Abstract
Introduction:
Patients are at the centre of managing their own disease but need the skills and support from health professionals to do so. An exacerbation is an unwelcome interruption to self management though is rarely sudden in onset. Helping to support self care in COPD is poorly developed in primary care and research has focused on the physical parameters of exacerbations using quantitative methods rather than the patient experience.
Aims:
The project aimed to gain insight into people with experience of an acute exacerbation of COPD.
Objectives:
For participants to recount their story of their most recent exacerbation which required admission to hospital. To identify implications for health professionals practice particularly in supporting self care strategies in patients living with COPD.
Subjects and method: 8 patients (5 men, 3 female) Age range 59–73
8 patients were interviewed at home and asked to tell their story of their recent exacerbation. Interviews were audio-taped, supplemented with field notes and transcribed verbatim. Data were manually analysed using sequential content analysis.
Results:
5 main themes were identified and described. All participants had a period of deterioration over at least 4 weeks which they attempted to manage using a variety of self help strategies and steps but following no clear plan. There was universal fear of “the attack” and military style language described the response to “fight back”. Fear that this was the final exacerbation was also described. The arrival of emergency services was welcome and confirmed to all the seriousness of the attack. The aftermath of the attack left participants weak and vulnerable both physically and mentally with the over riding sense that this would happen again.
Conclusions:
Patients and their support network are central to the management of their own health professionals. Although they were to some extent able to recognise the warning signs of an exacerbation of COPD they lacked clear strategies for which actions to take. Health professionals may need help in order to support these patients more effectively.
Conflict of interest and funding
None.
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Goddard, J. ABS54: Patients' experience of an exacerbation of COPD. Lessons for primary health professionals. Prim Care Respir J 15, 199–200 (2006). https://doi.org/10.1016/j.pcrj.2006.04.149
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DOI: https://doi.org/10.1016/j.pcrj.2006.04.149