Department of Respiratory Medicine, Odense University Hospital, Sdr. Boulevard 29 entrance 87-88, 5000, Odense C, Denmark.
Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Scand J Trauma Resusc Emerg Med. 2022 Feb 19;30(1):11. doi: 10.1186/s13049-022-00999-2.
In Denmark emergency medical technicians transport patients with acute COPD exacerbations to the nearest emergency department. From a clinical and economic perspective, this transport and assessment at the hospital may be inconvenient if the patient is immediately discharged from the emergency department. We established an emergency technical technicians point-of-care diagnostics and treatment program of patients with COPD with use of ultrasound and blood analysis. Patients' perspectives on treatment at home and sense of security are important to qualify clinical practice at home with patients with acute exacerbation.
To explore patient's and relatives' experience of treatment at home during emergency calls due to COPD in exacerbation and to investigate their attitude to avoid hospitalization as well as experience of stress during point-of-care diagnostics in their own home.
A qualitative study comprising semi-structured interviews with 16 patients carried out from April 1st, 2019 to March 31st, 2020 in Denmark. Data was analysed inspired by Malteruds' text condensation and informed by Critical Psychology with first person perspective focusing on the patient's views on point-of-care diagnostics and treatment of their COPD in acute exacerbation.
The interviews revealed that in order to ensure an experience of quality in the assessment and treatment of patients in their own homes, it was important that the ambulance staff showed great safety and experience in the use of the technical equipment and treatment of dyspnea. It was also of importance that the patients felt confident that their general practitioner followed up on the home treatment initiated.
Patients' perspectives showed that point-of-care diagnostics and treatment of acute COPD in exacerbation was considered a qualitative offer by the patients and their relatives. At the same time, it was crucial that the emergency medical technicians showed experience and safety in handling shortness of breath as well as the technical equipment.
Approved by the Danish Data Protection Agency Project-ID: 20/24845.
在丹麦，急救医疗技术员将急性 COPD 加重的患者送往最近的急诊室。从临床和经济角度来看，如果患者立即从急诊室出院，这种运输和在医院评估可能会不方便。我们建立了一个紧急技术人员在 COPD 患者床边的诊断和治疗计划，使用超声和血液分析。患者对在家中治疗的看法和安全感对于在临床实践中确定患有急性加重的患者在家中治疗的资格非常重要。
探讨患者和家属在因 COPD 加重而紧急呼叫时在家中接受治疗的经验，并调查他们避免住院的态度以及在自己家中进行床边诊断时的压力体验。
这是一项定性研究，包括对 2019 年 4 月 1 日至 2020 年 3 月 31 日期间丹麦的 16 名患者进行的半结构化访谈。数据分析受 Malteruds 的文本压缩启发，并受批判性心理学的启发，第一人称视角关注患者对 COPD 急性加重时床边诊断和治疗的看法。
访谈结果表明，为了确保患者在家中评估和治疗的体验质量，救护车工作人员在使用技术设备和治疗呼吸困难方面表现出极大的安全性和经验非常重要。同样重要的是，患者感到有信心他们的全科医生会跟进开始的家庭治疗。
患者的观点表明，床边诊断和治疗急性 COPD 加重被患者及其家属视为一种定性服务。同时，急救医疗技术员在处理呼吸困难以及技术设备方面表现出经验和安全性至关重要。
丹麦数据保护局批准项目-ID：20/24845。
