Bove D G, Midtgaard J, Kaldan G, Overgaard D, Lomborg K
Department of Pulmonary & Infectious Diseases, Copenhagen University Hospital, Nordsjælland, Dyrehavevej 29, 3400 Hillerød, Denmark.
Institute of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark; The University Hospital Centre for Health Research, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
J Psychosom Res. 2017 Jul;98:71-77. doi: 10.1016/j.jpsychores.2017.05.013. Epub 2017 May 15.
To explore the patients' experiences of a minimal home-based psychoeducative intervention aimed at reducing symptoms of anxiety.
In a randomised controlled trial (RCT) we have shown that a minimal home-based and nurse-led psychoeducative intervention has a significant effect in reducing symptoms of anxiety and increasing mastery of dyspnoea in patients with advanced chronic obstructive pulmonary disease (COPD). However, we do not know if the intervention is perceived as meaningful and applicable in the everyday life of patients with advanced COPD.
We conducted a nested post-trial qualitative study. The study methodology was Interpretive Description as described by Thorne. The study was based on semi-structured interviews with twenty patients from the RCT intervention group i.g. home-living people with a diagnosis of advanced COPD and symptoms of anxiety.
The patients described that making anxiety visible makes it manageable and provides relief. The patients described a feeling of being alone with managing anxiety and dyspnea, and the only way to gain in control of their cognitions was to mobilise internal resources. The intervention was appreciated by patients because it strengthened their internal resources. Further, it was perceived as a relief that the intervention insisted on talking about anxiety and thereby invited patients to verbalise worries related to end-of-life.
This study offers knowledge to better understand the patients' experiences of a psychoeducative intervention. The intervention was perceived as comprehensible and applicable in the patients' everyday life and contributed to the patients' ability to self-manage their condition.
探讨患者对一项旨在减轻焦虑症状的最低限度家庭心理教育干预措施的体验。
在一项随机对照试验(RCT)中,我们已表明,由护士主导的最低限度家庭心理教育干预措施对减轻晚期慢性阻塞性肺疾病(COPD)患者的焦虑症状和提高呼吸困难控制能力具有显著效果。然而,我们并不清楚该干预措施在晚期COPD患者的日常生活中是否被认为有意义且适用。
我们进行了一项嵌套式试验后定性研究。研究方法采用了索恩所描述的诠释性描述。该研究基于对随机对照试验干预组的20名患者进行的半结构式访谈,即居家生活、被诊断为晚期COPD且有焦虑症状的患者。
患者表示,正视焦虑能使其得到控制并缓解。患者描述了在应对焦虑和呼吸困难时感到孤独的感觉,而获得认知控制的唯一方法是调动内部资源。患者对该干预措施表示赞赏,因为它增强了他们的内部资源。此外,该干预措施坚持谈论焦虑,从而促使患者说出与临终相关的担忧,这让患者感到宽慰。
本研究为更好地理解患者对心理教育干预措施的体验提供了知识。该干预措施在患者的日常生活中被认为是可理解且适用的,并有助于患者自我管理病情的能力。