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

• Published in: International journal of chronic obstructive pulmonary disease 2015-01, Vol.10 (Issue 1), p.1043-1052
• Main Authors: Young, Hannah M L, Apps, Lindsay D, Harrison, Samantha L, Johnson-Warrington, Vicki L, Hudson, Nicky, Singh, Sally J
• Format: Article
• Language: English
• Subjects: Allied health personnel; Allied Health Personnel - psychology; Analysis; Attitude of Health Personnel; Care and treatment; Chronic illnesses; Chronic obstructive lung disease; Chronic obstructive pulmonary disease; Collaboration; Comprehension; Data analysis; Diagnosis; Education; Female; Health Behavior; Health Knowledge, Attitudes, Practice; Health services utilization; Humans; Interviews; Interviews as Topic; Male; Managerial skills; Medical personnel; Methods; Nurses; Nurses - psychology; Original Research; Patient Education as Topic; Patients; Perception; Perceptions; Practice; Primary care; Professional ethics; Professionals; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - psychology; Pulmonary Disease, Chronic Obstructive - therapy; Qualitative Research; R&D; Research & development; Self Care; Self care (Health)
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S78670

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. 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. 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. 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.