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Management of patients with chronic obstructive pulmonary disease in primary health care: a study of a nurse-led multidisciplinary programme of pulmonary rehabilitation
Örebro universitet, Hälsoakademin.ORCID-id: 0000-0002-8370-8834
2011 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
Abstract [en]

The aim of this thesis was to modify and evaluate effects, as well as todescribe experiences of a nurse-led multidisciplinary programme of pulmonaryrehabilitation in primary health care for patients with chronicobstructive pulmonary disease (COPD) and their next of kin.Interviews were performed with 12 COPD nurses about their experiencesof patient education (I). Forty-nine patients participated in the interventiongroup and 54 in the control group in a quasi-experimentalstudy which investigated the effects of the programme on functional capacity,quality of life and exacerbation frequency during one year (II).Interviews were performed related to the experiences of 20 patients whohad participated in the six-week programme (III) and the experiences of20 next of kin to the patients that had participated (IV).The results showed that COPD nurses fluctuated between security andinsecurity in patient education and were in need of support, time, structureand collaboration to develop their patient education (I). In Study IIthere were no differences between the groups with regard to functionalcapacity and quality of life, but the number of exacerbations decreased inthe intervention group and increased in the control group (II). The patientsin study III had allowed themselves to live at their own pace followingthe programme but a constant fear was present in spite of the programme(III). Next of kin in Study IV had a life that remained overshadowedby illness but there were positive outcomes of the programme aslong as two years afterwards. The next of kin also had constant fear,however (IV).In conclusion, the six week programme brought about results in changingeveryday life. Nevertheless, all lived in the shadow of fear and uncertaintyin spite of the programme. More research is needed to address therequirements of COPD nurses, patients and next of kin.

sted, utgiver, år, opplag, sider
Örebro: Örebro universitet , 2011. , s. 82
Serie
Örebro Studies in Medicine, ISSN 1652-4063 ; 59
Emneord [en]
COPD, exacerbations, experiences, functional capacity, next of kin, nursing care, primary care, quality of life
HSV kategori
Forskningsprogram
Vårdvetenskap
Identifikatorer
URN: urn:nbn:se:oru:diva-15732ISBN: 978-91-7668-819-9 (tryckt)OAI: oai:DiVA.org:oru-15732DiVA, id: diva2:419692
Disputas
2011-11-18, Wilandersalen, Universitetssjukhuset, Örebro, 13:00
Opponent
Veileder
Tilgjengelig fra: 2011-05-27 Laget: 2011-05-27 Sist oppdatert: 2024-01-02bibliografisk kontrollert
Delarbeid
1. The asthma/COPD nurses’ experience of educating patients with chronic obstructive pulmonary disease in primary health care
Åpne denne publikasjonen i ny fane eller vindu >>The asthma/COPD nurses’ experience of educating patients with chronic obstructive pulmonary disease in primary health care
2010 (engelsk)Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, nr 1, s. 147-155Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

The number of patients with chronic obstructive pulmonary disease (COPD) is increasing. These patients need nursing care, including education in self-care, which has a positive effect on their physical and psychoemotional well-being. The aim of this study was to describe the experiences of asthma/COPD nurses' in primary health care (PHC) of educating patients with COPD. A descriptive, qualitative study was conducted, with interviews of 12 asthma/COPD nurses. The data were analysed using qualitative content analysis. The findings are presented in two themes: Theme 1, receiving support results in a feeling of security, which enables the development of patient education; and Theme 2, a lack of support results in a feeling of insecurity, which makes it difficult to develop patient education. The asthma/COPD nurses were individual orientated with individualization of care, but the patient's mood, the varying support of those around and the nurses' varying degrees of security affected the education. The conclusion is that the asthma/COPD nurses' experience of patient education fluctuated between insecurity and security. The nurses' feeling of insecurity in their patient education can be strengthened through support from colleagues and by increased knowledge in promoting the learning of others. Collaborative teamwork with a well-functioning asthma/COPD clinic in PHC can facilitate and improve patient services; these initiatives can enable the asthma/COPD nurses to reach their full potential.

sted, utgiver, år, opplag, sider
Wiley-Blackwell Publishing Inc., 2010
Emneord
chronic obstructive pulmonary disease, district nurse, nursing, patient education, primary health care, self-care
HSV kategori
Forskningsprogram
Vårdvetenskap
Identifikatorer
urn:nbn:se:oru:diva-20123 (URN)10.1111/j.1471-6712.2009.00698.x (DOI)000274389900019 ()2-s2.0-76549124728 (Scopus ID)
Tilgjengelig fra: 2011-10-19 Laget: 2011-10-19 Sist oppdatert: 2024-01-02bibliografisk kontrollert
2. Nurse-led multidisciplinary programme for patients with COPD in primary health care: a controlled trial
Åpne denne publikasjonen i ny fane eller vindu >>Nurse-led multidisciplinary programme for patients with COPD in primary health care: a controlled trial
Vise andre…
2011 (engelsk)Inngår i: Primary Care Respiratory Journal, ISSN 1471-4418, E-ISSN 1475-1534, Vol. 20, nr 4, s. 427-433Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

AIM:To investigate the effects of a nurse-led multidisciplinary programme (NMP) of pulmonary rehabilitation in primary health care with regard to functional capacity, quality of life (QoL), and exacerbations among patients with chronic obstructive pulmonary disease (COPD).

METHOD:A 1-year longitudinal study with a quasi-experimental design was undertaken in patients with COPD, 49 in the intervention group and 54 in the control group. Functional capacity was assessed using the 6-minute walking test, and quality of life (QoL) was assessed using the Clinical COPD Questionnaire. Exacerbations were calculated by examination of patient records.

RESULTS:No significant differences were found between the groups in functional capacity and QoL after 1 year. The exacerbations decreased in the intervention group (n = -0.2) and increased in the control group (n = 0.3) during the year after NMP. The mean difference of change in exacerbation frequency between the groups was statistically significant after one year (p=0.009).

CONCLUSIONS:The NMP in primary care produced a significant reduction in exacerbation frequency, but functional capacity and QoL were unchanged. More and larger studies are needed to evaluate potential benefits in functional capacity and QoL.

sted, utgiver, år, opplag, sider
The Primary Care Respiratory Society U K, 2011
Emneord
COPD, management, exacerbations, nurse, primary care, rehabilitation, pulmonary, quantitative
HSV kategori
Forskningsprogram
Vårdvetenskap
Identifikatorer
urn:nbn:se:oru:diva-20124 (URN)10.4104/pcrj.2011.00060 (DOI)000304279300021 ()21687920 (PubMedID)2-s2.0-85027925385 (Scopus ID)
Merknad

The authors are also affiliated to Family Medicine Research Centre, Örebro University, Sweden • Centre for Assessment of Medical Technology in Örebro, Sweden.

Tidskriften har upphört 2014

Tilgjengelig fra: 2011-10-19 Laget: 2011-10-19 Sist oppdatert: 2024-01-03bibliografisk kontrollert
3. Experiences among patients with COPD one year after attending a primary care nurse-led multidisciplinary programme
Åpne denne publikasjonen i ny fane eller vindu >>Experiences among patients with COPD one year after attending a primary care nurse-led multidisciplinary programme
(engelsk)Manuskript (preprint) (Annet vitenskapelig)
HSV kategori
Forskningsprogram
Vårdvetenskap
Identifikatorer
urn:nbn:se:oru:diva-20125 (URN)
Tilgjengelig fra: 2011-10-19 Laget: 2011-10-19 Sist oppdatert: 2024-01-02bibliografisk kontrollert
4. Next of kin’s experience of living with a patient suffering from COPD two years after a nurse-led multidisciplinary programme of pulmonary rehabilitation in primary health care settings
Åpne denne publikasjonen i ny fane eller vindu >>Next of kin’s experience of living with a patient suffering from COPD two years after a nurse-led multidisciplinary programme of pulmonary rehabilitation in primary health care settings
(engelsk)Manuskript (preprint) (Annet vitenskapelig)
HSV kategori
Forskningsprogram
Vårdvetenskap
Identifikatorer
urn:nbn:se:oru:diva-20126 (URN)
Tilgjengelig fra: 2011-10-19 Laget: 2011-10-19 Sist oppdatert: 2024-01-02bibliografisk kontrollert

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