Important, misunderstood, and challenging: a qualitative study of nurses' and allied health professionals' perceptions of implementing self-management for patients with COPD

Int J Chron Obstruct Pulmon Dis. 2015 Jun 3:10:1043-52. doi: 10.2147/COPD.S78670. eCollection 2015.

Abstract

Background: In light of the growing burden of COPD, there is increasing focus on the role of self-management for this population. Currently, self-management varies widely. Little is known either about nurses' and allied health professionals' (AHPs') understanding and provision of self-management in clinical practice. This study explores nurses' and AHPs' understanding and implementation of supported COPD self-management within routine clinical practice.

Materials and methods: Nurses and AHPs participated in face-to-face semistructured interviews to explore their understanding and provision of COPD self-management, as well as their perceptions of the challenges to providing such care. Purposive sampling was used to select participants from a range of professions working within primary, community, and secondary care settings. Three researchers independently analyzed each transcript using a thematic approach.

Results: A total of 14 participants were interviewed. Nurses and AHPs viewed self-management as an important aspect of COPD care, but often misunderstood what it involved, leading to variation in practice. A number of challenges to supporting self-management were identified, which related to lack of time, lack of insight regarding training needs, and assumptions regarding patients' perceived self-management abilities.

Conclusion: Nurses and AHPs delivering self-management require clear guidance, training in the use of effective self-management skills, and education that challenges their preconceptions regarding patients. The design of health care services also needs to consider the practical barriers to COPD self-management support for the implementation of such interventions to be successful.

Keywords: COPD; allied health professionals; interviews; nurses; qualitative; self-management.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Allied Health Personnel / psychology*
  • Attitude of Health Personnel*
  • Comprehension
  • Female
  • Health Behavior
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Interviews as Topic
  • Male
  • Nurses / psychology*
  • Patient Education as Topic
  • Perception*
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Disease, Chronic Obstructive / psychology
  • Pulmonary Disease, Chronic Obstructive / therapy*
  • Qualitative Research
  • Self Care*