Weldam Saskia W M, Lammers Jan-Willem J, Zwakman Marieke, Schuurmans Marieke J
Department of Respiratory Diseases, Division Heart & Lungs, University Medical Center Utrecht, PO Box85500, 3508 GA Utrecht, The Netherlands.
Department of Respiratory Diseases, Division Heart & Lungs, University Medical Center Utrecht, PO Box85500, 3508 GA Utrecht, The Netherlands.
Appl Nurs Res. 2017 Feb;33:85-92. doi: 10.1016/j.apnr.2016.10.010. Epub 2016 Oct 28.
The major challenges in Chronic Obstructive Pulmonary Disease (COPD) care are guiding a patient in daily living with the consequences of the disease, reducing the impact of symptoms and improving Health Related Quality of Life (HRQoL). The new nurse-led COPD-Guidance, Research on an Illness Perception (COPD-GRIP) intervention translates the evidence concerning illness perceptions and Health Related Quality of Life (HRQoL) into a practice nurse intervention. The aim is to explore the nurses' experiences with applying the new COPD-GRIP intervention.
An explanatory mixed-method study nested in a cluster randomized trial in primary care was conducted. Pre-intervention questionnaires were sent to all participating nurses (N=24) to identify expectations. Post-intervention questionnaires identified experiences after applying the intervention followed by two focus groups to further extend exploration of findings. Questionnaires were analyzed by descriptive analyses. To identify themes the audio-taped and transcribed focus groups were independently coded by two researchers.
The nurses described the intervention as a useful, structured and individualized tool to guide COPD patients in living with the consequences of COPD. Applying the intervention took less time than the nurses initially expected. The intervention enables to provide patient-centered care and to address patient needs. Barriers were encountered, especially in patients with a lower social economic status, in patients with a lower health literacy and in patients with other cultural backgrounds than the Dutch background.
Nurses perceived the COPD-GRIP intervention as a feasible, individualized tool. According to the nurses, the intervention is a valuable improvement in the care for COPD patients.
慢性阻塞性肺疾病（COPD）护理中的主要挑战在于指导患者应对疾病后果的日常生活，减轻症状影响并改善健康相关生活质量（HRQoL）。新的由护士主导的慢性阻塞性肺疾病 - 疾病认知指导与研究（COPD - GRIP）干预措施将有关疾病认知和健康相关生活质量（HRQoL）的证据转化为执业护士的干预措施。目的是探索护士应用新的COPD - GRIP干预措施的经验。
在一项初级保健中的整群随机试验中进行了解释性混合方法研究。在干预前向所有参与的护士（N = 24）发送问卷以确定期望。干预后问卷确定应用干预后的经验，随后进行两个焦点小组讨论以进一步扩展对结果的探索。问卷通过描述性分析进行分析。为了确定主题，由两名研究人员对录音和转录的焦点小组进行独立编码。
护士们将该干预措施描述为指导COPD患者应对COPD后果的有用、结构化且个性化的工具。应用该干预措施所花费的时间比护士最初预期的要少。该干预措施能够提供以患者为中心的护理并满足患者需求。遇到了一些障碍，特别是在社会经济地位较低的患者、健康素养较低的患者以及文化背景与荷兰背景不同的患者中。
护士认为COPD - GRIP干预措施是一种可行的、个性化的工具。根据护士的说法，该干预措施是COPD患者护理方面的一项有价值的改进。
