School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.
Gold Coast University Hospital, Southport, Queensland, Australia.
Int J Chron Obstruct Pulmon Dis. 2022 Aug 23;17:1929-1942. doi: 10.2147/COPD.S366412. eCollection 2022.
Many people with chronic obstructive pulmonary disease (COPD) feel overburdened with the treatment and management of their illness. Although research has begun to shed light on how COPD patients experience treatment burden, most of what we know is limited to personal experiences of patients. The aim of this study is to identify and prioritise areas of treatment burden that should be discussed during the clinical encounter from the perspectives of COPD patients, carers, and respiratory physicians.
Data were collected from participants using the nominal group technique. Five nominal group sessions were conducted in total (n = 31); three sessions with patients (n = 18), one with carers (n = 7) and another with respiratory physicians (pulmonologists or chest physicians) (n = 6). Each session was recorded and analyzed using thematic analysis.
Going beyond understanding patients' and carers' experiences of treatment burden, this study offers a practical viewpoint of what should be discussed in a clinical encounter. Each group of participants contextualized treatment burden issues for discussion from their own perspectives. There was strong agreement, however, across the groups that difficulties accessing healthcare, lack of education and information, and worry about COPD treatment and prognosis were the most important treatment burden priorities for discussion.
Understanding and creating opportunities to discuss these issues in a clinical encounter is important in not only reducing treatment burden but also improving health outcomes and quality of life for COPD patients and their carers.
许多慢性阻塞性肺疾病（COPD）患者感到在治疗和管理疾病方面负担过重。尽管已经开始研究 COPD 患者如何体验治疗负担，但我们所知道的大多数信息仅限于患者的个人经历。本研究旨在从 COPD 患者、照顾者和呼吸科医生的角度确定和优先考虑在临床就诊期间应讨论的治疗负担领域。
使用名义小组技术从参与者那里收集数据。总共进行了五次名义小组会议（n=31）；三次与患者（n=18）、一次与照顾者（n=7）和另一次与呼吸科医生（肺科医生或胸科医生）（n=6）进行。每个会议都进行了记录，并使用主题分析进行了分析。
除了了解患者和照顾者对治疗负担的体验外，本研究还从实践的角度提供了在临床就诊中应讨论的内容。每组参与者都从自己的角度对治疗负担问题进行了背景化讨论。然而，各组之间存在强烈的共识，即难以获得医疗保健、缺乏教育和信息、以及对 COPD 治疗和预后的担忧是讨论治疗负担的最重要优先事项。
在临床就诊中理解和创造讨论这些问题的机会不仅可以减轻治疗负担，而且可以改善 COPD 患者及其照顾者的健康结果和生活质量。
