Managing chronic obstructive pulmonary disease in the community setting

Higginson, Ray; Parry, Andy

doi:10.12968/bjcn.2018.23.1.6

Cited by 7 publications

(6 citation statements)

References 17 publications

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“…A lack of sufficient education in COPD is a challenge in long-term care settings [ 4 ], while improved patient outcomes have been shown when nurses in such settings have been specially trained for respiratory diseases [ 17 ]. Higginson and Parry [ 18 ] suggest that opportunity should be given to increase respiratory competence to improve patient outcomes and decrease the risk for hospital admissions. This suggestion is supported by an official policy statement by the American Thoracic Society and the European Respiratory Society [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…This suggestion is supported by an official policy statement by the American Thoracic Society and the European Respiratory Society [ 19 ]. The responsibility of supporting and increasing the competence of healthcare professionals lies partly on the healthcare professionals themselves, but particularly with the management in health organisations and educational institutions [ 18 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

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Groping around in the dark for adequate COPD management: a qualitative study on experiences in long-term care

Lundell

Pesola

Nyberg

et al. 2020

BMC Health Serv Res

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Background Chronic obstructive pulmonary disease (COPD) is one of the most common and deadliest chronic diseases worldwide. Since COPD is a chronic and progressive disease, treatment is necessary throughout life. For people with COPD who cannot live independently, long-term care facilities are often required. However, knowledge is very limited about aspects of importance for effective COPD management in these settings in accordance with current treatment guidelines. The aim of this study was to explore aspects of importance in long-term care facilities for providing interventions according to treatment guidelines for people with COPD, from the perspective of healthcare professionals, in an effort to prove novel knowledge that could be used to facilitate implementation of treatment guidelines in these settings. Methods A qualitative study was performed in northern Sweden. In Sweden, municipalities are responsible for providing long-term care. Interviews with 36 healthcare professionals (nurses, physiotherapists, occupational therapists and dieticians) in municipal healthcare were conducted and analysed using qualitative content analysis with triangulation by the authors. Results The overarching theme that emerged from the analysis was Groping around in the dark for adequate COPD management. This represents healthcare professionals’ experiences of working with a complex diagnosis somewhat overlooked in the municipal healthcare, an underdog in the healthcare system. The groping around in the dark theme further represents the healthcare professionals’ lack of COPD-related competence, lack of interprofessional collaboration, and insufficient communication with the county council. The fragile group of people with COPD and their relatives were considered in need of support adapted to their context, but routines and resources for COPD management were limited. This lack of routines and resources also resulted in professionals being pragmatic and adopting short-term solutions without focusing on specific needs related to the diagnosis. Conclusions The COPD management in long-term care settings showed several insufficiencies, indicating a large gap between clinical practice and treatment guidelines for COPD. It is crucial to improve COPD management in long-term care settings. Consequently, several actions are needed, such as increasing professional competence, establishing new routines, acknowledging and making COPD a higher priority, as well as adapting treatment guidelines to the context.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Groping around in the dark for adequate COPD management: a qualitative study on experiences in long-term care

Lundell

Pesola

Nyberg

et al. 2020

BMC Health Serv Res

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“…This article analyzed the age, smoking, obstructive pulmonary disease [7], diabetes mellitus, cardiac function classification, liver function classification, renal function classification, anesthesia method, anesthesia time, intraoperative perfusion volume and other risk factors. The results showed that the independent influencing factors of pulmonary infection after gynecological surgery were as follows:…”

Section: Causes Of Pulmonary Infection After Operationmentioning

confidence: 99%

Influence of Nursing Intervention on Postoperative Pulmonary Infection Rate in Obstetrics and Gynecology Operating Room

2021

IJFM

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Clinical medical technology is also in continuous development; surgical treatment technology in the field of clinical medicine is more and more skilled and common. Compared with traditional drug therapy, surgical treatment has more prominent effect on treatment effect, quick effect and short treatment time. Surgical treatment has become one of the preferred treatment methods for many diseases. However, although surgical treatment is effective for the treatment of diseases, there are also great risks, such as postoperative pulmonary infection. In this paper, we mainly discuss the influence of nursing intervention on pulmonary infection rate of patients in obstetrics and Gynecology operating room. From 2017.10 to 2019.10, 140 patients were selected and randomly divided into intervention group and intervention group, with 70 patients in each group. The traditional group was given routine nursing measures, while the intervention group was given special nursing intervention in the operating room in addition to routine nursing. The pulmonary infection rate, physiological stress index, inflammatory index, incidence of postoperative complications and satisfaction of nursing service quality were compared between the two groups. Finally, we found that the incidence of pulmonary infection in the intervention group was 2.86%, while that in the traditional group was 14.29%. The physiological stress indexes of intervention group were lower than those of intervention group except fasting blood glucose. The inflammatory indexes of the intervention group were also lower than those of the traditional group. The satisfaction rate was 98.6% and 85.8%, the difference between the two groups was statistically significant. Therefore, we can see that the operating room nursing intervention can effectively reduce the incidence of postoperative pulmonary infection and inflammatory indicators in patients with gynecological and obstetric surgery. In addition to the operation of Obstetrics and Gynecology, it also plays a positive role in improving the satisfaction of patients.

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“…Care for people with COPD can be managed effectively in the community by general practitioners either independently or collaboratively with respiratory specialists providing outpatient care and through referral to community pulmonary rehabilitation [ 18 ]. The experience of care in these settings can influence ability to self-manage COPD and is important for reducing the need for acute and inpatient hospital services [ 12 , 19 ]. A key care objective is to improve quality of life [ 20 ], by supporting patients with COPD to self-manage their condition and offer assistance through appropriate referral where appropriate [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Healthcare experiences of adults with COPD across community care settings: a meta-ethnography

Madawala

Osadnik²,

Warren³

et al. 2022

ERJ Open Res

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BackgroundStudies investigating lived experiences of patients with COPD raise important concerns about interactions with healthcare professionals. Patients often describe feelings of guilt and shame associated with their COPD and may experience stigma and poor patient experience of care.Aim/ObjectivesTo systematically scope and synthesise findings from peer-reviewed qualitative studies describing healthcare experiences of patients living with COPD across community care settings.MethodsA meta-ethnography was undertaken. Database searches were performed in Ovid MEDLINE, PsychINFO, Ovid Emcare, CINAHL Plus and Sociological Abstracts. Eligible qualitative studies were included. Study screening and data extraction was performed by two independent reviewers. A ‘line-of-argument’ synthesis and deductive and inductive analysis was used to identify key themes, where the deductive element aligned to Wong and Haggerty's six key dimensions of patient experiences [1].ResultsData from 23 studies were included. Experiences and their meaning to patients were explored within the context of six domains of patient experience including access, interpersonal communication, continuity and coordination, comprehensiveness and trust. Inductive coding revealed emotion, stigma, identity and vulnerability shaped healthcare experiences of adults with COPD.ImplicationsExperiences often fell short of what was expected and needed in community settings. Adopting strategies to improve experiences of care in the community can be expected to improve self-management and contribute to improved health outcomes and quality of life. These strategies should take account of vulnerability, stigma and emotions such as guilt and blame that are potent affective drivers of the experience of care for patients with COPD.

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Managing chronic obstructive pulmonary disease in the community setting

Cited by 7 publications

References 17 publications

Groping around in the dark for adequate COPD management: a qualitative study on experiences in long-term care

Groping around in the dark for adequate COPD management: a qualitative study on experiences in long-term care

Influence of Nursing Intervention on Postoperative Pulmonary Infection Rate in Obstetrics and Gynecology Operating Room

Healthcare experiences of adults with COPD across community care settings: a meta-ethnography

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