Perspectives of patients and healthcare professionals on the impact of telemetrically supported patient self-management for chronic obstructive pulmonary disease (COPD): a qualitative study nested in the TELESCOT trial
نویسندگان
چکیده
Background: Early identification of exacerbations reduces hospital admissions and may slow disease progression. The TELESCOT randomised control trial based in Lothian, Scotland, is investigating the impact of a tele-monitoring service for COPD with the primary aim of reducing hospitalisation. Aim: The nested qualitative study explored the views of patients and professionals on models of telemetric service delivery and the impact on self-management. Method: We undertook semi-structured interviews with patient and professional participants at different time points in the TELESCOT COPD trial. Transcribed, coded data were analysed thematically. Interpretation was supported by multidisciplinary discussion. Results: 38 patients (47% male, mean age 67.5 years) and 32 healthcare professionals provided 70 interviews. Both patients and professionals considered that home tele-monitoring had the potential to reduce the risk of hospital admission. Patients generally appreciated being ‘watched over’ by the tele-monitoring, which gave them confidence to manage their own condition. They used tele-data to improving their understanding of COPD, determine their current state of health and influence decisions about their daily activities. Numerical data (e.g. oxygen saturations) were particularly valued. Changes in readings validated their decisions to adjust treatment or seek timely professional advice, and eased access to clinical care. Patients valued the personalised care provided by tele-monitoring staff familiar with their circumstances and state of health. Professionals emphasised the potential role of telemetry in encouraging prompt compliance with medically defined behaviours and attitudes, though some doubted whether it would be sufficient to overcome a perceived reluctance on the part of patients to acknowledge and take ownership of the disease. There was also a concern that ‘fixation’ on monitoring physiological parameters (especially oxygen saturation levels), promoted a medical model of the disease and might increase dependence on services in some patients. The GPs and community nursing or physiotherapy teams who provided the supporting services emphasised the importance of ‘knowing the patient’ and ‘knowing what’s normal for the individual’ in using their clinical skills to interpret incoming tele-monitoring data. Conclusion: Enthusiasm for tele-monitoring as a means of facilitating self-management and thereby reducing admissions is tempered by concerns about increased medicalisation and dependence on support services. Tele-monitoring provides data which can be used to support
منابع مشابه
Health-Related Quality of Life and Related Factors in Patients With Chronic Obstructive Pulmonary Disease
Background: Chronic Obstructive Pulmonary Disease (COPD) affects different aspects of patients’ life. By awareness of the quality of life and related factors of each patient, nurses can plan for and do proper care. So the present study was performed to evaluate health-related quality of life and related factors in patients with COPD. Methods: This study is a cross-sectional descriptive r...
متن کاملThe Effects of the Home-Based Self-Care Program Follow-Up on Re-Hospitalization Frequency and Quality of Life in Patients With Chronic Obstructive Pulmonary Disease
Background: Chronic Obstructive Pulmonary Disease (COPD) impacts the quality of life of the affected patients. The present study aimed to determine the effects of home-based self-care program follow-up on re-hospitalization frequency and quality of life in COPD patients. Methods: This quasi-experimental study was performed on 44 COPD patients at Masih Daneshvari Hospital in Tehran City, Iran, ...
متن کاملبررسی تأثیر برنامه خودمدیریتی مبتنی بر مدل 5A بر شدت خستگی و تنگی نفس بیماران مبتلا به بیماری مزمن انسدادی ریه
Background & Aim: Exacerbation of the symptoms among patients with chronic obstructive pulmonary disease is a part of the disease's cycle . Despite having medical treatments, most patients experience severe degrees of dyspnea. Self-management programs can help relieving the symptoms. T his study aimed to assess the effect of a self-management program on dyspnea and fatigue severity in patient...
متن کاملThe correlation between death anxieties with self-care in elderly patients with chronic obstructive pulmonary disease referring to masih daneshvari hospital, 2018.
Introduction: In elderly patients, the prevalence of chronic diseases, including chronic obstructive pulmonary disease, is increased. COPD causes many problems, including dyspnea, fatigue, depression, malnutrition and limitation in daily activities and death anxiety among patients that can affect their self-care. Method:This study considered as a descriptive-correlation study in 128 elderly wi...
متن کاملStatins and Pulmonary Hypertension in Chronic Obstructive Lung Disease
Chronic obstructive lung disease (COPD) is a chronic multisystem disease with a considerable burden. One of its most common complications is pulmonary artery hypertension (PAH). It has been demonstrated that the development of PAH is correlated with decreased quality of life and survival. Different medications have been proposed for the treatment of PAH, among which one can name statins. Howeve...
متن کامل