The type of care depended on who the patient met: either a task-oriented nurse or an individual-oriented nurse. Therefore, nursing programmes should pay special attention to the support and guidance of new and inexperienced and task-oriented nurses. Healthcare planners should take into consideration the need for individualized care when organizing care and allocating resources for chronically ill people.
AimThe aim of this study was to describe inhaler use in primary health care patients with chronic obstructive pulmonary disease (COPD) and to categorize these patients into those making errors related to devices, those making errors related to inhalation technique and those making errors related to both.DesignObservational study.MethodsCOPD nurses used a checklist to assess the use of inhalers by patients with spirometry‐verified COPD (N = 183) from primary healthcare centres. The STROBE checklist has been used.ResultsThe mean age of the patients was 71 (SD 9) years. Almost half of them (45%) made at least one error; of these, 50% made errors related to devices, 31% made errors related to inhalation technique and 19% made errors related both to devices and to inhalation technique.
The theoretical model 'Patients trying to quit smoking' contributes to a better understanding of the pressure-filled mental states and destructive strategies experienced by some patients with COPD in the process of trying to quit. This better understanding can help nurses individualise counselling. Moreover, patients' own awareness of these states and strategies may facilitate their efforts to quit. The information in the model can also be used as a supplement to methods such as motivational interviewing (MI).
Aims and objective
To investigate the effects on the quality of care of the Patient Report Informing Self‐Management Support (PRISMS) form compared with usual care among patients with chronic obstructive pulmonary disease (COPD) consulting a COPD nurse in primary health care.
Background
Patients with COPD experience symptoms affecting their everyday lives, and there is a need for interventions in self‐management support. The delivery of chronic care in an organised, structured and planned manner can lead to more productive relationships between professionals and patients.
Design
A multicentre randomised controlled trial with a post‐test design, according to the CONSORT checklist, in one intervention group (n = 94) and one control group (n = 108).
Methods
In addition to usual care, the intervention group (n = 94) completed the PRISMS form to indicate areas where they wanted self‐management support before the consultation with the COPD nurse. This form comprises 17 items that patients with COPD commonly experience as problems. The control group received usual care (n = 108). The primary outcome was patients’ satisfaction with quality of care, assessed using the Quality from the Patient's Perspective (QPP) questionnaire. Means and (SD) are presented where applicable. Differences between the intervention and control group were analysed with Student's t test for independent groups for interval data, and the Mann–Whitney U test for ordinal data.
Results
Participants in the intervention group were more satisfied with the QPP domains “personal attention,” regarding both “perceived reality” (p = .021) and “subjective importance” (p = .012). The PRISMS form revealed “shortness of breath” as the most commonly experienced problem and the issue most desired to discuss.
Conclusion
The PRISMS form improved patient satisfaction with quality of care regarding personal attention, which is an important factor in patient participation and improving relationships and communication.
Relevance to clinical practice
The PRISMS form can be a useful tool in improving person‐centred care when delivering self‐management support.
Register Id
192691 at http://www.researchweb.org/is/en/sverige/project/192691.
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