Machado Ana, Almeida Sara, Burtin Chris, Marques Alda
Institute of Biomedicine, University of Aveiro, Aveiro, Portugal.
Department of Medical Sciences, University of Aveiro, Aveiro, Portugal.
Chronic Obstr Pulm Dis. 2022 Jul 29;9(3):336-348. doi: 10.15326/jcopdf.2022.0283.
Acute exacerbations of chronic obstructive pulmonary disease (AECOPDs) have a negative impact on health status and disease progression, but their clinical presentation is heterogenous. A comprehensive understanding of individuals' experiences during an AECOPD is needed to develop person-centered interventions, such as pulmonary rehabilitation (PR). This study aimed to explore people's experiences during mild to moderate AECOPDs, and their thoughts on PR during this period.
Short, semi-structured interviews were conducted with people with mild to moderate AECOPDs treated on an outpatient basis within 48 hours of the diagnosis. Interviews were audio recorded, transcribed, and analyzed by deductive thematic analysis using the Web Qualitative Data Analysis software.
Eleven people with AECOPDs (9 male, 67±10 years, forced expiratory volume in 1 second 41±16%predicted) participated. Four themes and 17 subthemes were identified: impact of an AECOPD (symptoms, physiological changes, limitations in activities of daily living, social constraints, psychological and emotional challenges, family disturbances); dealing with an AECOPD, ([not] depending on others, planning and compensation strategies); main needs during an AECOPD (breathe better, feel less tired, get rid of sputum, be able to walk); and (un)certainty about PR (lack of knowledge, getting better, exercises, design and timing, trust in health professionals).
AECOPDs, even when not requiring hospital admission, have a huge negative impact on people's lives. Individuals' thoughts about PR reflect the need to raise awareness for this intervention during AECOPDs. This study provides a foundation for the development of meaningful person-centered interventions during AECOPDs.
慢性阻塞性肺疾病急性加重(AECOPD)对健康状况和疾病进展有负面影响,但其临床表现具有异质性。为了制定以患者为中心的干预措施,如肺康复(PR),需要全面了解个体在AECOPD期间的经历。本研究旨在探讨轻度至中度AECOPD患者的经历,以及他们在此期间对PR的看法。
对在诊断后48小时内接受门诊治疗的轻度至中度AECOPD患者进行简短的半结构式访谈。访谈进行录音、转录,并使用网络定性数据分析软件通过演绎主题分析进行分析。
11名AECOPD患者(9名男性,67±10岁,1秒用力呼气量为预测值的41±16%)参与了研究。确定了四个主题和17个子主题:AECOPD的影响(症状、生理变化、日常生活活动受限、社会限制、心理和情感挑战、家庭干扰);应对AECOPD([不]依赖他人、计划和补偿策略);AECOPD期间的主要需求(呼吸更顺畅、感觉不那么疲惫、咳出痰液、能够行走);以及对PR的(不)确定性(缺乏知识、病情好转、锻炼、设计和时间安排、对医护人员的信任)。
AECOPD即使不需要住院治疗,也会对人们的生活产生巨大负面影响。个体对PR的看法反映了在AECOPD期间提高对这种干预措施认识的必要性。本研究为在AECOPD期间制定有意义的以患者为中心的干预措施奠定了基础。