GP, School of Primary and Allied Health Care.
School of Public Health and Preventive Medicine.
Br J Gen Pract. 2023 Feb 23;73(728):e186-e195. doi: 10.3399/BJGP.2022.0342. Print 2023 Mar.
Exacerbations are the strongest risk factor for future exacerbations for patients living with chronic obstructive pulmonary disease (COPD). The period immediately following exacerbation is a high-risk period for recurrence and hospital admission, and is a critical time to intervene. GPs are ideally positioned to deliver this care.
To explore perceptions of GPs regarding the care of patients following exacerbations of COPD and to identify factors affecting the provision of evidence-based care.
A descriptive qualitative study was undertaken involving semi-structured, in-depth interviews with Australian GPs who volunteered to participate following a national survey of general practice care for COPD patients following exacerbations.
Interviews were conducted via the Zoom video conference platform, which were audio-recorded and transcribed verbatim. QSR NVivo was used to support data management, coding, and inductive thematic analysis.
Eighteen GPs completed interviews. Six key themes were identified: 1) GPs' perceptions and knowledge in the management of COPD patients following exacerbation and admission to hospital; 2) pharmacological management; 3) consultation time; 4) communication between healthcare professionals; 5) access to other health services; and 6) patient compliance.
Delivery of post-exacerbation care to COPD patients is affected by GPs, patients, and health service-related factors. The care of COPD patients may be further improved by supporting GPs to overcome identified barriers.
对于患有慢性阻塞性肺疾病(COPD)的患者来说,加重是未来加重的最强风险因素。在加重后立即是复发和住院的高风险期,也是进行干预的关键时期。全科医生是提供这种护理的理想人选。
探讨全科医生对 COPD 加重后患者护理的看法,并确定影响提供循证护理的因素。
采用描述性定性研究,对澳大利亚全科医生进行了半结构化深入访谈,这些全科医生是在对 COPD 患者加重后接受一般实践护理的全国调查后自愿参加的。
通过 Zoom 视频会议平台进行访谈,录音并逐字转录。使用 QSR NVivo 支持数据管理、编码和归纳主题分析。
18 名全科医生完成了访谈。确定了 6 个关键主题:1)全科医生对 COPD 患者加重后和住院管理的看法和知识;2)药物治疗管理;3)咨询时间;4)医疗保健专业人员之间的沟通;5)获得其他卫生服务的机会;6)患者依从性。
COPD 患者加重后护理的提供受到全科医生、患者和卫生服务相关因素的影响。通过支持全科医生克服已确定的障碍,可以进一步改善 COPD 患者的护理。