Background: Qualitative research provides real-life information on patients’ condition and facilitates informed design of future clinical studies. Objective: We used Online Communities as a qualitative research tool to evaluate the effect of cough and mucus on COPD patients. Methods: Two 2-week Online Communities were run in parallel in the UK and in the USA, including COPD patients with persistent cough and excessive mucus. Patients anonymously posted their responses to pre-assigned tasks, supervised and guided by a trained moderator. Five themes around the impact of cough and mucus were explored with new questions posted every 2–3 days. On the final day, high-level conclusions were shared with patients for feedback. Data were analyzed following the principles of grounded theory. Results: Twenty COPD patients (UK, n=10; USA, n=10) participated in the Online Communities. We found that cough and mucus disrupted COPD patients’ lives at functional, emotional, social and economic levels. Patients created daily rituals and adjusted their lifestyle to cope with the impact of these symptoms. Patients identified themselves with our conclusions and saw the Online Community as an effective forum to share their experiences. Conclusion: Findings of our study add to the body of evidence on the negative impact of COPD symptoms and unmet needs of these patients.
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.
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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