Reilly Charles C, Bristowe Katherine, Roach Anna, Maddocks Matthew, Higginson Irene J
Dept of Physiotherapy, King's College Hospital, London, UK.
Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK.
ERJ Open Res. 2022 Feb 21;8(1). doi: 10.1183/23120541.00557-2021. eCollection 2022 Jan.
The burden of chronic breathlessness on individuals, family, society and health systems is significant, and set to increase exponentially with population ageing, complex multimorbidity and coronavirus disease 2019 (COVID-19)-related disability. Breathlessness support services are effective; however, reach and access are limited. Delivering online breathlessness interventions may build capacity and resilience within health systems to tackle chronic breathlessness through supported self-management. The aim of this study was to explore accessibility and willingness of patients with chronic breathlessness to use an internet-based breathlessness self-management intervention (SELF-BREATHE).
Semi-structured telephone interviews were conducted with adults living with advanced malignant and non-malignant disease and chronic breathlessness (July to November 2020). Interviews were analysed using conventional and summative content analysis.
25 patients (COPD: n=13; lung cancer: n=8; interstitial lung disease (ILD): n=3; bronchiectasis: n=1) were interviewed: 17 male, median (range) age 70 (47-86) years and Medical Research Council dyspnoea score 3 (2-5). 21 patients had internet access. Participants described greater use, acceptance and normalisation of the internet since the advent of the COVID-19 pandemic. They described multifaceted internet use: functional, self-investment (improving health and wellbeing) and social. The concept of SELF-BREATHE was highly valued, and most participants with internet access were willing to use it. In addition to technical limitations, personal choice and perceived value of the internet were important factors that underpinned readiness to use online resources.
These findings suggest that patients living with chronic breathlessness that have access to the internet would have the potential to benefit from the online SELF-BREATHE intervention, if given the opportunity.
慢性呼吸急促给个人、家庭、社会和卫生系统带来的负担十分巨大,且随着人口老龄化、复杂的多重疾病以及与2019冠状病毒病(COVID-19)相关的残疾问题,这一负担预计将呈指数级增长。呼吸急促支持服务是有效的;然而,其覆盖范围和可及性有限。提供在线呼吸急促干预措施可能会增强卫生系统的能力和恢复力,以便通过支持自我管理来应对慢性呼吸急促。本研究的目的是探讨慢性呼吸急促患者使用基于互联网的呼吸急促自我管理干预措施(SELF-BREATHE)的可及性和意愿。
对患有晚期恶性和非恶性疾病以及慢性呼吸急促的成年人进行了半结构化电话访谈(2020年7月至11月)。采用常规和总结性内容分析法对访谈进行分析。
共访谈了25名患者(慢性阻塞性肺疾病:n = 13;肺癌:n = 8;间质性肺疾病(ILD):n = 3;支气管扩张症:n = 1):17名男性,年龄中位数(范围)为70(47 - 86)岁,医学研究委员会呼吸困难评分为3(2 - 5)。21名患者可以上网。参与者表示自COVID-19大流行以来,对互联网的使用、接受度和常态化程度都有所提高。他们描述了互联网的多方面用途:功能性、自我投资(改善健康和幸福感)以及社交。SELF-BREATHE的概念受到高度重视,大多数有上网条件的参与者愿意使用它。除了技术限制外,个人选择和对互联网的认知价值是影响使用在线资源意愿的重要因素。
这些研究结果表明,如果有机会,能够上网的慢性呼吸急促患者有可能从在线SELF-BREATHE干预措施中受益。