Gardener A Carole, Ewing Gail, Kuhn Isla, Farquhar Morag
Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Centre for Family Research, University of Cambridge, Cambridge, UK.
Int J Chron Obstruct Pulmon Dis. 2018 Mar 26;13:1021-1035. doi: 10.2147/COPD.S155622. eCollection 2018.
Understanding the breadth of patients' support needs is important for the delivery of person-centered care, particularly in progressive long-term conditions such as chronic obstructive pulmonary disease (COPD). Existing reviews identify important aspects of managing life with COPD with which patients may need support (support needs); however, none of these comprehensively outlines the full range of support needs that patients can experience. We therefore sought to systematically determine the full range of support needs for patients with COPD to inform development of an evidence-based tool to enable person-centered care.
We conducted a systematic search and narrative review of the literature. Medline (Ovid), EMBASE, PsycINFO, Cochrane Library, and CINAHL were systematically searched for papers which included data addressing key aspects of support need, as identified by patients with COPD. Relevant data were extracted, and a narrative analysis was conducted.
Thirty-one papers were included in the review, and the following 13 domains (broad areas) of support need were identified: 1) understanding COPD, 2) managing symptoms and medication, 3) healthy lifestyle, 4) managing feelings and worries, 5) living positively with COPD, 6) thinking about the future, 7) anxiety and depression, 8) practical support, 9) finance work and housing, 10) families and close relationships, 11) social and recreational life, 12) independence, and 13) navigating services. These 13 domains of support need were mapped to three of the four overarching categories of need commonly used in relevant national strategy documents (ie, physical, psychological, and social); however, support needs related to the fourth category (spiritual) were notably absent.
This review systematically identifies the comprehensive set of domains of support need for patients with COPD. The findings provide the evidence base for a tool to help patients identify and express their support needs, which underpins a proposed intervention to enable the delivery of person-centered care: the Support Needs Approach for Patients (SNAP).
了解患者广泛的支持需求对于提供以患者为中心的护理至关重要,尤其是在慢性阻塞性肺疾病(COPD)等进行性长期疾病中。现有综述确定了COPD患者在管理生活中可能需要支持的重要方面(支持需求);然而,这些综述均未全面概述患者可能经历的所有支持需求。因此,我们试图系统地确定COPD患者的所有支持需求,以为开发基于证据的工具提供信息,以实现以患者为中心的护理。
我们对文献进行了系统检索和叙述性综述。对Medline(Ovid)、EMBASE、PsycINFO、Cochrane图书馆和CINAHL进行了系统检索,以查找包含COPD患者确定的支持需求关键方面数据的论文。提取相关数据并进行叙述性分析。
该综述纳入了31篇论文,并确定了以下13个支持需求领域(广泛领域):1)了解COPD,2)管理症状和药物,3)健康生活方式,4)管理情绪和担忧,5)积极应对COPD生活,6)思考未来,7)焦虑和抑郁,8)实际支持,9)财务、工作和住房,10)家庭和亲密关系,11)社交和娱乐生活,12)独立性,13)服务导航。这13个支持需求领域被映射到相关国家战略文件中常用的四个总体需求类别中的三个(即身体、心理和社会);然而,与第四类(精神)相关的支持需求明显缺失。
本综述系统地确定了COPD患者支持需求的全面领域。研究结果为帮助患者识别和表达其支持需求的工具提供了证据基础,该工具是拟议的以实现以患者为中心的护理的干预措施的基础:患者支持需求方法(SNAP)。