About this project
COPD is increasing and takes medical service resources in pretension. That is why new methods need to improve caring in primary health care. COPD affects in a persons’ function in daily life. The treatment is in first stop smoking. Medical treatment is regarded without effect on the disease course of event but can, in best case, be symptom relieved. Earlier studies from hospitals specialist clinics have shown that multidisciplinary education within rehabilitation to patients with COPD has a good effect on patients physical and psychological health condition. Such studies we don’t have proved, as far as we know, have been done in primary health care once before.
The aim of this study is to investigate how nurse-led multidisciplinary COPD-rehabilitation in primary health care affect the function in daily life in patients with COPD and their next of kin and when patient education in rehabilitation takes place in group-settings. Further on investigates how asthma/COPD-nurses experience their education to this group of patients to get a basic knowledge to implement an improvement of caring.
Material and methods
The intention is to make both quantitative measurements and qualitative in-depth interviews to answer the different parts of question at issue.
The studies are completed with defending of the doctoral thesis Management of patients with Chronic Obstructive Pulmonary Disease in Primary Health Care - A study of a nurse-led multidisciplinary programme of pulmonary rehabilitation, 2011-11-18. The conclusion in this doctoral thesis, from patients and next of kin’s perspective, are that patients with COPD and their next of kin live in the shadow of fear and uncertainty despite the nurse-led multidisciplinary programme of pulmonary rehabilitation. New knowledge has been derived that a programme could both raise fear and give calmness. The participants had gotten help in managing life with COPD as patients or next of kin through the programme, but this does not seem to be enough. Patients might need more education and follow-up on an individual basis during and after the programme. Next of kin need more attention to their own needs and more education about COPD related to how to be of help, although they by the programme felt a shared responsibility with the PHC. New knowledge that also was derived in this thesis is that next of kin did not see COPD as the worst disease. Their problems were with the co-morbidity. Six weeks of a nurse-led multidisciplinary programme of pulmonary rehabilitation was shown to influence the decreasing of exacerbations but no difference between the intervention group and the control group were found in functional capacity and HRQoL. COPD nurses described that they wanted more support in their education to patients with COPD when they sometimes experienced insecurity.
Delstudie 1; Zakrisson AB, Hägglund D. The asthma/COPD nurses’ experience of educating patients with chronic obstructive pulmonary disease in pri-mary health care. Scand J Caring Sci 2010;24(1):147-55. Delstudie 2; Zakrisson, AB, Engfeldt, P, Hägglund D, Odencrants S, Hasselgren M, Arne M, Theander K. Nurse-led multidisciplinary programme for patients with COPD in Primary Health Care: a controlled trial. Prim Care Respir J 2011 Dec;20(4):427-33. Delstudie 3; Zakrisson AB, Theander K, Anderzén Carlsson A. Experiences among patients with COPD one year after attending a primary care nurse-led multidisciplinary programme. Submitted for publication. Delstudie 4; Zakrisson AB, Theander K, Anderzén Carlsson A. Next of kin’s experi-ence of living with a patient suffering from COPD two years after a nurse-led multidisciplinary programme of rehabilitation in primary health care settings. Submitted for publication.