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United Kingdom

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摘要

BACKGROUND: Self-management interventions are increasingly implemented to manage the health impact and economic burden of the growing prevalence of chronic obstructive pulmonary disease. Nurses are the primary providers of self-management education, yet there have been few attempts to assess their contribution in delivering these programmes. Qualitative evidence that explores patients' perceptions of the benefits of self-management is limited. OBJECTIVE: To synthesize qualitative evidence on patient perceived benefits of nursing interventions to support self-management. DESIGN: Systematic review and qualitative synthesis. METHODS: Data were collected from six electronic databases: British Nursing Index (BNI, Proquest), MEDLINE (Ovid), CINAHL (EBSCO), AMED (Ovid), Embase (Ovid), and PsycINFO (Ovid). Pre-defined keywords were used to identify qualitative or mixed methods English-language studies published in any year. The included studies were selected by screening titles, abstracts and full-texts against inclusion and exclusion criteria that were established a priori. The Critical Appraisal Skills Programme tool was used to undertake a quality review. Data were analysed with a framework approach using categories of self-management outcomes reported in a previous review as a coding structure. RESULTS: Fourteen articles were included in the review. Four key themes were identified from the original research: Empowerment through new knowledge, Psychological wellbeing, Expanding social worlds and Increased physical activity. CONCLUSIONS: When provided with adequate knowledge and support, patients gained self-confidence and their coping behaviour increased. Social and psychological support were identified as key aspects of self-management interventions that patients found improved their sense of wellbeing. Group exercise components of self-management programmes were also favourably evaluated due to a perceived sense of increased well-being and enhanced social interaction.

Chronic obstructive pulmonary disease;Disease management;Nurse-led clinics;Qualitative studies;Self-care;Systematic review

医疗服务人员 ; 医疗护理 ; 慢性非传染性疾病

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