Aims and objectives
To explore the experiences of chronic obstructive pulmonary disease (COPD) amongst individuals who have a high frequency of presentations to the Emergency Department and their carers.
Background
Patients with COPD are amongst the most frequent attenders in the Emergency Department despite the chronic nature of their condition. Good self‐management has previously been identified as a key to maintaining health and reducing COPD exacerbations. There has been limited investigation of those with COPD who frequently attend the Emergency Department.
Design
Descriptive qualitative phase of a mixed methods study.
Methods
Individuals who had attended an Emergency Department within a single health district at least three times in the previous year for COPD were invited to participate in semistructured face‐to‐face interviews. A total of 19 individuals consented to participate, of whom 12 were male. Half of the interviews included both those with COPD and carers. Data were audio‐recorded and transcribed, before being analysed using thematic analysis.
Results
Five main themes emerged from the data, namely (i) a sense of grief, loss and guilt, yet hope for the future; (ii) the impact on carers; (iii) the end point of self‐management; (iv) the healthcare experience; and (v) the primary care experience.
Conclusion
The experience of individuals with COPD who frequently present to the Emergency Department and their carers highlights the complexity of living with this disease. Providing effective intervention to manage exacerbation requires an understanding of the issues that are faced by patients and their carers. Clear systems and skills for sharing information are essential to decrease avoidable use of the Emergency Department.
If effective, the trial will provide a model for both upper limb and lower limb exercise programs that can be performed at home and implemented at scale to community-dwelling older adults.
Young people entering custody have poor oral health, with those from geographically remote areas without water fluoridation at highest risk. The incarceration period is an opportunity for oral health improvements in these young people through access to dental treatment services. Better triaging systems are needed to identify those of greatest priority, and prevention services are needed.
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