학술논문

Oximetry-supported self-management for chronic obstructive pulmonary disease: mixed method feasibility pilot project.
Document Type
Journal Article
Source
BMC Health Services Research. 10/26/2015, Vol. 15, p1-13. 13p. 3 Diagrams, 4 Charts, 2 Graphs.
Subject
*OBSTRUCTIVE lung disease treatment
*OBSTRUCTIVE lung diseases
*ANXIETY
*COMPARATIVE studies
*MENTAL depression
*FOCUS groups
*RESEARCH methodology
*MEDICAL cooperation
*OXIMETRY
*PSYCHOLOGICAL tests
*QUESTIONNAIRES
*RESEARCH
*HEALTH self-care
*PILOT projects
*EVALUATION research
*HELPLINES
*PSYCHOLOGY
Language
ISSN
1472-6963
Abstract
Background: Pulse oximetry could potentially contribute to self-monitoring. NHS Lothian's 'Light Touch' service provided COPD patients with a self-management plan based on symptoms and oximetry. The service was overseen (though not actively monitored) by respiratory-trained community teams who were contactable by a telephone helpline. We aimed to assess the feasibility, perceived utility and impact of the 'Light Touch' service.Methods: A before-and-after assessment of St George's Respiratory Questionnaire (SGRQ), Hospital Anxiety and Depression Scale (HADS) and use of healthcare resources during the 6-month feasibility study compared to the previous corresponding 6-months. Paired semi-structured interviews with patients at baseline and 6-months, interviews with managers and a focus group of professionals explored perceptions of the service and self-management. Transcripts were coded, and analysed thematically.Results: We recruited 51 participants (mean age 69.7 years (SD 8.4); 21 (46%) male). 46 participants completed quantitative follow up (2 died, 2 were unwell, 1 refused). SGRQ: 21 (46%) participants improved by 4 or more (the minimum important difference); 12 (26%) deteriorated by 4 or more. HADS: more participants had normal scores for anxiety (65%) and depression (80%) at 6-months than at baseline (51 and 64%). More emergency therapy was prescribed during the study period compared to the previous year. Only 18 participants (39%) contacted the Light Touch Helpline during the 6-month study. Twenty patients provided a total of 36 interviews, 8 clinicians contributed to a focus group and 6 managers were interviewed. Patients considered that the oximetry readings heightened awareness of their condition and gave them confidence to make self-management decisions. Healthcare professionals valued oximetry as a tool for teaching people self-management skills, but were concerned that patients rarely contacted the teams for help or advice during the study.Conclusions: 'Light Touch' shows promise as a low-cost strategy for empowering patients' self-management skills and reducing reliance on clinical supervision. [ABSTRACT FROM AUTHOR]