care was; HF 20.9%, stroke 25.2%, COPD 24.6% and cancer 19.3%. The corresponding adjusted hazard ratios (HRs), with HF patients used as reference, were: stroke 1.35[1.30–1.40]; COPD 1.29[1.25–1.34]; and cancer 1.19[1.14–1.23]. The five-year incidence of nursing home admission was 6.6% for stroke, and substantially lower in patients with HF(2.6%), COPD(2.6%) and cancer (1.5%). The adjusted HRs were (HF reference): stroke, 2.44 [2.23–2.68]; COPD 1.01 [0.91–1.13] and cancer 0.76 [0.67–0.86]. Living alone, older age, diabetes, chronic kidney disease, depression and dementia predicted a higher likelihood of both types of care. Conclusions In patients with HF, stroke, COPD or cancer 5-year risk of domiciliary care and nursing home admission, ranged from 19–25% and 1–7%, respectively. Patients with stroke had the highest rate of domiciliary care and were more than twice as likely to be admitted to a nursing home, compared to patients with the other conditions.
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Chen, Yongqing, and Luyi Pan. "Nursing Research on Patients with Chronic Obstructive Pulmonary Disease and Respiratory Failure Based on Big Data." Journal of Healthcare Engineering 2021 (September 29, 2021): 1–8. http://dx.doi.org/10.1155/2021/2541751.
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This work organically integrates a systematic and individualized nursing plan with big data technology and applies it to the care of patients with chronic obstructive pulmonary disease (COPD) and respiratory failure (RF) and explores the continuous care model based on modern big data technologies to improve COPD and RF. It aims to relieve the symptoms of COPD and RF, reduce the number of acute episodes of COPD and RF and the number of hospitalizations, and improve the quality of life of patients. One hundred COPD and RF patients hospitalized in the respiratory medicine department of a tertiary hospital were selected and were categorized into control and experimental group. The nursing mode of the patients in the control group was the original telephone follow-up in the department, and the contents of the follow-up were determined according to the questions of the patients on the telephone at that time. Based on the original nursing in the department, the experimental group adopted individualized continual nursing plans based on the Internet and big data techniques for patients to conduct a pulmonary rehabilitation-related functional assessment, functional exercise guidance, and health guidance. Experimental results show that, compared with traditional continuous care, individualized continuous care combined with big data techniques can improve the lung function of patients with stable COPD and RF, reduce the number of acute COPD and RF attacks and the number of readmissions, and improve self-management ability and quality of life. The method can be applied and implemented in continuous nursing care.
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Øfsti, Ruth, Siri Andreassen Devik, Ingela Enmarker, and Rose Mari Olsen. "“Looking for Deviations”: Nurses’ Observations of Older Patients With COPD in Home Nursing Care." Global Qualitative Nursing Research 7 (January 2020): 233339362094633. http://dx.doi.org/10.1177/2333393620946331.
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Nurses working in home care play a significant role in observing and identifying changes in the health status of patient with chronic obstructive pulmonary disease (COPD). The aim of this study was to explore and describe nurses’ observations of older patients with COPD when providing home nursing care. In this qualitative explorative study, data were collected through observations of 17 home care visits using the think-aloud technique, followed up with individual interviews with the nurses. Qualitative content analysis was used to analyze the data. The findings showed that the nurses’ observations (focus, methods, and interpretation) were characterized by their search for deviations from what they judged to be the patient’s habitual state. The nurses did not use any tool or guidelines, nor did they follow a standard procedure. Instead, when observing and interpreting, they performed a complex process guided by their experience and knowledge of the patient, and the patient’s individual and contextual circumstances. This knowledge contributes to warranted reflection on nurses’ practice in this context to secure COPD patients’ safety and quality of life.
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Schmid-Mohler, Gabriela, Christian Clarenbach, Gabi Brenner, Malcolm Kohler, Eva Horvath, Marc Spielmanns, and Heidi Petry. "Advanced nursing practice in COPD exacerbations: the solution for a gap in Switzerland?" ERJ Open Research 6, no. 2 (April 2020): 00354–2019. http://dx.doi.org/10.1183/23120541.00354-2019.
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AimThis study aimed to address the need for adaptation of the current model of chronic obstructive pulmonary disease (COPD) care in Switzerland, particularly in regard to acute exacerbations, and how far an integrated approach involving advanced nursing practice can meet those needs.MethodsA state analysis guided by the PEPPA framework was initiated by the Pulmonology Clinic of University Hospital Zürich. Literature describing the current provision of COPD care regarding exacerbations in Switzerland and international qualitative studies describing the patient perspective were systematically searched and summarised. The health providers' perspective was investigated in three focus-group interviews.ResultsA lack of systematic and state-of-the-art support for patient self-management in Switzerland was described in literature and confirmed by the health providers interviewed. While care was assessed as being comprehensive and of good quality in each individual sector, such as inpatient, outpatient, rehabilitation and home settings, it was identified as being highly fragmented across sectors. The interview participants described day-to-day examples in which a lack of support in COPD self-management and fragmentation of care negatively affected the patients' disease management.ConclusionThe necessity of coordinating the transition between healthcare sectors and self-management support and that these organisational boundaries should be addressed by a multi-professional team were identified. Initial evaluation indicates that advanced practice nurses potentially have the skill set to coordinate the team and address patients' self-management needs in complex patient situations. However, the legal foundation and a reimbursement system to ensure long-term implementation is not yet available.
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Dwi Anugrah, Annisa. "NURSING CARE IN EFFECTIVENESS OF BREATHING FOR CHRONIC OBSTRUCTION PATIENTS IN RSI NASHRUL UMMAH LAMONGAN." Journal of Vocational Nursing 2, no. 1 (May 31, 2021): 53. http://dx.doi.org/10.20473/jovin.v2i1.26877.
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Introduction: Air pollution can cause respiratory system disorders in the form of alveoli damage, airway, and lung tissue inflammation. Inflammation of the lungs can damage the respiratory tissue and stimulate excess sputum production which causes ineffective airway clearance. This process, if it takes a long time, causes irreversible structural damage to the airway wall. This condition can progress to severe airway obstruction, called COPD. This research aims to explain nursing care for patients with Chronic Obstructive Pulmonary Disease (COPD) in the Tuberose Room at RSI Nashrul Ummah Lamongan. Methods: The research design used in this research is case study research. Participants in the study for Mr. "K" 69 years. The result of problem identification that arises is Chronic Obstructive Pulmonary Disease (COPD) with the main nursing diagnosis of Ineffective Airway Cleansing. Interventions that were emphasized and carried out in the field in cases were maintaining oxygen therapy, semi-fowler position, and administration of a nebulizer. The final evaluation of nursing diagnoses in patients was not resolved within the specified time. Result: Implementation of Nursing Care Ineffective Airway Cleansing of COPD patients in the Tuberose Room at RSI Nashrul Ummah Lamongan, there are still gaps with the literature. Conclusion: Suggestions for nurses are expected to be the focus of nurses in developing science to be applied to all nursing personnel in providing nursing care to ineffective airway cleaning for COPD patients.
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Lane, Nicholas David, Karen Brewin, Tom Murray Hartley, William Keith Gray, Mark Burgess, John Steer, and Stephen C. Bourke. "Specialist emergency care and COPD outcomes." BMJ Open Respiratory Research 5, no. 1 (October 2018): e000334. http://dx.doi.org/10.1136/bmjresp-2018-000334.
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IntroductionIn exacerbation of chronic obstructive pulmonary disease (ECOPD) requiring hospitalisation greater access to respiratory specialists improves outcome, but is not consistently delivered. The UK National Confidential Enquiry into Patient Outcome and Death 2015 enquiry showed over 25% of patients receiving acute non-invasive ventilation (NIV) for ECOPD died in hospital. On 16 June 2015 the Northumbria Specialist Emergency Care Hospital (NSECH) opened, introducing 24/7 specialty consultant on-call, direct admission from the emergency department to specialty wards and 7-day consultant review. A Respiratory Support Unit opened for patients requiring NIV. Before NSECH the NIV service included mandated training and competency assessment, 24/7 single point of access, initiation of ventilation in the emergency department, a door-to-mask time target, early titration of ventilation pressures and structured weaning. Pneumonia or hypercapnic coma complicating ECOPD have never been considered contraindications to NIV. After NSECH staff-patient ratios increased, the NIV pathway was streamlined and structured daily multidisciplinary review introduced. We compared our outcomes with historical and national data.MethodsPatients hospitalised with ECOPD between 1 January 2013 and 31 December 2016 were identified from coding, with ventilation status and radiological consolidation confirmed from records. Age, gender, admission from nursing home, consolidation, revised Charlson Index, key comorbidities, length of stay, and inpatient and 30-day mortality were captured. Outcomes pre-NSECH and post-NSECH opening were compared and independent predictors of survival identified via logistic regression.ResultsThere were 6291 cases. 24/7 specialist emergency care was a strong independent predictor of lower mortality. Length of stay reduced by 1 day, but 90-day readmission rose in both ventilated and non-ventilated patients.ConclusionProvision of 24/7 respiratory specialist emergency care improved ECOPD survival and shortened length of stay for both non-ventilated and ventilated patients. The potential implications in respect to service design and provision nationally are substantial and challenging.
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Nnate, Daniel A., David Barber, and Ukachukwu O. Abaraogu. "Discharge Plan to Promote Patient Safety and Shared Decision Making by a Multidisciplinary Team of Healthcare Professionals in a Respiratory Unit." Nursing Reports 11, no. 3 (July 30, 2021): 590–99. http://dx.doi.org/10.3390/nursrep11030056.
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Patients with chronic obstructive pulmonary disease (COPD) often require frequent hospitalization due to worsening symptoms. Preventing prolonged hospital stays and readmission becomes a challenge for healthcare professionals treating patients with COPD. Although the integration of health and social care supports greater collaboration and enhanced patient care, organizational structure and poor leadership may hinder the implementation of patient-oriented goals. This paper presents a case of a 64-year-old chronic smoker with severe COPD who was to be discharged on long-term oxygen therapy (LTOT). It also highlights the healthcare decisions made to ensure the patient’s safety at home and further provides a long-lasting solution to the existing medical and social needs. The goal was accomplished through a discharge plan that reflects multidisciplinary working, efficient leadership, and change management using Havelock’s theory. While COPD is characterized by frequent exacerbation and hospital readmission, it was emphasized that most failed discharges could be attributed to bureaucratic organizational workflow which might not be in the patient’s best interest. It was further demonstrated that healthcare professionals are likely to miss the window of opportunity to apply innovative and long-lasting solutions to the patient’s health condition in an attempt to remedy the immediate symptoms of COPD.
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Yin, Hua, Ling Yang, and Qiao Ye. "A systematic review of the effectiveness of clinical nurse specialist interventions in patients with chronic obstructive pulmonary disease (COPD)." Frontiers of Nursing 5, no. 2 (August 14, 2018): 147–56. http://dx.doi.org/10.2478/fon-2018-0019.
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Abstract Objective This review aimed to examine the effectiveness of clinical nurse specialist (CNS) interventions in patients with chronic obstructive pulmonary disease (COPD). COPD significantly affects people’s health worldwide. With the development in nursing, CNSs are playing increasingly important roles in different departments. However, the studies on the effectiveness of CNSs in COPD are not as well organized as the studies on the effectiveness of CNSs in bronchiectasis and asthma. Therefore, this review aims to find some updated evidence on the CNS interventions for patients with COPD and on whether these interventions are effective. Methods A narrative analysis of the data was performed for the eligible studies. Four databases were chosen: CINAHL, MEDLINE, British Nursing Index, and Cochrane Library. Other websites such as the National Institute for Health and Clinical Excellence, National Health Service Evidence, Association of Respiratory Nurse Specialists, and National Association of Clinical Nurse Specialist were searched as well. Two reviewers performed study identification independently, and all the retrieved articles were stored using the EndNote X7 software. The risk of bias in the included studies was assessed using the Cochrane Collaboration’s risk of bias tool. Results A total of nine studies were included in this review. There were five current interventions by CNSs for patients with COPD. These interventions were home nursing support, CNS’s supported discharge, multidisciplinary cooperation programs, nurse-led care programs, and self-care management education. The effectiveness of these five interventions was evaluated individually. There is low- to moderate-quality evidence indicating that home nursing support interventions may have a positive effect on mortality and quality of life. No significant difference in quality of life has been found between the CNS-supported discharge intervention and the usual service. The multidisciplinary cooperation program probably had a positive effect on quality of life in patients with COPD. Both nurse-led care and self-care management education intervention had a positive effect on mortality of patients with COPD. Conclusions The findings of this review provide updated evidence on the effectiveness of CNS interventions for patients with COPD. Although nine trials were included and five types of interventions were identified, there is still lack of high-quality evidence.
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Stellefson, Michael, Samantha R. Paige, Julia M. Alber, and Margaret Stewart. "COPD360social Online Community: A Social Media Review." Health Promotion Practice 19, no. 4 (June 8, 2018): 489–91. http://dx.doi.org/10.1177/1524839918779567.
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People living with chronic obstructive pulmonary disease (COPD) commonly report feelings of loneliness and social isolation due to lack of support from family, friends, and health care providers. COPD360social is an interactive and disease-specific online community and social network dedicated to connecting people living with COPD to evidence-based resources. Through free access to collaborative forums, members can explore, engage, and discuss an array of disease-related topics, such as symptom management. This social media review provides an overview of COPD360social, specifically its features that practitioners can leverage to facilitate patient–provider communication, knowledge translation, and community building. The potential of COPD360social for chronic disease self-management is maximized through community recognition programming and interactive friend-finding tools that encourage members to share their own stories through blogs and multimedia (e.g., images, videos). The platform also fosters collaborative knowledge dissemination and helping relationships among patients, family members, friends, and health care providers. Successful implementation of COPD360social has dramatically expanded patient education and self-management support resources for people affected by COPD. Practitioners should refer patients and their families to online social networks such as COPD360social to increase knowledge and awareness of evidence-based chronic disease management practices.
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Digby, Geneviève C., and Andrew Robinson. "Quality Improvement Initiatives to Optimize the Management of Chronic Obstructive Pulmonary Disease in Patients With Lung Cancer." Journal of Oncology Practice 13, no. 11 (November 2017): e957-e965. http://dx.doi.org/10.1200/jop.2017.022228.
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Purpose: Patients with lung cancer (LC) frequently have chronic obstructive pulmonary disease (COPD), the optimization of which improves outcomes. A 2014 Queen’s University Hospitals audit demonstrated that COPD was underdiagnosed and undertreated in outpatients with LC. We sought to improve the diagnosis and management of COPD in this population. Methods: We implemented change using a Define/Measure/Analyze/Improve/Control (DMAIC) improvement cycle. Data were obtained by chart review from the Cancer Care Ontario database and e-Patient System for patients with newly diagnosed LC, including patient characteristics, pulmonary function test (PFT) data, and bronchodilator therapies. Improvement cycle 1 included engaging stakeholders and prioritizing COPD management by respirologists in the Lung Diagnostic Assessment Program. Improvement cycle 2 included physician restructuring and developing a standard work protocol. Data were analyzed monthly and presented on statistical process control P-charts, which assessed differences over time. The χ2 and McNemar tests assessed for significance between independent and dependent groups, respectively. Results: A total of 477 patients were studied (165 patients at baseline, 166 patients in cycle 1, and 127 patients in cycle 2). There was no change in PFT completion over time, although respirology-managed patients were significantly more likely to undergo a PFT than patients who were not managed by respirology (56.7% v 96.1%; P < .00001). The proportion of respirology-managed patients with LC with airflow obstruction receiving inhaled bronchodilator significantly increased (baseline, 46.3%; cycle 1, 51.0%; and cycle 2, 74.3%). By cycle 2, patients with airflow obstruction were more likely to receive a long-acting bronchodilator if managed by respirology (74.3% v 44.8%; P = .0009). Conclusion: COPD is underdiagnosed and undertreated in outpatients with LC. A DMAIC quality improvement strategy emphasizing COPD treatment during LC evaluation in the Lung Diagnostic Assessment Program significantly improved COPD management.
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Scullion, Jane. "The Nurse Practitioners’ Perspective on Inhaler Education in Asthma and Chronic Obstructive Pulmonary Disease." Canadian Respiratory Journal 2018 (August 5, 2018): 1–9. http://dx.doi.org/10.1155/2018/2525319.
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Asthma and chronic obstructive pulmonary disease (COPD) can be debilitating conditions adversely affecting a person’s quality of life. Effective treatments are available, but common errors in the use of inhalers compound the issue of disease control. The beliefs and concerns of a patient can also have an impact on treatment adherence, the consequences of which are diminished disease control and the occurrence of exacerbations. Once a treatment has been prescribed, it is often nurses who manage the patient long-term, and they may even be the main care provider. This puts nurses in a key position to monitor inhaler technique, communicate with the patient to improve adherence, and even suggest alternative treatments if the patient and therapy are incompatible. This review examines the central role that nurses play in disease management and emphasizes how effective inhaler education can make a difference to disease control. Good communication between the nurse and patient is vital if this is to be achieved. Recent updates to asthma and COPD guidelines are reviewed, and key resources available to help manage patients are highlighted. Finally, with regard to inhaler education, we reconsider the nursing keystones of “Know it,” “Show it,” “Teach it,” and “Review it.”
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Heath, Janie, Sara Young, Sharon Bennett, Mary Beth Ginn, and Geoffrey Cox. "Evidence-Based Smoking Cessation Interventions for Patients With Acute Respiratory Disorders." Annual Review of Nursing Research 27, no. 1 (December 2009): 273–96. http://dx.doi.org/10.1891/0739-6686.27.273.
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Worldwide, tobacco use continues to be the most significant preventable cause of death and hospital admissions, particularly related to respiratory diseases. Acute respiratory illnesses requiring hospitalization provide an opportunity for nurses to intervene and help smokers quit. Of the three top hospital admissions related to respiratory diseases, chronic obstructive pulmonary disease (COPD) is the one that continues to have increased mortality whereas community acquired pneumonia and asthma have decreased over the past 5 years. The course of all three can be caused or exacerbated by continued smoking. This review describes the state of the science of nursing research focused on tobacco cessation interventions for hospitalized patients with COPD, asthma, or community acquired pneumonia. Additionally, we describe two evidence-based, nurse-driven, hospital protocols to treat tobacco dependence that can serve as models of care. Recommendations are made as to how to effectively promote nursing interventions for tobacco cessation in the acute care setting.
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Xu, Wenjie, Hui Hu, and Yanjun Mao. "Questionnaire Survey-Based Quantitative Assessment of the Impact of Transitional Care on Self-Management of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease." Computational and Mathematical Methods in Medicine 2021 (November 13, 2021): 1–6. http://dx.doi.org/10.1155/2021/3634548.
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Background and Objective. Chronic obstructive pulmonary disease (COPD) features high morbidity. Different nursing interventions can relieve patient’s burden. This investigation quantitatively assessed the impact of transitional care (TC) on self-management of patients with acute exacerbation of COPD based on a questionnaire survey. Methods. Clinical information of 78 COPD patients treated with TC (intervention group) or routine care (control group) in Shanghai Pulmonary Hospital during March 2019 and August 2020 was gathered. Patients were followed up for 3 months after discharge. The intervention group ( n = 39 ) was subjected to a TC plan for 3 months to help patients and their family caregivers for self-management of COPD. TC was provided by specially trained nurses, and patients were supported by standardized tools. Nursing measures in the control group ( n = 79 ) included transitional support for 30 d after hospital discharge. In this way, patients were guaranteed to follow discharge plans and transit to outpatient nursing. Patient’s anxiety and depression symptoms, sleep quality, survival quality, mobility, and life quality at admission and after 3 months of discharge were assessed by Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, Quality of Life Scale Abbreviated Version, Activity of Daily Life Scale, St. George’s Respiratory Questionnaire, and COPD Assessment Test. Results. Except for anxiety and depression, patient’s sleep quality, survival quality, mobility, and life quality in two groups were significantly improved. Moreover, average change of total CAT score during 3 months of intervention was -5.44, while that in the control group was -1.74 ( p = 0.011 ). Improvement of survival quality of patients in the intervention group ( p = 0.001 ) was markedly greater than that in the control group ( p = 0.016 ). Conclusion. Altogether, TC based on quantification by questionnaire survey is beneficial to COPD patient’s life quality and self-management.
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Gardener, Carole, Gail Ewing, and Morag Farquhar. "20 Validation of the support needs approach for patients (SNAP) tool to enable patients with advanced copd to identify and express their support needs to healthcare professionals." BMJ Supportive & Palliative Care 8, no. 3 (September 2018): 367.2–367. http://dx.doi.org/10.1136/bmjspcare-2018-mariecurie.20.
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IntroductionPatient identified need is key to delivering a person-centred approach in supportive and palliative care. The support needs approach for patients (SNAP) tool aims to enable patients with advanced COPD to identify and express their support needs to healthcare professionals (HCPs) but its validity is unknown.AimTo establish the face content and criterion validity of the SNAP tool in advanced COPD.MethodsTwo-stage mixed method primary care study involving patients with advanced COPD and their carers. Stage 1: Face and content validity assessed though focus groups involving patients and carers (n=12) considering appropriateness relevance and completeness of the SNAP tool. Thematic data analysis within a Framework Approach. Stage 2: Content and criterion validity assessed in a postal survey through patient self-completion of the SNAP tool and disease impact measures (chronic respiratory questionnaire COPD assessment test and hospital anxiety and depression scale). Content validity assessed using summary statistics; criterion validity via correlations between tool items and impact measures.ResultsThe SNAP tool has good face content and criterion validity. Patients and carers found the tool patient-friendly with potential clinical utility. No tool items were redundant. Clear correlations were found between tool items and the majority of items/sub-scales of the impact measures.DiscussionThe SNAP tool has good face content and criterion validity. It has the potential to support the delivery of supportive and palliative care in advanced COPD by enabling patients to identify and express their support needs to HCPs. Future work will pilot SNAP in clinical practice.
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Williams, Molly T., Sharon L. Kozachik, Mohana Karlekar, and Rebecca Wright. "Advance Care Planning in Chronically Ill Persons Diagnosed With Heart Failure or Chronic Obstructive Pulmonary Disease: An Integrative Review." American Journal of Hospice and Palliative Medicine® 37, no. 11 (March 13, 2020): 950–56. http://dx.doi.org/10.1177/1049909120909518.
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Introduction: Advance care planning (ACP) discussions help guide future medical care consistent with patient wishes. These discussions should be a part of routine care and should be readdressed frequently as a patient’s medical condition changes. Limited literature exists supporting structured processes for identifying persons who may benefit from these conversations. The purpose of this integrative review was to understand whether targeting patients with episodic disease trajectories in the acute care setting will increase their willingness to participate in ACP discussions. Methods: Using the Johns Hopkins Nursing Evidence-Based Practice Model as a guideline, this integrative review focused on the research query “In the acute care setting, does targeting patients with heart failure or chronic obstructive pulmonary disease for ACP lead to increased willingness to participate in these discussions.” Articles from 2009 to September 2019 were considered for review. Results: Six articles met inclusion criteria for final analysis. Articles outside of the United States were excluded. Four themes emerged from the literature: (1) improved patient attitudes toward ACP, (2) effective communication surrounding care preferences, (3) strengthened connection between preferred and delivered care, and (4) increased patient involvement in ACP. Conclusion: Chronic diseases such as heart failure and COPD have a high symptom burden punctuated by exacerbations, making it difficult to know when introduction of ACP discussions would be most beneficial. Future research should focus on a deeper evaluation of when to introduce ACP conversations in this population and which ACP interventions are effective to facilitate these discussions.
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Domańska-Glonek, Ewa, Karolina Załuska, Monika Oberc, Ewa Lewicka, Kamil Torres, Anna Torres, and Ryszard Maciejewski. "Evaluation of Patients' Satisfaction and Quality of Life in Selected Healthcare Institutions in Southern-Eastern Poland." Polish Journal of Public Health 124, no. 4 (March 1, 2015): 183–86. http://dx.doi.org/10.1515/pjph-2015-0004.
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Abstract Introduction. In recent times, patient outcome measurement has developed from being narrowly focussed upon levels of symptomatology and service use, to being a broader assessment of the impact of illness and treatment on the individual. Thus, it can be said that quality of life has become as significant as life expectance. This has brought about a transition in the assessment of treatment. Quality of life (QOL) is a multidimensional concept that usually includes subjective evaluations of both positive and negative aspects of life as it is being led. With regard to healthcare, a cross-sectional comparison of palliative care needs is crucial in understanding differences in the patients' quality of life. Hence, an analysis of programme implementation within different types of healthcare institutions is significant in evaluating current medical care standards. Our study analyzed the satisfaction level and quality of life of patients with Chronic Obstructive Pulmonary Disease (COPD), and after myocardial infarction (MI). Different types of healthcare institutions were evaluated. Aim. To evaluate patients' satisfaction and quality of life in selected healthcare institutions in southern-eastern Poland. Material and methods. The quality of life of patients with Chronic Obstructive Pulmonary Disease (COPD) was analyzed through the medical documentation obtained from different types of healthcare institutions. Among these are the pulmonary outpatient department in Moczary, as well as a GP Practice and a Nursing Home in this location. The quality of life of patients after myocardial infraction was analyzed through a survey study conducted at “Polonia” hospital spa in Rymanów Zdrój (the cardiology department). Results and conclusions. The post-myocardial infarction incident patients had began to care more about their health condition and the quality of life they led. Moreover, their satisfaction level from received treatment and medical care indicated that the cardiological services implemented in southern-eastern Poland has proceeded in a good direction. Of note, these patients were systematically under specialist control. In contrast, among patients with COPD, only those under everyday care in the Nursing Home in Moczary received a similar systematic treatment, thus, COPD patients in Moczary lead a poor quality of life. This indicates a need to re-evaluate the current programmes and services provided by health care institutions in this region.
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Boyer, Paula. "COPD, exacerbation and self-management: a literature review." Practice Nursing 33, no. 2 (February 2, 2022): 58–64. http://dx.doi.org/10.12968/pnur.2022.33.2.58.
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The incidence of COPD is rising in the UK. Paula Boyer looks at the evidence for the self-management of COPD and how this can help manage exacerbations Chronic obstructive pulmonary disease (COPD) is being increasingly diagnosed in the UK, and is expected to continue to rise due to an ageing population with multiple co-morbidities and exposure to risk factors, such as cigarette smoke, noxious gases and air pollutants. The prevalence of this disease is high in areas of socioeconomic deprivation and among highly industrial areas. The use of self-management plans in COPD is recommended by the National Institute for Health and Care Excellence (NICE), to enable patients with this disease to be competent and confident in taking part in managing their own health condition and recognising signs and symptoms of an exacerbation. The aim of this article is to discuss self-management of COPD and the clinical guidance surrounding exacerbation of disease.
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Shay, Amy, Janet S. Fulton, and Patricia O’Malley. "Mobility and Functional Status Among Hospitalized COPD Patients." Clinical Nursing Research 29, no. 1 (March 10, 2019): 13–20. http://dx.doi.org/10.1177/1054773819836202.
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Older adults with chronic obstructive pulmonary disease (COPD) are at known risk for deconditioning and functional decline during hospitalization. The purpose of this study was to examine correlations between in-hospital mobility activities and functional status indicators in hospitalized older adults with COPD. A predictive correlational, secondary analysis design using multivariate analyses assessed the relationship between mobility events and functional status indicators in patients with COPD ( n = 111) and non-COPD ( n = 190) diagnoses. Ambulation to the bathroom, ambulation outside the room, and number of days to first out-of-bed activity predicted discharge to home versus extended care facility (ECF; p ≤ .05); days to first out-of-bed activity and out-of-room ambulation predicted reduced length of stay (LOS; p ≤ .05); no variables predicted 30-day readmission. COPD patients experienced more nonweight-bearing activity and longer lengths of stay than non-COPD patients. Specific early weight-bearing activities were associated with positive functional status-related outcomes in hospitalized COPD patients.
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Shany, Tal, Michael Hession, David Pryce, Mary Roberts, Jim Basilakis, Stephen Redmond, Nigel Lovell, and Guenter Schreier. "A small-scale randomised controlled trial of home telemonitoring in patients with severe chronic obstructive pulmonary disease." Journal of Telemedicine and Telecare 23, no. 7 (July 26, 2016): 650–56. http://dx.doi.org/10.1177/1357633x16659410.
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Introduction This was a pilot study to examine the effects of home telemonitoring (TM) of patients with severe chronic obstructive pulmonary disease (COPD). Methods A randomised controlled 12-month trial of 42 patients with severe COPD was conducted. Home TM of oximetry, temperature, pulse, electrocardiogram, blood pressure, spirometry, and weight with telephone support and home visits was tested against a control group receiving only identical telephone support and home visits. Results The results suggest that TM had a reduction in COPD-related admissions, emergency department presentations, and hospital bed days. TM also seemed to increase the interval between COPD-related exacerbations requiring a hospital visit and prolonged the time to the first admission. The interval between hospital visits was significantly different between the study arms, while the other findings did not reach significance and only suggest a trend. There was a reduction in hospital admission costs. TM was adopted well by most patients and eventually, also by the nursing staff, though it did not seem to change patients’ psychological well-being. Discussion Ability to draw firm conclusions is limited due to the small sample size. However the trends of reducing hospital visits warrant a larger study of a similar design. When designing such a trial, one should consider the potential impact of the high quality of care already made available to this patient cohort.
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Hong, Lingzhi, Xufang Cheng, and Deming Zheng. "Application of Artificial Intelligence in Emergency Nursing of Patients with Chronic Obstructive Pulmonary Disease." Contrast Media & Molecular Imaging 2021 (November 24, 2021): 1–6. http://dx.doi.org/10.1155/2021/6423398.
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The research achievements of artificial intelligence technology in the development of chronic obstructive pulmonary disease were explored, and the advantages and problems encountered in the development of intelligent nursing were analyzed. This paper presents the application of artificial intelligence in the emergency care of patients with chronic obstructive pulmonary disease. The method included 447 COPD patients in a randomized controlled trial to observe the improvement of quality of life at 4 and 12 months after artificial intelligence medical intervention. A prospective randomized controlled trial included 101 patients with COPD who underwent a 9-month web-based knowledge exercise on the prevention of acute exacerbation of COPD through artificial intelligence medicine and were randomly divided into two groups: the experimental group and the control group. The results show that, in the experimental group and the control group, after 4 months, the quality of life does not change; after 12 months, compared with controls, the quality of life and emotional and psychological conditions have improved obviously. 29 patients who participated in the experiment and were randomly divided into the experimental group and the control group showed satisfactory results. COPD hospitalized rate and length of hospital stay were decreased in the experimental group than in the control group. For single-factor analysis, artificial intelligence medical intervention has not achieved significant significance, and the experimental results have preliminarily confirmed the effectiveness of artificial intelligence medical treatment.
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Jo, Yong Suk, Chin Kook Rhee, Kyung Joo Kim, Kwang Ha Yoo, and Yong-Bum Park. "Risk factors for early readmission after acute exacerbation of chronic obstructive pulmonary disease." Therapeutic Advances in Respiratory Disease 14 (January 2020): 175346662096168. http://dx.doi.org/10.1177/1753466620961688.
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Background and aims: Patients discharged after treatment for acute exacerbation of chronic obstructive pulmonary disease (COPD) are at high risk for readmission. We aimed to identify the prevalence and risk factors for readmission. Methods: We included 16,105 patients who had claimed their medical expenses from 1 May 2014 to 1 May 2016 after discharge from any medical facility in Korea, following treatment for acute exacerbation of COPD. We analysed the potential risk factors for readmission within 30 days of discharge. Results: Readmission rate was 26.4% (3989 patients among 15,101 patients) and over 50% of readmissions occurred within 10 days of discharge. Approximately 57% of readmissions occurred due to respiratory causes. Major causes of readmission were COPD (27%), pneumonia (14.2%), and lung cancer (7.1%), in that order. Patients who were readmitted were male, had more comorbidities and were less frequently admitted to tertiary hospitals than those who were not readmitted. Risk factors for readmission within 30 days of discharge were male sex, medical aid coverage, longer hospital stay, longer duration of systemic steroid use during hospital stay, high comorbid condition index, and discharge to skilled nursing facility. Conclusion: Readmission occurred in approximately one-quarter of patients, and was associated with patient-related and clinical factors. Using these results, we can identify high-risk patients for readmission and precautions are needed to be taken before deciding on a discharge plan. Further research is needed to develop accurate tools for predicting the risk of readmission before discharge, and development and evaluation of an effective care programme for COPD patients are necessary. The reviews of this paper are available via the supplemental material section.
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Moore, David. "Home oxygen therapy in patients with COPD: safety issues for nurse prescribers." British Journal of Nursing 28, no. 14 (July 25, 2019): 912–17. http://dx.doi.org/10.12968/bjon.2019.28.14.912.
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Two landmark studies demonstrated survival benefit in chronic obstructive pulmonary disease (COPD) complicated by chronic hypoxaemia with the prescription of long-term oxygen therapy (LTOT). Best practice evidence therefore recommends that individuals with stable COPD and resting hypoxaemia (PaO2≤7.3 kPa) should be assessed for long-term oxygen therapy. However, it is estimated that up to one-quarter of COPD patients prescribed LTOT continue to smoke. Oxygen therapy consequently presents an obvious fire hazard in the case of such patients, who are therefore at greater risk of death or sustaining devastating head and neck burns. This article critically analyses, through the context of a care study, the professional, ethical and legal issues involved in making a safe prescribing decision for LTOT in an individual with COPD who is a current smoker. Home oxygen prescription is a growing trend in the COPD population, and it is important for nurse prescribers to be aware of the issues highlighted in the article to ensure safe prescribing practices.
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Gao, Yunlei. "The Impact of a Multidisciplinary Nursing Model on the Quality of Life of COPD Patients in Remission in the Elderly." Journal of Clinical and Nursing Research 6, no. 1 (January 19, 2022): 35–40. http://dx.doi.org/10.26689/jcnr.v6i1.2879.
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Objective: To study the effects of multidisciplinary nursing model on self-care ability, lung function, exercise endurance, negative emotion and quality of life of elderly patients with chronic obstructive pulmonary disease (COPD). Methods: 80 patients with COPD hospitalized in the Aerospace Center Hospital from August 2019 to August 2020 were recruited. They were randomly divided into control group and experimental group, with 40 patients in each group. The patients in the control group received routine nursing, and the patients in the experimental group received multidisciplinary nursing intervention on the basis of routine nursing. The nursing observation time of the two groups was 8 weeks. Results: after 8 weeks of nursing intervention, it was found that FEV1 / FVC and 6MWD in the observation group were significantly higher than those in the control group (P < 0.05). There was no significant difference in SAS score and SDS score between the two groups before nursing, but it was significantly lower in the observation group after nursing. The difference between the above data was statistically significant (P < 0.05). The SGRQ score of the observation group was significantly lower than that of the control group (P < 0.05). Conclusion: the application of multidisciplinary nursing model can effectively improve the exercise endurance of elderly patients with COPD, eliminate the negative emotions of patients, and improve the quality of life of patients. The comprehensive application value is significant.
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Qualls, Brandon, Hiwot Seyoum, Tammy Walker, and Mary Carey. "Unplanned Re-Hospitalization Among Older Persons Results in Loss of their Independence." Innovation in Aging 4, Supplement_1 (December 1, 2020): 912–13. http://dx.doi.org/10.1093/geroni/igaa057.3355.
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Abstract The Centers for Medicare & Medicaid Services defines a hospital readmission as an inpatient stay that begins within 30 days of the discharge date of an index admission, to the same or a different hospital. The aims of the study were to analyze the recurrent readmissions of older persons admitted to a community hospital with diagnoses of: Chronic Obstructive Pulmonary Disease (COPD), Pneumonia (PNA), and Congestive Heart Failure (CHF). Based on the results, we will develop additional strategies that can be used to reduce the rate for hospital readmission for older patients. A retrospective chart review of hospitalizations was conducted. Among 30 readmissions, the mean age was 79.5±14. The index disposition was distributed among three destinations: self-care (27%), home health organization (40%), and to skilled nursing home (33%). Most of the readmissions were for CHF (27%), COPD (10%), and PNA (13%), the only other large category include respiratory failure (10%). The readmission disposition was different from the index disposition: self-care (7%), home health organization (47%), and to skilled nursing home (20%). After hospital readmission within 30 days, older persons were more likely to be discharged to home health care organization than self-care, p<0.05. Actions that can be taken by hospitals to reduce 30-day readmissions to maintain older person independence include: clinical readiness of patients for discharge, proper infection prevention techniques, reconciling medications, good communication, and adequate patient education. This study reports that that older persons are at higher risk for unplanned hospital re-admissions and often lose their independence.
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Howard, Mark, and Christina Ramsenthaler. "Behind the wheel safety in palliative care: a literature review." BMJ Supportive & Palliative Care 9, no. 3 (December 6, 2018): 255–58. http://dx.doi.org/10.1136/bmjspcare-2018-001639.
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BackgroundDriving is a complex activity that requires physical abilities and adequate executive and cognitive functioning. There is concern among specialist palliative care services about patients continuing to drive despite having progressive incurable illnesses, comorbidities and medications to manage their symptoms.ObjectivesTo determine the quality of literature available about driving that would apply to palliative care patients, specifically in relation to road test or simulated driving scores and neurocognitive testing.MethodA literature search based on systematic principles was conducted on the Ovid Medline, PsycINFO, Embase and CINAHL database up to 14 October 2018. Patient populations with life-limiting illness such as cancer, cardiorespiratory and neurological diagnoses were included.Results37,546 articles were screened. 14 articles satisfied the search criteria. Six studies focused on patients with multiple sclerosis (MS). Four studies investigated driving ability in patients with Huntington’s disease. The remaining four articles studied heart failure, chronic obstructive pulmonary disease (COPD), interstitial lung disease and patients with cancer. In the road test studies, 19%–47% of patients with MS and Huntington’s failed the behind-the-wheel assessment. The simulated driving scores in seven studies demonstrated statistically significant differences in errors made between study participants and controls. Divided attention was found in seven studies to be associated with poorer road-test or simulated driving ability.ConclusionsThis review highlights the scarcity of studies available for patients who would be known to palliative care services. For most patient groups, a battery of neurocognitive tests combined with a road-test or simulated driving assessment is still considered the best practice in determining driving safety.
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Misra, Sumi, Carrie Speck, and Tim Lewis. "CareBeyond: A Chronic Disease Management Model in Hospice Care for COPD Patients (407)." Journal of Pain and Symptom Management 39, no. 2 (February 2010): 374–75. http://dx.doi.org/10.1016/j.jpainsymman.2009.11.292.
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Houben, Carmen HM, and Daisy JA Janssen. "O-92 Advance care planning in patients with chronic obstructive pulmonary disease (COPD)." BMJ Supportive & Palliative Care 5, Suppl 2 (September 2015): A29.2—A29. http://dx.doi.org/10.1136/bmjspcare-2015-000978.91.
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Karaca, Türkan, and Emine Derya İster. "Nursing care for patients with copd on long-term oxygen therapyUzun süreli oksijen tedavisi alan koah hastalarında hemşirelik bakımı." Journal of Human Sciences 13, no. 2 (May 25, 2016): 2588. http://dx.doi.org/10.14687/jhs.v13i2.3547.
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According to Maslow's theory, clear air is the highest priority which hierarchical human needs for maintaining the vitality of the human. İndividuals can not maintain the respiratory function effectively any reason (such as chronic obstructive pulmonary disease (COPD), lung cancer, pneumonia, tuberculosis, asthma and cystic fibrosis disease) that cause unabling to fulfill task of these constructions. From the report of the Global Burden of the Diseases that is updated in 2010 by World Health Organization, within non-communicable (chronic) diseases; chronic respiratory diseases, cardiovascular diseases, cancers and diabetes are the biggest killer which cause estimated 35 million deaths every year. In addition to these data, the cause of deaths rank in the world, COPD is fourth. Also in this report, the cause of death in the ranking for the year 2030, COPD is expected to rise to third place (WHO, 2010). Developments in technology and health care allow early diagnosis of diseases and optimal treatment application in case of illness. Long-term oxygen therapy is the most commonly used method for espiratory diseases. So, for a high quality nursing care that provide by nurses, it is important that nurses be aware of basic concepts of oxygen therapy, methods of application and possible complications. ÖzetMaslow’ un teorisine göre, insan gereksinimleri hiyerarşik sıralamasında insanın canlılığını sürdürebilmesi için en öncelikli karşılaması gereken gereksinimi temiz havadır. Herhangi bir nedenle bu yapılar görevini yerine getiremediği durumlarda (Kronik Obstrüktif Akciğer Hastalığı (KOAH), akciğer kanseri, pnomöni, tüberküloz, astım ve kistik fibrozis gibi hastalıklar) bireyler solunum sistemi fonksiyonunu etkin bir şekilde sürdüremez. Dünya Sağlık Örgütü’nün (DSÖ), 2010 yılında güncellediği Hastalıkların Küresel Yükü başlıklı raporunda bulaşıcı olmayan (kronik) hastalıkların içinde kronik solunum yolu hastalıkları, kalp damar hastalıkları, kanserler ve diyabet ile beraber dünyanın en büyük katilleri olup, her yıl tahminen 35 milyon ölüme neden olmaktadır. Bu verilere ek olarak, dünyada ölüm nedeni sıralamasında solunum sistemi hastalıklarından, KOAH dördüncü sırada yer almaktadır. Ayrıca bu raporda, 2030 yılı için öngörülen ölüm nedeni sıralamasında, KOAH’ın üçüncü sıraya yükseleceği tahmin edilmektedir (DSÖ, 2010). Teknolojide ve sağlık alanında ki gelişmeler, hastalıklara erken tanı koymasına ve hastalık durumunda en uygun tedavi yöntemini uygulamasına olanak sağlamaktadır. KOAH’da en sık kullanılan tedavi yöntemi uuzun süreli oksijen tedavisidir. Bu nedenle hemşirelerin kaliteli bir hemşirelik bakımı vermeleri için, oksijen tedavisinin temel kavramlarını, uygulama yöntemlerini, gelişebilecek komplikasyonları bilmesi önemlidir.
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Odencrants, Sigrid, Margareta Ehnfors, and Susan J. Grobe. "Living with chronic obstructive pulmonary disease (COPD): Part II. RNs? experience of nursing care for patients with COPD and impaired nutritional status." Scandinavian Journal of Caring Sciences 21, no. 1 (March 2007): 56–63. http://dx.doi.org/10.1111/j.1471-6712.2007.00441.x.
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Sobeh, Dena E. "The Effect of Nursing Care Protocol on Health Outcomes of Patients with Chronic Obstructive Pulmonary Disease (COPD)." International Journal of Nursing Didactics 09, no. 03 (March 31, 2019): 49–56. http://dx.doi.org/10.15520/ijnd.v9i03.2499.
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B Ramadhani, Fatina, Yilan Liu, Xue Jing, Ye Qing, Han Xiong, Fengjian Zhang, and Pian Wei. "Comparing the association of cardiovascular nursing care with blood pressure and length of stay of in-patients with coronary artery disease in Wuhan, China." African Health Sciences 20, no. 4 (December 16, 2020): 1716–24. http://dx.doi.org/10.4314/ahs.v20i4.23.
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Background: Coronary artery disease is a leading cause of morbidity and mortality worldwide. Comorbidity-like hyperten- sion has been among the major risks of coronary artery disease. Recent evidence identified multiple benefits of cardiovas- cular nursing care to coronary patients. However, little has been appraised on benefits regarding patients’ blood pressure control and length of hospitalisation.
Objective: To compare the association of cardiovascular nursing care delivered to coronary artery patients with patients’ blood pressure and length of stay.
Methods: Records based retrospective design was applied at a large teaching hospital in Wuhan, China. SPSS 21 version was used for data entry and analysis with univariate and multivariate logistic regression models for comparing study variables.
Results: Of 300 patients, 224 (74.7%) were known to be hypertensive and admitted with subnormal blood pressure. Cardiovascular nursing care like “assess to grade pain severity on 1-10 scale” and “counsel patient to cope with stress” were six and three times more likely to contribute improved patients’ blood pressure (AOR=5.8; 95%CI: 2.8-12.2, p=0.001) and (AOR=3.1; 95%CI: 1.2-7.8, p=0.015) respectively. No significant difference with length of stay (p>0.05).
Conclusion: There is a possibility of coronary artery patients to recover with normal blood pressure following reception of evidence-based cardiovascular nursing care.
Keywords: Cardiovascular nursing care; blood pressure; in-patients; coronary artery; Wuhan; China.
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Murphy, Linda A., Patricia Harrington, Stephanie JC Taylor, Conor Teljeur, Susan M. Smith, Hilary Pinnock, and Máirín Ryan. "Clinical-effectiveness of self-management interventions in chronic obstructive pulmonary disease: An overview of reviews." Chronic Respiratory Disease 14, no. 3 (February 24, 2017): 276–88. http://dx.doi.org/10.1177/1479972316687208.
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Self-management (SM) is defined as the provision of interventions to increase patients’ skills and confidence, empowering the individual to take an active part in their disease management. There is uncertainty regarding the optimal format and the short- and long-term benefits of chronic obstructive pulmonary disease (COPD) SM interventions in adults. Therefore, a high-quality overview of reviews was updated to examine their clinical effectiveness. Sixteen reviews were identified, interventions were broadly classified as education or action plans, complex interventions with an SM focus, pulmonary rehabilitation (PR), telehealth and outreach nursing. Systematic review and meta-analysis quality and the risk of bias of underlying primary studies were assessed. Strong evidence was found that PR is associated with significant improvements in health-related quality of life (HRQoL). Limited to moderate evidence for complex interventions (SM focus) with limited evidence for education, action plans, telehealth interventions and outreach nursing for HRQoL was found. There was strong evidence that education is associated with a significant reduction in COPD-related hospital admissions, moderate to strong evidence that telehealth interventions and moderate evidence that complex interventions (SM focus) are associated with reduced health care utilization. These findings from a large body of evidence suggesting that SM, through education or as a component of PR, confers significant health gains in people with COPD in terms of HRQoL. SM supported by telehealth confers significant reductions in healthcare utilization, including hospitalization and emergency department visits.
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Yao, Xiaoling, Xiaoyu Wang, Jing Yuan, Zhikang Huang, Dan Wu, and Hongyan Xu. "Benefits Conferred by Peer-Support Nursing Intervention to Pulmonary Function and Quality of Life in Nonsmoking Patients with COPD." Canadian Respiratory Journal 2021 (June 15, 2021): 1–6. http://dx.doi.org/10.1155/2021/7450979.
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Objective. Peer support is a concept of substantial significance to health scientists and practitioners today due to its focus shifting from disease treatment to health promotion. Effective incorporation peer relationships in support-enhancing interventions could improve quality care and health outcomes. More and more cases of chronic obstructive pulmonary disease (COPD) have been diagnosed in nonsmokers. In this study, the effects of peer-support nursing intervention on the pulmonary function and quality of life of nonsmoking patients with COPD were investigated. Methods. A total of 100 COPD nonsmoking patients admitted to our hospital from October 2018 to October 2020 were selected as study subjects. All nonsmoking patients were in accordance with the guidelines of COPD diagnosis and treatment issued by the Respiratory Medicine Branch of Chinese Medical Association, and they were not in the habit of smoking. According to the different interventions, the nonsmoking patients were divided into the control group (n = 50) and the observation group (n = 50). Among them, nonsmoking patients in the control group received routine care, and nonsmoking patients in the observation group received routine care and peer-support nursing. The difference on the scores of social support, self-management efficacy, healthy lifestyle, and the distance of six-minute walking were to be compared between the two groups before and after the intervention. Results. There was no significant statistical difference on the general information between the two groups in terms of age, gender, and course of disease ( P > 0.05 ). Before intervention, the social support score involving subjective support, objective support, utilization of support, and total score revealed slight difference between the two groups ( P > 0.05 ). However, after the intervention, the subjective support, utilization of support, and total score remained statistically different between the two groups ( P < 0.05 ), and the objective support showed no significant difference between the two groups ( P > 0.05 ). Before intervention, there was no statistical difference in the self-management efficacy scores such as positive attitude, stress reduction, self-decision-making, and total score between the two groups ( P > 0.05 ). After the intervention, the two groups indicated statistical difference in the self-management efficacy scores ( P < 0.05 ). Before intervention, there was no significant difference between the two groups in the healthy lifestyle score in terms of health responsibility, self-realization, interpersonal support, and stress management ( P > 0.05 ), and the abovementioned outcome measures indicated significant difference between the two groups after intervention ( P < 0.05 ). There was no statistical difference in six-minute walking distance between the two groups before the intervention ( P > 0.05 ), but after the intervention, the observation group revealed a significantly longer distance of six-minute walking compared to the control group ( P < 0.05 ). Conclusion. These data suggest that peer-support nursing intervention can effectively improve pulmonary function and quality of life of nonsmoking patients with COPD.
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Micklewright, Kerry, and Morag Farquhar. "58 Support needs of informal carers of patients with copd and implications for improving carer support." BMJ Supportive & Palliative Care 8, no. 3 (September 2018): 382.2–382. http://dx.doi.org/10.1136/bmjspcare-2018-mariecurie.58.
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IntroductionInformal carers play a key supportive role for patients with chronic obstructive pulmonary disease (COPD) but with considerable impact on their health and wellbeing.1 2 The literature on support needs of these carers has not been fully synthesised and our knowledge of the comprehensiveness of the Carer Support Needs Assessment Tool3 (CSNAT) for carers of patients with COPD is limited.AimTo identify relevant carer support needs from the published literature in order to explore the comprehensiveness of the CSNAT for carers of patients with COPD.MethodsEnglish language studies published between 1997–2017 were identified against predetermined inclusion/exclusion criteria through searches of MEDLINE, CINAHL, EMBASE, CDSR, ASSIA, PsycINFO and Scopus. Further studies were identified through searching reference lists and citations of included papers. Papers were critically appraised and data extracted and synthesised by two reviewers. Identified needs were mapped to CSNAT items.Results24 studies were included in the review. Preliminary results (synthesis ongoing: completes September 2018) indicate that carers have support needs in a range of domains that include physical psychological spiritual and social needs. Early findings suggest additional CSNAT items may be required in order to encompass the full range of needs of this group particularly relating to difficulties within the patient-carer relationship and accessing services.ConclusionBased on preliminary results there is evidence to suggest the need for additional CSNAT items for COPD carers and that these carers would benefit from identification and response to their support needs by healthcare professionals to improve carer support.References. Cruz J, Marques A, Figueiredo D. Impacts of COPD on family carers and supportive interventions: A narrative review.Health and Social Care in the Community2017;25(1):11–25.. Grant M, Cavanagh A, Yorke J. The impact of caring for those with chronic obstructive pulmonary disease (COPD) on carers’ psychological well-being: A narrative review. International Journal of Nursing Studies2012;49:1459–1471.. Ewing G, Grande G. The CSNAT2018. Available at: http://csnat.org/ (Accessed: 29/05/18)
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Rykkje, Linda, and Gunhild H. B. Hjorth. "“Safety at Home”: Experiences From Testing of Video Communication Between Patients and Home Health Care Personnel." SAGE Open 7, no. 4 (October 2017): 215824401774490. http://dx.doi.org/10.1177/2158244017744900.
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The implementation of welfare technology in Norwegian municipals is a governmental priority, but there is little research on transfer of technological solutions into regular health care services. The aim of the project “Safety at home” was to test and evaluate the use of video communication between patients and health care personnel. There were two test periods, with the initial phase focusing on patients with chronic obstructive pulmonary disease (COPD). The second phase focused on patients who most likely would benefit from video communication. Nine patients tested the equipment, and they were interviewed afterward. In addition, nursing personnel evaluated the project through focus group interviews. The results identified that the equipment was user friendly and contributed to the patients’ feelings of safety. However, there were concerns about video calls replacing the “human touch” of home visits. The personnel also experienced that the technological solution had limitations, and new tasks added to their workload. The choice of focusing on COPD patients was considered a disadvantage, and we recommend that future projects should not be restricted by diagnosis and should target the most eligible candidates.
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Represas-Represas, Cristina, Luz Aballe-Santos, Alberto Fernández-García, Ana Priegue-Carrera, José-Luis López-Campos, Almudena González-Montaos, Maribel Botana-Rial, and Alberto Fernández-Villar. "Evaluation of Suboptimal Peak Inspiratory Flow in Patients with Stable COPD." Journal of Clinical Medicine 9, no. 12 (December 5, 2020): 3949. http://dx.doi.org/10.3390/jcm9123949.
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Objective: Although the importance of assessing inspiratory flow in the selection of treatments for chronic obstructive pulmonary disease (COPD) is understood, evaluation of this factor is not yet widespread or standardized. The objective of the present work was to evaluate the peak inspiratory flow (PIF) of patients with COPD and to explore the variables associated with a suboptimal PIF. Methods: An observational, cross-sectional study was carried out at specialized nursing consultations over a period of 6 months. We collected clinical data as well as data on symptoms, treatment adherence, and patient satisfaction with their inhalers via questionnaires. PIF was determined using the In-Check Dial G16® device (Clement Clarke International, Ltd., Harlow, UK). In each case, the PIF was considered suboptimal when it was off-target for any of the prescribed inhalers. The association with suboptimal PIF was evaluated using multivariate logistic regression and the results were expressed as the odds ratio (OR) with 95% confidence interval (CI). Results: A total of 122 COPD patients were included in this study, of whom 34 (27.9%) had suboptimal PIF. A total of 229 inhalers were tested, of which 186 (81.2%) were dry powder devices. The multivariate analysis found an association between suboptimal PIF and age (OR = 1.072; 95% CI (1.019, 1.128); p = 0.007) and forced vital capacity (OR = 0.961; 95% CI (0.933, 0.989); p = 0.006). Conclusions: About a third of patients in complex specialized COPD care have suboptimal PIFs, which is related to age and forced vital capacity.
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Dalgaard, Karen Marie, Heidi Bergenholtz, Marianne Espenhain Nielsen, and Helle Timm. "Early integration of palliative care in hospitals: A systematic review on methods, barriers, and outcome." Palliative and Supportive Care 12, no. 6 (March 13, 2014): 495–513. http://dx.doi.org/10.1017/s1478951513001338.
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AbstractObjective:According to the World Health Organization (WHO), palliative care (PC) should be available to everyone suffering from life-threatening diseases and should be started early on in the illness trajectory. However, PC is often initiated much later and is restricted to cancer patients. There is a need for more knowledge about how early PC can be implemented in clinical practice. The purpose of our study was to document the best evidence on methods for early identification (EI) of palliative trajectories in cancer, chronic heart failure (CHF), and chronic obstructive pulmonary disease (COPD) populations, and to identify preconditions for early integration of general PC in hospitals and outcomes for patients and relatives.Method:A comprehensive systematic review of methods, preconditions, and outcomes was conducted via an electronic literature search of publications between 2002 and September 2012. A final sample of 44 papers was reviewed in detail.Results:Our study identified disease-specific and general methods for EI of patients who might benefit from PC. Prognostication of end-stage disease based on (holistic) clinical judgment, prognostic factors, and/or care needs are the most frequently recommended methods. A number of interacting disease-, staff-, user-, and organization-specific barriers need to be overcome in order to implement early integration of PC in clinical practice. Early integration of PC may lead to better symptom management, prolonged survival, and better quality of life.Significance of Results:No methods can be recommended for routine clinical practice without further validation. There is an urgent need to develop and evaluate methods based on the holistic assessment of symptoms or needs. The barriers to early integration of PC are most extensive with regard to CHF and COPD. Professional training and education are recommended to facilitate early implementation of PC. The evidence about outcome is sparse and mostly relates to cancer populations receiving specialized PC.
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Mostafavi-Pour-Manshadi, Seyed-Mohammad-Yousof, Nafiseh Naderi, Miriam Barrecheguren, Abolfazl Dehghan, and Jean Bourbeau. "Investigating fractional exhaled nitric oxide (FeNO) in chronic obstructive pulmonary disease (COPD) and asthma–COPD overlap (ACO): a scoping review protocol." BMJ Open 7, no. 12 (December 2017): e018954. http://dx.doi.org/10.1136/bmjopen-2017-018954.
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IntroductionDuring the last decade, many articles have been published, including reviews on fractional exhaled nitric oxide (FeNO) use and utility in clinical practice and for monitoring and identifying eosinophilic airway inflammation, especially in asthma, and evaluating corticosteroid responsiveness. However, the exact role of FeNO in patients with chronic obstructive pulmonary disease (COPD) and its ability to distinguish patients with COPD and those having concomitant asthma, that is, asthma–COPD overlap (ACO) is still unclear and needs to be defined. Due to the broad topics of FeNO in chronic airway disease, we undertook a scoping review. The present article describes the protocol of a scoping review of peer-reviewed published literature specific to FeNO in COPD/ACO over the last decade.Methods and analysisWe used Joanna Briggs Institute Reviewers’ Manual scoping review methodology as well as Levacet al’s and Arkseyet al’s framework as guides. We searched a variety of databases, including Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Web of Science, and BioSciences Information Service (BIOSIS) on 29 June 2016. Additional studies will be recognised by exploring the reference list of identified eligible studies. Screening of eligible studies will be independently performed by two reviewers and any disagreement will be solved by the third reviewer. We will analyse the gathered data from article bibliographies and abstracts.Ethics and disseminationTo investigate the body of published studies regarding the role of FeNO in patients with COPD and its usefulness in the clinical setting, a scoping review can be used as a modern and pioneer model, which does not need ethics approval. By this review, new insights for conducting new research specific to FeNO in COPD/ACO population will emerge. The results of this study will be reported in the scientific meetings and conferences, which aim to provide information to the clinicians, primary care providers and basic science researchers.
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Gysels, Marjolein H., and Irene J. Higginson. "Caring for a person in advanced illness and suffering from breathlessness at home: Threats and resources." Palliative and Supportive Care 7, no. 2 (June 2009): 153–62. http://dx.doi.org/10.1017/s1478951509000200.
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ABSTRACTObjective:Little is known about the factors that mediate the caregiving experience of informal carers at home, which could inform about ways of supporting them in their caregiving role. Our objective was to investigate the caring experience of carers for patients with an advanced progressive illness (chronic obstructive pulmonary disease [COPD], heart failure, cancer, or motor neuron diseases [MND]), who suffer from breathlessness.Methods:A purposive sample of 15 carers was selected. They were recruited via the patients they cared for (who suffered from COPD, cancer, MND, or heart failure) from the hospital and the community. Data were collected through semistructured, in-depth interviews. All were tape-recorded and transcribed verbatim. The analysis used a Grounded Theory approach and NVivo software facilitated the management and analysis of the data.Results:Several key issues affected caring in a positive or a negative way. The threats to caring were uncertainty, carers' own health problems, an imploded world, negative reactions from outside, person loss, and acute exacerbations. Resources that carers drew on were acceptance, self-care, availability of support, feeling that caring is a shared responsibility with the patient, and “getting on with” caring in case of emergencies. Breathlessness was particularly challenging, and carers did not have any strategies to relieve the symptom. They were ill prepared for acute exacerbations.Significance of results:Carers need to be included in opportunities for support provision in advanced illness. Negotiated involvement of a health professional could buffer the heavy responsibilities related to home care. They could provide problem-solving skills and build on the resources that carers draw on in response to what they experience as most threatening to their caring role.
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Zheng, Dandan, Wentao Cheng, Heyu Wu, Haichao Wu, and Yuqi Cao. "Research Progress of Nursing Care for Elderly Patients With Complicating Postoperative Hip Fracture Deep Vein Thrombosis in China." International Journal of Studies in Nursing 6, no. 4 (December 30, 2021): 81. http://dx.doi.org/10.20849/ijsn.v6i4.948.
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Introduction: The aging of China's population has further deepened, and according to the results of the seventh national census, the population aged 60 years and above in China was 264.02 million, accounting for 18.70% (China.2021).The rapid growth of the elderly population has led to an increase a geriatric orthopedic morbidity. The hip fracture is one of the common orthopedic diseases, which has posed a severe threat to the elderly's life and health (Yu, 2019).Purpose: In this study, we investigated the domestic and international literature, focusing on the analysis of DVT nursing prevention programs for elderly patients after hip arthroplasty, and proposed the current nursing research progress in preventing DVT to help elderly patients actively cope with DVT, improve the quality of life in later life, and make DVT a truly preventable disease.Method: Electronic searches using scholarly databases were employed and only significant articles that met the review objective were utilized.Findings: Currently, the main treatment option for hip fracture patients in clinical practice is surgery, and how to prevent Deep Vein Thrombosis (DVT) is an important task in the postoperative care of elderly orthopedic patients (Li, 2016). Research studies have shown that all elderly patients are at a very high risk of DVT during hospitalization, but the current trend is that 50% of patients at high risk of thrombosis are still not actively and effectively prevented from developing thrombosis for various reasons.Conclusion: This disease, which has a high incidence, a high mortality rate, and is difficult to prevent, requires increased attention and necessitates exploration to derive effective nursing intervention programs and related nursing measures to prevent reduce the formation of DVT and alleviate suffering for patient (Xu, 2016).In this review, we summarized the main nursing methods for preventing deep vein thrombosis of the lower extremities after hip fracture surgery in the elderly. Elderly patients are a special group of people, both physically and psychologically in a relatively fragile state, especially after the operation, so they need to be more careful in nursing work. In addition to general physical care, the care of their psychological state is also extremely important. This article describes in detail the physiological and psychological nursing interventions for patients, which can effectively guide and help medical staff to cope with the clinical care of such patients, and enable patients to better recover from surgery and trauma, and obtain a good prognosis.
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Gulen, Muge, Salim Satar, Selen Acehan, Mehmet Bozkurt, Ebru Funda Aslanturkiyeli, Sarper Sevdimbas, Cemre Ipek Esen, et al. "Have the Diagnoses of Patients Transported by Ambulances Changed in the Early Stage of the COVID-19 Pandemic?" Prehospital and Disaster Medicine 37, no. 1 (November 10, 2021): 4–11. http://dx.doi.org/10.1017/s1049023x21001229.
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AbstractIntroduction:Since December 2019, emergency services and Emergency Medical Service (EMS) systems have been at the forefront of the fight against the coronavirus disease 2019 (COVID-19) pandemic world-wide.Objective:The objective of this study was to examine the reasons and the necessity of transportation to the emergency department (ED) by ambulance and the outcomes of these cases with the admissions during the COVID-19 pandemic period and during the same period in 2019.Methods:A retrospective descriptive study was conducted in which patients transported to the ED by ambulance in April 2019 and April 2020 were compared. The primary outcomes were the changes in the number and diagnoses of patients who were transferred to the ED by ambulance during the COVID-19 period. The secondary outcome was the need for patients to be transferred to the hospital by ambulance.Results:A total of 4,466 patients were included in the study. During the COVID-19 period, there was a 41.6% decrease in ED visits and a 31.5% decrease in ambulance calls. The number of critically ill patients transported by ambulance (with diagnoses such as decompensated heart failure [P <.001], chronic obstructive pulmonary disease [COPD] attack (P = .001), renal failure [acute-chronic; P = .008], angina pectoris [P <.001], and syncope [P <.001]) decreased statistically significantly in 2020. Despite this decrease in critical patient calls, non-emergency patient calls continued and 52.2% of the patients transported by ambulance in 2020 were discharged from the ED.Conclusions:Understanding how the COVID-19 pandemic is affecting EMS use is important for evaluating the current state of emergency health care and planning to manage possible future outbreaks.
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Begum, Shima, Khondoker Mahmuda Akter Halim, Sharmin Islam, Ratna Khatun, and Faisal Muhammad. "Nurses’ knowledge regarding nursing care and management of hypertensive patients in a selected hospital in Dhaka city." International Journal of Research in Medical Sciences 7, no. 5 (April 26, 2019): 1914. http://dx.doi.org/10.18203/2320-6012.ijrms20191700.
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Background: Heart diseases, hypertension, diabetes, COPD and cancer are some of the major NCDs and account for more than three-fifths of a death in Bangladesh. This study was aimed to assess the level of nurses’ knowledge regarding nursing care and management of the hypertensive patients.Methods: This study utilized a descriptive cross-sectional study type and the data were collected using self-administered questionnaire. The respondents were informed about the purpose of the study to obtain their consent and they were given clear instructions on how to fill the questionnaires. All the data were analyzed using Statistical Package for Social Sciences (SPSS) version 22.Results: In this study slightly above 60.0% of the participants were female and 73% of them were Muslims. More than half (53.0%) of the respondents had B.Sc. in nursing and 51.3% of them had <10 years of service experience. About 70.4% of the respondents had attended a training on hypertension and 92.2% of them knows about normal blood pressure measurement. About 92.2% of the participants knows the causes of hypertension and 82.6% of the respondents mentioned that hypertension management aims to prevent morbidity and mortality and only 39.1% of them knows the recommended diet for people with hypertension.Conclusions: The finding reported that the nurses' knowledge regarding the management of hypertensive patients and knowledge on hypertension were very good. Developing knowledge among the nurses in relation to hypertension is the key factor to plan for comprehensive nursing care for better prognosis of the patient.
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Longman, Jo, Jennifer Johnston, Dan Ewald, Adrian Gilliland, Michael Burke, Tabeth Mutonga, and Megan Passey. "What could prevent chronic condition admissions assessed as preventable in rural and metropolitan contexts? An analysis of clinicians’ perspectives from the DaPPHne study." PLOS ONE 16, no. 1 (January 7, 2021): e0244313. http://dx.doi.org/10.1371/journal.pone.0244313.
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Introduction Reducing potentially preventable hospitalisations (PPH) is a priority for health services. This paper describes the factors that clinicians perceived contributed to preventable admissions for angina, diabetes, congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD), and what they considered might have been done in the three months leading up to an admission to prevent it. Methods The study was conducted in a rural and a metropolitan health district in NSW, Australia. Expert Panels reviewed detailed case reports to assess preventability. For those admissions identified as preventable, comments from clinicians indicating what they perceived could have made a difference and/or been done differently to prevent each of the preventable admissions were analysed qualitatively. Results 148 (46%) of 323 admissions were assessed as preventable. Across the two districts, the most commonly identified groups of contributing factors to preventable admissions were: ‘Systems issues: Community based services missing or inadequate or not referred to’; ‘Patient issues: Problems with adherence/self-management’; and ‘Clinician issues: GP care inadequate’. In some instances, important differences drove these groups of factors. For example, in the rural district ‘Systems issues: Community based services missing or inadequate or not referred to’ was largely driven by social and welfare support services missing/inadequate/not referred to, whereas in the metropolitan district it was largely driven by community nursing, allied health, care coordination or integrated care services missing/inadequate/not referred to. Analyses revealed the complexity of system, clinician and patient factors contributing to each admission. Admissions for COPD (rural) and CHF (metropolitan) admissions showed greatest complexity. Discussion and conclusion These findings suggest preventability of individual admissions is complex and context specific. There is no single, simple solution likely to reduce PPH. Rather, an approach addressing multiple factors is required. This need for comprehensiveness may explain why many programs seeking to reduce PPH have been unsuccessful.
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Budiman, Budiman, and Sri Garnewi. "Effects of Diaphragmatic Breathing Exercise on the Degree of Breathlessness in Patients With Chronic Obstructive Pulmonary Disease." Iranian Rehabilitation Journal 19, no. 1 (March 1, 2021): 69–74. http://dx.doi.org/10.32598/irj.19.1.1094.1.
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Objectives: The present study aimed to determine the effect of diaphragmatic breathing exercises on the degree of breathlessness among patients with Chronic Obstructive Pulmonary Disease (COPD) in West Java Province, Indonesia. Methods: This was a quasi-experimental study with a pretest-posttest and no control group design. In total, 33 patients with COPD participated in this study using a consecutive sampling technique. The Modified Medical Research Council was used to measure the degree of breathlessness. A portable spirometer was used to assess Forced Expiratory Volume in one second (FEV1) and Forced Vital Capacity (FVC). Results: The Mean±SD age of the study subjects was 44.5±3.17 years; 54.4% of the study participants were male, with healthy a body mass index. Approximately 42.4% of the studied patients experienced the fourth degree of breathlessness before the intervention. There was a reduction in the Mean±SD score of breathlessness from 3.42±0.53 to 1.64±0.13 after the intervention (P=0.001). There were improvements in the breathing frequency (Mean±SD: 11.8±4.9 vs 9.5±1.6), oxygen saturation (93.39±3.20 vs 95.47±4.21), and FEV1/FVC (0.5±0.12 vs 0.3±0.45) in the study subjects. Discussion: It is expected for the hospital, educational institutions, nurses, and patients to be able to apply diaphragmatic breathing exercises as one form of nursing care measure. This is because it is proven effective to reduce the degree of breathlessness.
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Yin Shuen, C., N. Woon Leung, L. Man Chi, L. Chi Kwai, C. Ching Man, S. P. Kong, L. Pik Fan, and C. L. Leung. "AB1352-HPR SHARED CARE – AN ALTERNATIVE WAY TO COPE WITH INCREASING SERVICE DEMAND." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1964.1–1964. http://dx.doi.org/10.1136/annrheumdis-2020-eular.4381.
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Background:Rheumatic diseases are immune-mediated disorders that affect the musculoskeletal system, soft tissues, blood vessels and connective tissue. Patients with rheumatic diseases need regular follow up for disease and drug toxicity monitoring. To cope with the increasing service demand, the Division of Rheumatology in the United Christian Hospital developed and expanded the shared care service. In the conventional practice, patients have to been seen by rheumatologist for every visit while the shared care service involved follow up by rheumatologist and rheumatology nurse in alternate sessions.Objectives:1.To evaluate the effectiveness and safety of the shared cared service2To evaluate the effectiveness of reduction in workload of rheumatology clinicMethods:This is a retrospective study involving the period from 1/1/2019 to 31/12/2019. Patients who attended the rheumatology nurse clinic for shared care were recruited and reviewed. All patients were selected and referred by rheumatologists. Criteria for shared care included regular follow up in rheumatology clinic and stable clinical condition. The length of follow up is adjusted according to patient condition. Services provided by rheumatology nurse (RhN) included disease education, drug and disease monitoring, drug advice and referral to other professionals and community service as indicated. During each visit, patient’s vital signs, disease activity and laboratory results were assessed according to standard protocol. RhN will make discharge record to ensure continuity of care.Results:Totally 489 episodes of attendance to nurse led clinic were recruited. Majority (97.3%) were arthritis patients. Others included lupus, vasculitis, Sjogren’s syndrome and miscellaneous conditions. The length of follow up ranged from 3 weeks to 24 weeks and most of the patients were follow up between 8 to 16 weeks. Shared care patients included those with stable disease for interval monitoring, and patients for drug initiation and titration. The ratio for disease monitoring and drug monitoring are 41.3% and 58.7% respectively.For the 489 episodes of attendance, 10 (2%) episodes needed rheumatologist intervention and 8 (1.6%) cases need advancement of follow up. Problems that required doctor interventions and advance follow up mainly are suboptimal disease control requiring medication adjustment or musculoskeletal ultrasound investigation.178 (36.4%) episodes of nursing intervention were delivered, majority were medication advice (133, 27.2%). Reasons for nursing intervention included adverse drug reaction, abnormal investigation results, poor drug adherence and disease flare up. There were no emergency department attendance or admission related to rheumatic problems within one month of RhN follow up.Conclusion:The shared care service is smooth and can safely lengthen the follow-up intervals to reduce clinic visit burden in rheumatology clinic. RhN input also allowed prompt advice for steroid tapering and dose titration for disease specific medication for better disease control. Proper case selection and close collaboration between rheumatologist and rheumatology nurse is the key.Disclosure of Interests:None declared
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Strang, Susann, Josefin Fährn, Peter Strang, Agneta Ronstad, and Louise Danielsson. "Support to informal caregivers of patients with severe chronic obstructive pulmonary disease: a qualitative study of caregivers’ and professionals’ experiences in Swedish hospitals." BMJ Open 9, no. 8 (August 2019): e028720. http://dx.doi.org/10.1136/bmjopen-2018-028720.
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ObjectivesInformal caregivers of patients with chronic obstructive pulmonary disease (COPD) experience a heavy caregiver burden, but few studies have explored what support they need. The aim of this study was to describe perceptions of healthcare support to informal caregivers, both from the family caregiver’s and the staff’s perspective.DesignA qualitative interview study involving semi-structured interviews and analysed with content analysis.ParticipantsIn total, 54 participated: 36 informal caregivers of patients with severe (stage 3–4) COPD and 17 healthcare staff.ResultsTwo main themes emerged from the analysis: (1) Ambiguity impedes provision of support. Both caregivers and staff experienced ambiguity. The informal caregivers needed emotional, practical and informational support but talked about unclear expectations, while the staff described an uncertainty about their duties regarding the families. There were no routines to unburden the families. Moreover, language and cultural barriers hampered their efforts. (2) Knowledgeable and perceptive communication is key to support. Both caregivers and staff described positive experiences of dialogue. The dialogue may facilitate means to caregiver support and was a support in itself.ConclusionsOur findings suggest that strategies and routines for caregiver support, including communication skills among the staff, should be developed, to move toward the family perspective advocated in palliative- and nursing family care.
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Moore, Caroline, Gail Ewing, Carole Gardener, Patrick White, Peter Burge, Ravi Mahadeva, Sophie Howson, Sara Booth, Tom Ling, and Morag Farquhar. "Modifiable barriers to meeting care and support needs of patients with advanced chronic obstructive pulmonary disease (COPD) and their informal carers." BMJ Supportive & Palliative Care 6, no. 3 (September 2016): 399.3–400. http://dx.doi.org/10.1136/bmjspcare-2016-001204.41.
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Siouta, N., A. Heylen, B. Aertgeerts, P. Clement, W. Janssens, J. Van Cleemput, and J. Menten. "Quality of Life and Quality of Care in patients with advanced Chronic Heart Failure (CHF) and advanced Chronic Obstructive Pulmonary Disease (COPD): Implication for Palliative Care from a prospective observational study." Progress in Palliative Care 29, no. 1 (January 2, 2021): 11–19. http://dx.doi.org/10.1080/09699260.2020.1831248.
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Kendall, Marilyn, Susan Buckingham, Susie Ferguson, William MacNee, Aziz Sheikh, Patrick White, Allison Worth, Kirsty Boyd, Scott A. Murray, and Hilary Pinnock. "Exploring the concept of need in people with very severe chronic obstructive pulmonary disease: a qualitative study." BMJ Supportive & Palliative Care 8, no. 4 (August 26, 2015): 468–74. http://dx.doi.org/10.1136/bmjspcare-2015-000904.
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BackgroundDespite apparent unmet needs, people with chronic obstructive pulmonary disease (COPD) rarely ask for help. We explored the concept of need from the perspective of patients, their family carers and professionals.MethodsWe recruited inpatients at two National Health Service (NHS) Lothian hospitals to a structured, holistic review of care needs delivered at home by a respiratory nurse 4 weeks postdischarge. Using semistructured interviews and group discussions, review notes and field-notes we explored the views of patients, carers and professionals on perceptions of need and the actions requested. Data were analysed thematically using Bradshaw's classification of need.Results14 patients, 3 carers, 28 professionals provided 36 interviews and 2 discussion groups. Few needs were identified by our intervention and few actions planned. Professionals identified ‘normative’ needs some of which had been addressed during routine discharge planning. Other needs (physical/psychological limitations, social/financial concerns, existential issues) were ‘felt’ by patients and carers but articulated in response to the researcher's questions rather than actively ‘expressed’. Patients often did not wish any action to address the problems, preferring care from family members rather than formal agencies. Many spoke of the over-arching importance of retaining a sense of independence and autonomy, considering themselves as ageing rather than ill.ConclusionsIn contrast to professionally-defined ‘normative’ needs, patients rarely perceived themselves as needy, accepting their ‘felt’ needs as the result of a disability to which they had now adapted. Sensitive approaches that foster independence may enable patients to ‘express’ needs that are amenable to help without disturbing the adaptive equilibrium they have achieved.Trial registration numberNCT01650480.