Apps Lindsay D, Harrison Samantha L, Mitchell Katy E, Williams Johanna E A, Hudson Nicky, Singh Sally J
Centre for Exercise and Rehabilitation Science, Leicester, UK.
School of Applied Social Sciences, DeMontfort University, Leicester, UK.
ERJ Open Res. 2017 Oct 4;3(4). doi: 10.1183/23120541.00017-2017. eCollection 2017 Oct.
The aim of this study was to understand experiences of participation in a supported self-management programme for chronic obstructive pulmonary disease (COPD). There is a wealth of clinical trials examining the outcomes of self-management interventions for individuals with COPD, but current understanding regarding patients' perspectives of such complex interventions is limited. Further insight may help to tailor self-management interventions and maximise patient engagement. Semi-structured interviews were conducted with individuals participating in a self-management programme, SPACE for COPD. Interviews took place at 6 weeks and 6 months following the programme. Data were analysed at each time point using inductive thematic analysis, and subsequently re-examined together. 40 interviews were undertaken and four themes emerged from the analysis: perceptions of the programme; lifestyle changes; social support; and disrupting factors and barriers to maintaining routines. SPACE for COPD was acceptable to participants in this study. The importance of education and social support was emphasised at both time points studied, but there were challenges such as comorbidities, ill health of family members and limited maintenance of exercise behaviours over the longer term. Further consideration of the role of carers and partners may help to improve adherence to self-management programmes once healthcare professional support has stopped.
本研究的目的是了解参与慢性阻塞性肺疾病(COPD)支持性自我管理计划的体验。有大量临床试验研究了针对COPD患者的自我管理干预措施的效果,但目前对于患者对这类复杂干预措施的看法的了解有限。进一步深入了解可能有助于调整自我管理干预措施并最大限度地提高患者的参与度。对参与COPD自我管理计划“SPACE”的个体进行了半结构化访谈。访谈在该计划结束后的6周和6个月进行。每次访谈的数据都采用归纳主题分析法进行分析,随后一起重新审视。共进行了40次访谈,分析得出了四个主题:对该计划的看法;生活方式的改变;社会支持;以及维持日常活动的干扰因素和障碍。本研究中的参与者认为“SPACE”计划是可以接受的。在研究的两个时间点都强调了教育和社会支持的重要性,但存在一些挑战,如合并症、家庭成员健康状况不佳以及长期运动行为维持有限。一旦医疗专业人员的支持停止,进一步考虑照顾者和伴侣的作用可能有助于提高对自我管理计划的依从性。