OBJECTIVES: To synthesise qualitative evidence on patient perceived benefits of nurse led self-management interventions for people with COPD. METHODS: A systematic review and qualitative synthesis was conducted using guidelines outlined by the Joanna Briggs Institute. Six electronic databases were searched using pre-defined keywords to identify qualitative and mixed methods English language studies published in any year. The included studies were selected by screening titles, abstracts and full-texts against inclusion and exclusion criteria established a priori. A quality review was undertaken using the Critical Skills Programme tool. A framework approach was used in data analysis and the coding structure was informed by categories of self-management outcomes identified in a previous review. RESULTS: Fourteen articles were included in the final review. Four key themes were identified from the original studies: Empowerment through new knowledge, Psychological well-being, Expanding social worlds and Increased physical activity. CONCLUSIONS: When provided with knowledge and support, patients' self-confidence and coping behaviour increased. Participants identified social and psychological support as key aspects of self-management interventions for enhancing well-being, yet some interventions contained neither element. Improved training in psychotherapeutic techniques could enable nurses to manage the anxiety and depression prevalent amongst COPD patients. Due to lower health literacy and social isolation, COPD patients may need intense self-management support from nurses, but this aspect of care is difficult to provide in routine appointments due to time constraints. Group-based exercise components of self-management programmes were favourably evaluated due to a perception of increased well-being and enhanced social interaction. The provision of group-based interventions could address social isolation faced by many patients. Future studies should focus on which features of physical activity programmes affect patient well-being as it is unclear as to what degree the social element confers benefit. Further research is also required to evaluate the benefits of computer-based self-management interventions for patients with COPD.
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