REDUCTION OF HOSPITAL UTILIZATION IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A DISEASE-SPECIFIC SELF-MANAGEMENT INTERVENTION

2004 ◽  
Vol 24 (4) ◽  
pp. 282-283 ◽  
Author(s):  
J Bourbeau ◽  
M Julien ◽  
F Maltais ◽  
M Rouleau ◽  
A Beaupre ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Hospital Utilization ◽  
Self Management ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Management Intervention ◽  
Disease Specific

Exploring the interactional sphere of a systemic self-management intervention for chronic obstructive pulmonary disease (COPD)

2014 ◽  
Vol 3 (4) ◽  
pp. 291-304
Author(s):  
Ingeborg Farver-Vestergaard ◽  
Frances Early ◽  
Jonathan Fuld ◽  
Christina Gundgaard Pedersen
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Self Management ◽  
Chronic Obstructive ◽  
Management Support ◽  
Psychological Consequences ◽  
Obstructive Pulmonary Disease ◽  
Management Intervention ◽  
Management Interventions ◽  
Based Medicine

Patients with chronic obstructive pulmonary disease (COPD) face challenges in managing the physical and psychological consequences of the condition. Systemic self-management interventions based on the Wagner chronic care model seek to facilitate change in patient, healthcare professional (HCP) and healthcare system in order to support patients to self-manage their condition. Few studies have investigated the interactional sphere between patients and HCPs in the context of a systemic self-management intervention. The aim of the present study was to evaluate such an intervention and explore the discursive implications for self-management in COPD. Data were collected via interviews with patients and HCPs, observations of patient-provider interaction and document analysis of documents given to the patients to support self-management. An illustrative analytical model was developed on the basis of Willig’s discourse analysis guidelines. The findings suggested two different ways of talking about self-management – biomedical and patient-centred – that seemed to have implications for what speakers drawing on these discursive repertoires could say, do and experience in relation to self-management support and practice. Whilst the analytical method does not pass judgement on which discourse is ‘best’, results of this study show how the two identified discourses are oriented to different actions and positions, and highlight their relative strengths and limitations. The findings of the present study are relevant to the issue of how the ‘healthcare institution’, and evidence-based medicine as we know it, should be manifested – empirically and practically – in the future.

scholarly journals Reluctance of patients with chronic obstructive pulmonary disease in its early stages and their families to participate in a partnership-based self-management trial: A search for explanation

2017 ◽  
Vol 15 (3) ◽  
pp. 315-322 ◽  
Author(s):  
Helga Jónsdóttir ◽  
Thorbjörg Sóley Ingadóttir
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Family Member ◽  
Pulmonary Disease ◽  
Controlled Trial ◽  
Self Management ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Self Blame ◽  
Management Intervention ◽  
Quit Smoking

Recruitment, the process of accessing, screening, selecting and retaining participants for research remains a challenge. In a randomized controlled trial, partnership-based self-management intervention for patients who have chronic obstructive pulmonary disease (COPD) in its initial stages, and their families, a theoretical framework developed for patients with an advanced COPD and their families was modified and implemented in a primary care context. In contrast to recruitment to the original study where 4% decline participation, in this study 25% of the potential patients declined participation. Although participants were encouraged to bring a family member, only 25% of them did so. The main reason for not being accompanied by a family member was that patients did not want anybody accompany them. Those who had quit smoking were more often accompanied by a family member compared to those who smoked. Reviewing the literature, the most compelling explanations for non-participation are shame and self-blame due to smoking, and that potential participants may not have envisioned any benefits from participating since they might not have realized that they had COPD. An alternative recruitment process needs to embrace the situation that potential participants find themselves in and which takes account of the issues at stake.

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