Participatory action research: A strategy for improving self-care management in chronic obstructive pulmonary disease patients

2016 ◽  
Vol 14 (3) ◽  
pp. 240-256 ◽  
Author(s):  
J Miguel Padilha ◽  
Artur P Sousa ◽  
Filipe M Pereira
2021 ◽  
pp. 026921632110289
Author(s):  
Tanja Fusi-Schmidhauser ◽  
Katherine Froggatt ◽  
Nancy Preston

Background: Chronic obstructive pulmonary disease (COPD) is a life-limiting condition with palliative care needs. Despite increasing awareness about the role palliative care can play in care provision for patients with advanced COPD, integration in standard care remains underdeveloped. The unpredictability of the disease progression and misconceptions about palliative care being equivalent to end-of-life care often prevent a timely integrated approach in advanced COPD. Aim: To identify practices designed to increase integration of palliative care in the management of patients with advanced COPD in a respiratory service in Southern Switzerland. Design: A participatory action research approach was chosen and key stakeholders were involved to develop new knowledge and practices, supported by a Theory of Change framework. Data from each cycle and retrospective analysis at the end of the whole research were analysed using thematic analysis. Setting/participants: Five action research cycles with seven healthcare professionals working in palliative or respiratory care settings were conducted. Results: Three elements of integrated palliative care in advanced COPD were identified: multidimensional assessment, healthcare professionals’ education and interdisciplinary team meetings, which are the pillars of a new integrated palliative care model for patients with advanced COPD. Conclusions: The new integrated palliative care model in advanced COPD includes essential elements with a focus on patients, healthcare professionals and care delivery. Further research on testing this model in clinical practice, service development, implementation processes and possible outcomes, including evaluation of the financial impact of integrated palliative care is necessary to foster this care approach across all possible settings.


2018 ◽  
Vol 6 (4) ◽  
pp. 526
Author(s):  
Eñaut Agirre ◽  
Naiara Perez ◽  
Iratxe Urreta ◽  
Isabel Huerta ◽  
Ander Berroeta ◽  
...  

Rationale: The Personalised Multidisciplinary Care Programme (PMCC) in operation at Donostia University Hospital since 2009 for patients suffering from Heart Failure (HF) and/or Chronic Obstructive Pulmonary Disease (COPD) has helped to cut down the number of re-admissions and visits to the emergency department (ED), at the expense of increasing the number of consultations and telephone calls.Objectives: To compare whether a web-based self-care programme (WSC group) can maintain the same standard as that found in the PMCC programme, while reducing the number of times patients needed to contact professionals (consultations and calls). Methods: Randomised clinical trials with concealment of the randomised sequence, not blind, involving 100 patients recruited from a historical cohort study (PMCC study participants) and monitored for one year (from May 2014 to May 2015). Mortality rates, the number of visits to the ED and hospital admissions in relation to the process, the number of telephone calls and consultations and quality of life (QoL) were measured using EuroQol while patients were a part of the study.Results: No significant statistical differences were observed in terms of mortality, visits to the ED and hospital admissions between the comparison groups. More in-person consultations and calls from nurses to patients were registered with the PMCC group, as expected as this was part of the procedure.Conclusion: A self-care web can be an effective and useful tool when managing chronic diseases in re-admitted patients, the effectiveness of which greatly depends on the patients’ preparedness and on their access to multimedia format.


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