Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama, USA.
J Am Geriatr Soc. 2024 Nov;72(11):3346-3359. doi: 10.1111/jgs.19158. Epub 2024 Aug 31.
Identifying priority challenges of older adults with chronic obstructive pulmonary disease (COPD) is critical to designing interventions aimed at improving their well-being and independence.
To prioritize challenges of older adults with COPD and those who care for them to guide refinement of a telephonic nurse coach intervention for patients with COPD and their family caregivers (EPIC: Empowering People to Independence in COPD).
Multiphase study guided by Baltes Theory of Successful Aging and the 5Ms Framework: Phase 1: Nominal group technique (NGT), a structured process of prioritizing responses to a question through group consensus. Phase 2: Rapid qualitative analysis. Phase 3: Intervention mapping and refinement.
Ambulatory, virtual.
Older adults with COPD, family caregivers, clinic staff (nurses, respiratory therapists), clinicians (physicians, nurse practitioners), and health system leaders.
NGT sessions were conducted by constituency group with 37 participants (n = 7 patients, n = 6 family caregivers, n = 8 clinic staff, n = 9 clinicians, n = 7 health system leaders) (Phase 1). Participants generated 92 statements across five themes (Phase 2): (1) "Barriers to care", (2) "Family caregiver needs", (3) "Functional status and mobility issues", (4) "Illness understanding", and (5) "COPD care complexities". Supplemental oxygen challenges emerged as a critical problem, and prioritized challenges differed by group. Patients and clinic staff prioritized "Functional status and mobility issues", family caregivers prioritized "Family caregiver needs", and clinicians and health system leaders prioritized "COPD care complexities". Intervention mapping (Phase 3) guided EPIC refinement focused on meeting patient priorities of independence and mobility but accounting for all priorities.
Diverse constituency groups identified priority challenges for older adults with COPD. Functional status and mobility issues, particularly related to supplemental oxygen, emerged as patient prioritized challenges.
Patient-centered interventions for older adults with COPD must account for their prioritized functional and supplemental oxygen needs and explore diverse constituent perspectives to facilitate intervention enrichment.
确定患有慢性阻塞性肺疾病（COPD）的老年人的优先挑战对于设计旨在改善其幸福感和独立性的干预措施至关重要。
确定 COPD 老年患者及其照顾者的挑战，以指导针对 COPD 患者及其家庭照顾者的电话护士教练干预措施（EPIC：增强 COPD 患者的独立性）的完善。
多阶段研究，以巴尔特斯成功老龄化理论和 5Ms 框架为指导：第 1 阶段：名义群体技术（NGT），这是一种通过小组共识对问题的回答进行优先排序的结构化过程。第 2 阶段：快速定性分析。第 3 阶段：干预映射和细化。
门诊，虚拟。
COPD 老年患者、家庭照顾者、诊所工作人员（护士、呼吸治疗师）、临床医生（医生、护士从业者）和卫生系统领导人。
由利益相关者小组进行 NGT 会议，共有 37 名参与者（7 名患者、6 名家庭照顾者、8 名诊所工作人员、9 名临床医生、7 名卫生系统领导人）（第 1 阶段）。参与者提出了五个主题的 92 项声明（第 2 阶段）：（1）“护理障碍”，（2）“家庭照顾者需求”，（3）“功能状态和移动性问题”，（4）“疾病理解”和（5）“COPD 护理复杂性”。补充氧气挑战成为一个关键问题，并且不同组的优先事项不同。患者和诊所工作人员优先考虑“功能状态和移动性问题”，家庭照顾者优先考虑“家庭照顾者需求”，临床医生和卫生系统领导人优先考虑“COPD 护理复杂性”。干预映射（第 3 阶段）指导 EPIC 细化，重点关注满足患者对独立和移动性的优先事项，但同时考虑所有优先事项。
不同利益相关者群体确定了 COPD 老年患者的优先挑战。功能状态和移动性问题，特别是与补充氧气有关的问题，成为患者的优先挑战。
针对 COPD 老年患者的以患者为中心的干预措施必须考虑到他们的优先考虑的功能和补充氧气需求，并探索不同的构成观点，以促进干预措施的丰富。
