Cent Eur J Nurs Midw 2024, 15(3):1166-1176 | DOI: 10.15452/cejnm.2024.15.0016

Patients’ perspectives on a nurse led self-management intervention after acute exacerbation of COPD

Loris Uehlinger1, Daniela Händler-Schuster1,4,5, Christine Hübsch2,3, Christian F. Clarenbach2,3, Gabriela Schmid-Mohler2,3
1 Institute of Nursing, School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
2 Division of Pulmonology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
3 Centre of Clinical Nursing Science, University Hospital Zurich, Switzerland
4 UMIT TIROL – Private University of Health Sciences, Medical Informatics, and Technology, Department of Nursing Science and Gerontology, Institute of Nursing Science, Hall in Tyrol, Austria
5 Te Kura Tapuhi Hauora, School of Nursing, Midwifery, and Health Practice at Victoria University of Wellington Te Herenga Waka – Victoria University of Wellington – New Zealand

Aim:  Patients living with chronic obstructive pulmonary disease (COPD) are challenged with managing the medical, social, and emotional consequences of the disease. Self-management of the disease plays a major role in actively preventing a deterioration such as an acute exacerbation (AECOPD). The aim of this study was to explore patients’ perspectives on self-management, for both participants who received a complex multicomponent behavior-focused intervention (e.g., physical activity) after hospitalization (intervention group) and participants who did not (control group).

Design:  A qualitative descriptive study design was used.

Methods:  Semi-structured one-to-one interviews were conducted (n = 10). A newly implemented counselling program conducted by an Advanced Nursing Practice (ANP) care team was introduced as part of the study. Participants in the control group received standard treatment for hospitalized AECOPD, while the intervention group received counselling focused on patient self-management from the ANP care team over a 13-week period. Control and intervention group narratives were compared using framework analysis.

Results:  The predominant four topics in both groups were deducted from Lorig’s conceptualization of self-management. These were: the management of burdensome emotions, the management of life roles, the management of medical regimen and recommendations, and the perception of self-management needs. The participants in the intervention group reported that counselling by the ANP team helped motivate them to sustain physical activity. They also found it reassuring to have a contact person they could easily reach out to in case of any queries or uncertainties, which provided them with a sense of security.

Conclusion:  There is a need for support in several areas of self-management after hospitalization for AECOPD. The newly introduced nurse-led self-management support was immediately well-received. Indeed, all participants appreciated the contact with their respective health professionals.

Keywords: Advanced Practice Nursing, COPD, exacerbations, nursing, self-management

Received: March 13, 2024; Revised: August 7, 2024; Accepted: August 19, 2024; Published: September 10, 2024  Show citation

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Uehlinger L, Händler-Schuster D, Hübsch C, Clarenbach CF, Schmid-Mohler G. Patients’ perspectives on a nurse led self-management intervention after acute exacerbation of COPD. Central European Journal of Nursing and Midwifery. 2024;15(3):1166-1176. doi: 10.15452/cejnm.2024.15.0016.
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