Psychosocial issues need more attention in COPD self-management education

Abstract

Objective: To find out how regularly the contents of patient education regarded as essential for COPD patients' self-management are provided by healthcare professionals in specialised healthcare (SHC) and primary healthcare (PHC) in Finland. Design: A cross-sectional study based on an e-questionnaire with 42 items on the content of self-management education of COPD patients. Setting: The study sample included all public SHC units with pulmonary outpatient clinics (n ¼ 29) and nine out of 160 health centres in Finland. Subjects: 83 doctors and 162 nurses. Main outcome measures: The respondents' answers on how regularly they included the contents regarded as essential for COPD patients' self-management in their education of COPD patients. Results: COPD patients were educated regularly on medical issues regarding COPD treatment, such as smoking cessation, exercise and pharmacological treatment. However, issues vital for coping with the disease, such as psychological well-being, stress management or fatigue, were often ignored. Patient education in SHC seemed to be more systematic than education in PHC. The education provided by the asthma/COPD nurses (n ¼ 70) was more systematic than the education provided by the other nurses (n ¼ 84). Conclusion: Healthcare professionals' continuous education should cover not only the medical but also the psychosocial aspects of coping with COPD. The role of doctors and nurses should be considered to ensure that there is no gap in COPD patients' education. Training asthma/COPD nurses and promoting specialised nurse-led asthma/COPD clinics in primary care could be beneficial while improving practices of patient education that enhance patients' ability to cope with the disease. KEY POINTS Issues vital for coping with chronic obstructive pulmonary disease (COPD), such as psychological well-being, stress and fatigue, are irregularly included in self-management education both in primary and specialised healthcare. Patient education provided by asthma/COPD nurses is more regular than patient education provided by other nurses. The distribution of work between doctors and nurses should be considered to ensure that there is no gap in COPD patients' education.

The information needs of people with COPD—The holistic approach with special reference to gender and time since diagnosis

“…The items were developed for this study using previous systematic reviews (Stoilkova et al., 2013 ; Tan et al., 2012 ), a questionnaire (Bristol COPD knowledge questionnaire (BCKQ); White et al., 2006 ), clinical pathways (NICE, 2016 ) and the Finnish guidelines for COPD management (Kankaanranta et al., 2015 ). Moreover, a previous study of healthcare professionals’ perceptions of counselling was used due to the holistic approach of the questionnaire employed in that study (Siltanen et al., 2020 ).…”

Educational Processes for Health and Disease Self-Management in Public Health: A Systematic Review

“…According to the SIGN checklist, 18 of the studies [ 7 , 20 , 28 , 30 , 31 , 33 , 35 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 49 , 55 ] were rated “high quality” and 17 studies were “acceptable quality” [ 5 , 6 , 15 , 19 , 29 , 34 , 36 , 46 , 47 , 48 , 50 , 51 , 52 , 53 , 54 , 56 ]. Although the studies were rated as being high and acceptable quality, for sample selection random assignment was used and no detailed description of the procedure was provided.…”

“…Other health education initiatives have reflected on the role of health education professionals to ensure that there are no gaps in access to educational programs [ 18 ]. Furthermore, it is considered that the training processes of health professionals should be continuous and cover not only the clinical or physical aspects, but also the psychosocial aspects of a population [ 19 ]. In this regard, health education should be provided holistically by various professionals who have both updated knowledge and adequate skills.…”

Exploration of the feasibility to combine patients with chronic obstructive pulmonary disease and chronic heart failure in self-management groups with focus on exercise self-efficacy

“…Most patients in our study reported symptoms of depression and anxiety under the level that could indicate a diagnosis of depression or anxiety disorder, but it seems that even symptoms at this low level are negatively associated with the patient’s self-efficacy. A recent study showed that issues like psychological well-being, stress and fatigue often are underemphasized in self-management education [ 34 ]. Discussing these issues and supporting the patients in finding strategies will possibly facilitate rehabilitation efforts.…”