Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa1278
M. Pereira, Filipa Moreira, P. Machado, M. Padilha
Background: Exercise training is a major component of Respiratory Rehabilitation included in the non-pharmacological treatment of the person with COPD which has shown to reduce the number of exacerbations of the disease and to improve the quality of life (GOLD,2019). However, little is known about the impact of the nurse-led intervention on the capacity for self-care of the person with COPD. Methods: Systematic literature review based on Cochrane model. We used the PICOT method with the main starting question: what is the impact of a nurse-led intervention on the capacity for self-care of the person with COPD? Database search was conducted before February 4, 2019, in CINAHL; MEDLINE; EMBASE and Web of Science and SCOPUS. Four independent reviewers assessed methodologic quality and reviewed the studies. Results: We identified 24 articles and 14 thesis. After removing the duplicates (n=5) and reading 19 articles by title and abstract, 13 were excluded. Six articles were submitted a full text reading to assess the inclusion criteria. One article was included. Nurse-led intervention in respiratory rehabilitation enhance quality of life, activity of daily living performance and reduce fatigue. Conclusion: This systematic literature review shows the need to develop robust studies focused on assessing the impact of nurse-led interventions on the capacity for self-care of people with COPD in order to broaden the body of disciplinary nursing knowledge.
背景:运动训练是COPD患者非药物治疗中呼吸康复的主要组成部分，已被证明可以减少疾病恶化次数并改善生活质量(GOLD,2019)。然而，对护士主导的干预对慢性阻塞性肺病患者自我护理能力的影响知之甚少。方法:采用Cochrane模型进行系统文献综述。我们使用PICOT方法的主要问题是:护士主导的干预对慢性阻塞性肺病患者自我护理能力的影响是什么?数据库检索于2019年2月4日前在CINAHL进行;MEDLINE;EMBASE、Web of Science和SCOPUS。四名独立评审员评估了方法学质量并对研究进行了评审。结果:共检索到文献24篇，论文14篇。在去除重复(n=5)并按标题和摘要阅读19篇文章后，排除了13篇。提交了六篇文章的全文阅读，以评估纳入标准。其中包括一篇文章。以护士为主导的呼吸康复干预可提高生活质量、日常生活活动能力和减轻疲劳。结论:本系统的文献综述表明，需要开展强有力的研究，重点评估护士主导的干预措施对慢性阻塞性肺病患者自我护理能力的影响，以扩大学科护理知识体系。
{"title":"Impact of a nurse-led intervention on the capacity for self-care of the person with Chronic Obstructive Pulmonary Disease - Systematic Review of Literature","authors":"M. Pereira, Filipa Moreira, P. Machado, M. Padilha","doi":"10.1183/13993003.congress-2019.pa1278","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1278","url":null,"abstract":"Background: Exercise training is a major component of Respiratory Rehabilitation included in the non-pharmacological treatment of the person with COPD which has shown to reduce the number of exacerbations of the disease and to improve the quality of life (GOLD,2019). However, little is known about the impact of the nurse-led intervention on the capacity for self-care of the person with COPD. Methods: Systematic literature review based on Cochrane model. We used the PICOT method with the main starting question: what is the impact of a nurse-led intervention on the capacity for self-care of the person with COPD? Database search was conducted before February 4, 2019, in CINAHL; MEDLINE; EMBASE and Web of Science and SCOPUS. Four independent reviewers assessed methodologic quality and reviewed the studies. Results: We identified 24 articles and 14 thesis. After removing the duplicates (n=5) and reading 19 articles by title and abstract, 13 were excluded. Six articles were submitted a full text reading to assess the inclusion criteria. One article was included. Nurse-led intervention in respiratory rehabilitation enhance quality of life, activity of daily living performance and reduce fatigue. Conclusion: This systematic literature review shows the need to develop robust studies focused on assessing the impact of nurse-led interventions on the capacity for self-care of people with COPD in order to broaden the body of disciplinary nursing knowledge.","PeriodicalId":76252,"journal":{"name":"Nurses Lamp","volume":"108 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87611170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa1271
A. Bagnasco, G. Catania, M. Zanini, Silvia Rossi, N. Dasso, G. Aleo, Loredana Sasso
Background: Chronic respiratory diseases are among the most common causes of mortality and comorbidity in the world. In the medical wards there are often inpatients with complex conditions, who cannot be admitted to a specialized unit due to their complex clinical and nursing needs. Nurses in this context play an important role and are responsible for the surveillance and prevention of complications in these inpatients. Aims: To describe the frequency and patterns of care left undone in medical wards in Italy. Methodology: Data were extracted from the RN4CAST@IT study, a larger cross-sectional observational study conducted in 2015, involving nurses, through convenience sampling of 40 hospitals. For this analysis we considered nurses involved (n=2082) in medical wards or similar. We surveyed which activities, from a list of 13, were necessary but left undone because of lack of time during the last shift worked. Results: The most frequent care left undone activity was ‘oral hygiene’ (47.6%), ‘frequent mobilisation of bedridden patient’ (47.3%), ‘comforting and talking with patients’ (45.8%), ‘information and education’ (45.1%). Conclusion: Care left undone is an error of omission that has a negative impact on patient outcomes. Omitting basic care, such as ‘oral hygiene’, leads to an increase of the workload for nurses and negative clinical outcomes in frail patients admitted to medical wards, especially when patients are affected by chronic respiratory diseases.
{"title":"Care left undone in patients with chronic respiratory diseases admitted to medical wards: an observational study","authors":"A. Bagnasco, G. Catania, M. Zanini, Silvia Rossi, N. Dasso, G. Aleo, Loredana Sasso","doi":"10.1183/13993003.congress-2019.pa1271","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1271","url":null,"abstract":"Background: Chronic respiratory diseases are among the most common causes of mortality and comorbidity in the world. In the medical wards there are often inpatients with complex conditions, who cannot be admitted to a specialized unit due to their complex clinical and nursing needs. Nurses in this context play an important role and are responsible for the surveillance and prevention of complications in these inpatients. Aims: To describe the frequency and patterns of care left undone in medical wards in Italy. Methodology: Data were extracted from the RN4CAST@IT study, a larger cross-sectional observational study conducted in 2015, involving nurses, through convenience sampling of 40 hospitals. For this analysis we considered nurses involved (n=2082) in medical wards or similar. We surveyed which activities, from a list of 13, were necessary but left undone because of lack of time during the last shift worked. Results: The most frequent care left undone activity was ‘oral hygiene’ (47.6%), ‘frequent mobilisation of bedridden patient’ (47.3%), ‘comforting and talking with patients’ (45.8%), ‘information and education’ (45.1%). Conclusion: Care left undone is an error of omission that has a negative impact on patient outcomes. Omitting basic care, such as ‘oral hygiene’, leads to an increase of the workload for nurses and negative clinical outcomes in frail patients admitted to medical wards, especially when patients are affected by chronic respiratory diseases.","PeriodicalId":76252,"journal":{"name":"Nurses Lamp","volume":"121 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78424991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa1277
M. Padilha, A. I. Ribeiro, José Ramos, P. Machado
Background: ECare-COPD is a project that aims to improve the nurse’s skills for the promotion of self-management of the disease in people with COPD. We developed an e-learning training programme (sponsored by the European Union). This innovative e-learning programme integrates education modules on self-management, pulmonary rehabilitation, supported by video and a web clinical virtual simulator (CVS). Method: Participatory action research based on a cyclical process divided into five phases: diagnosis, action planning, implementation, assessment and identification of what was acquired. A systematic literature review and scientometric analysis were performed to identify the contents to be included in the programme. These programme contents and clinical scenarios for the CVS (n=8) were organized and developed with the collaboration of a group of nurses with respiratory expertise. We assessed the easiness, usefulness and intention of nurses and nursing students to use the programme. Results: The training programme was made available in three modules. The initial programme for nursing degree students was organized in 6 modules with 18 lessons; the intermediate programme for nurses was organized in 13 modules with 61 lessons; and the advanced programme for nursing specialists was organized in 19 modules with 82 lessons. The training programme was supported by more than 90 videos. The users showed easiness, usefulness and intention to use this programme in their nursing education. Conclusion: This training programme responds to the demand for the dematerialization of nursing education and the intention of nurses to use information and communication technologies in education and lifelong learning.
{"title":"Innovation in Nursing education - ECare-COPD. Self-management promotion in people with COPD","authors":"M. Padilha, A. I. Ribeiro, José Ramos, P. Machado","doi":"10.1183/13993003.congress-2019.pa1277","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1277","url":null,"abstract":"Background: ECare-COPD is a project that aims to improve the nurse’s skills for the promotion of self-management of the disease in people with COPD. We developed an e-learning training programme (sponsored by the European Union). This innovative e-learning programme integrates education modules on self-management, pulmonary rehabilitation, supported by video and a web clinical virtual simulator (CVS). Method: Participatory action research based on a cyclical process divided into five phases: diagnosis, action planning, implementation, assessment and identification of what was acquired. A systematic literature review and scientometric analysis were performed to identify the contents to be included in the programme. These programme contents and clinical scenarios for the CVS (n=8) were organized and developed with the collaboration of a group of nurses with respiratory expertise. We assessed the easiness, usefulness and intention of nurses and nursing students to use the programme. Results: The training programme was made available in three modules. The initial programme for nursing degree students was organized in 6 modules with 18 lessons; the intermediate programme for nurses was organized in 13 modules with 61 lessons; and the advanced programme for nursing specialists was organized in 19 modules with 82 lessons. The training programme was supported by more than 90 videos. The users showed easiness, usefulness and intention to use this programme in their nursing education. Conclusion: This training programme responds to the demand for the dematerialization of nursing education and the intention of nurses to use information and communication technologies in education and lifelong learning.","PeriodicalId":76252,"journal":{"name":"Nurses Lamp","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90559162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa1264
Lidia Perera Lopez, R. Garcia-Tenorio, Teresa Lopez Ruiz, Auxiliadora Romero, Asunción Martín Hernández, Margarita Izquierdo Nazar, Joaquín Salamanca Blanco, Julio César Vargas Espinal, P. Lozano, Angela Gomez Del Aguila
Methods: We’ve reviewed the clinical and smoking histories of pregnant smokers. In this unit, they were applied the same assistance program:offering pharmacological treatment, nicotine replacement therapy (NRT), and psychological, which includes the development of cognitive-behavioral techniques designed specifically for this group of smokers in 9 consultations, over 6months of tracing. The characteristics of smoking in all subjects were analyzed. Results: 22 pregnant women. The average age was 34.27 yrs and they were approximately at week 17 gestation (mean value). Through an analog-visual scale they showed a high motivation to stop smoking (average 8.66 pts). Characteristics of smoking, smoked 17.18yrs(±5.21), the index of packets years was 19.86 and 64% of them smoked for negative reward. Average score in the Fagerstrom Test: 6.68±1.93; more than 80% of them lit the 1 cigarette of the day in the 1 half hour. Before becoming pregnant, they smoked an average of 23.13cig/day and after finding out that they were pregnant their consumption dropped to an average of 9.63cig/day; despite them the CO in expired air was 21.27 ppm (±9.25ppm) (See figure 1). Pharmacological treatment was received by 20 of them in the form of chewing gum and nicotine tablets. The abstinence rate at 6 mths was 27%, the same as the rate of failure (27%). The worrying fact is that 46% of them left in the 1 consultation Conclusions: It was high degree of physical dependence due to nicotine in the pregnant women who attended. Before pregnancy, they smoked an average of 23cig/day and after being pregnant they smoked an average of 10cig/day that is not related to the carbon monoxide figures. Abstinence rate27%. The 46% of them abandoned the treatment after the first consultation.
{"title":"Maternal consumption of tobacco and pregnancy","authors":"Lidia Perera Lopez, R. Garcia-Tenorio, Teresa Lopez Ruiz, Auxiliadora Romero, Asunción Martín Hernández, Margarita Izquierdo Nazar, Joaquín Salamanca Blanco, Julio César Vargas Espinal, P. Lozano, Angela Gomez Del Aguila","doi":"10.1183/13993003.congress-2019.pa1264","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1264","url":null,"abstract":"Methods: We’ve reviewed the clinical and smoking histories of pregnant smokers. In this unit, they were applied the same assistance program:offering pharmacological treatment, nicotine replacement therapy (NRT), and psychological, which includes the development of cognitive-behavioral techniques designed specifically for this group of smokers in 9 consultations, over 6months of tracing. The characteristics of smoking in all subjects were analyzed. Results: 22 pregnant women. The average age was 34.27 yrs and they were approximately at week 17 gestation (mean value). Through an analog-visual scale they showed a high motivation to stop smoking (average 8.66 pts). Characteristics of smoking, smoked 17.18yrs(±5.21), the index of packets years was 19.86 and 64% of them smoked for negative reward. Average score in the Fagerstrom Test: 6.68±1.93; more than 80% of them lit the 1 cigarette of the day in the 1 half hour. Before becoming pregnant, they smoked an average of 23.13cig/day and after finding out that they were pregnant their consumption dropped to an average of 9.63cig/day; despite them the CO in expired air was 21.27 ppm (±9.25ppm) (See figure 1). Pharmacological treatment was received by 20 of them in the form of chewing gum and nicotine tablets. The abstinence rate at 6 mths was 27%, the same as the rate of failure (27%). The worrying fact is that 46% of them left in the 1 consultation Conclusions: It was high degree of physical dependence due to nicotine in the pregnant women who attended. Before pregnancy, they smoked an average of 23cig/day and after being pregnant they smoked an average of 10cig/day that is not related to the carbon monoxide figures. Abstinence rate27%. The 46% of them abandoned the treatment after the first consultation.","PeriodicalId":76252,"journal":{"name":"Nurses Lamp","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86042549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa1266
W. I. G. Matute, Margarita Hernandez Yañez, Rosa Maria Rojas Moreno-Tomé, María Gallardo Bermejo, M. Rubio, L. P. Maestú
Introduction and Objective: Low peak inspiratory flow rate (PIFR) can cause suboptimal inhaler usage, leading to ineffective bronchodilation.1 This study aim was to determine the frequency of PIFR with a manual inspiratory flow meter in patients using inhaler devices. Methods: A descriptive, cross-sectional study including adult patients assisting lung function laboratory on their routine follow-up of their chronic respiratory disease using inhaled medication. In-Check DIAL G16® device was used to simulate the resistance of the inhaler and determine the patient’s PIFR. Results: Total number was 155 patients, mean age of 63±15.2 years, 58.1% women. 64 (41.3%) patients used inhalers with an optimal PIFR greater than 60 L/ minute. The specific values of each one are observed in table 1, finding statistically significant differences by both group comparisons (p Conclusions: Low PIFR was frequently determined in patients using various inhalers devices, and consequently, not reaching its optimal value for adequate treatment. 1Kawamatawong T., et. al. Peak inspiratory flow rate measurements by using In-Check Dial for the different inhaler devices in elderly with obstructive airway diseases. Journal of Asthma and Allergy 2017: 10; 17-21.
{"title":"Low maximum inspiratory flow index in patients with inhaler therapy","authors":"W. I. G. Matute, Margarita Hernandez Yañez, Rosa Maria Rojas Moreno-Tomé, María Gallardo Bermejo, M. Rubio, L. P. Maestú","doi":"10.1183/13993003.congress-2019.pa1266","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1266","url":null,"abstract":"Introduction and Objective: Low peak inspiratory flow rate (PIFR) can cause suboptimal inhaler usage, leading to ineffective bronchodilation.1 This study aim was to determine the frequency of PIFR with a manual inspiratory flow meter in patients using inhaler devices. Methods: A descriptive, cross-sectional study including adult patients assisting lung function laboratory on their routine follow-up of their chronic respiratory disease using inhaled medication. In-Check DIAL G16® device was used to simulate the resistance of the inhaler and determine the patient’s PIFR. Results: Total number was 155 patients, mean age of 63±15.2 years, 58.1% women. 64 (41.3%) patients used inhalers with an optimal PIFR greater than 60 L/ minute. The specific values of each one are observed in table 1, finding statistically significant differences by both group comparisons (p Conclusions: Low PIFR was frequently determined in patients using various inhalers devices, and consequently, not reaching its optimal value for adequate treatment. 1Kawamatawong T., et. al. Peak inspiratory flow rate measurements by using In-Check Dial for the different inhaler devices in elderly with obstructive airway diseases. Journal of Asthma and Allergy 2017: 10; 17-21.","PeriodicalId":76252,"journal":{"name":"Nurses Lamp","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81441807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa1262
Samantha Halliwell, Heidi Groombridge, A. Scott
Background: –The National Asthma and COPD Audit Programme (NACAP) aims to drive improvements in the quality of care and services provided forRespiratory patients in England and Wales (RCP / BTS 2017) –Part of this programme is the continuous audit of admission to hospital for those patients with COPD –This commenced in April 2017 and currently is scheduled to continue until March 2019 –Best Practice Tariff (BPT) was introduced to improve the proportion of patients who receive specialist respiratory input to their care within 24 hours of admission and completion of a COPD discharge bundle. Aims: –Primary aim was to deliver on the COPD BPT –Secondary aim was to improve the inpatient experience and deliver evidence based care –This would be evidenced by length of stay, readmission rates and inpatient mortality rates Methods: Recruited Associate Practitioners, Registered Nurse and Physiotherapist to into Specialist Practioner Roles. Results: Development of an Inpatient Respiratory Practitioner Team has enabled the Trust to achieve the required 60% for BPT by quarter 3 (Oct-Dec 2017) and thus qualification for the enhanced tariff
{"title":"The National Asthma and COPD Audit Programme in East Kent Hospitals University NHS Foundation Trust – The first year","authors":"Samantha Halliwell, Heidi Groombridge, A. Scott","doi":"10.1183/13993003.congress-2019.pa1262","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1262","url":null,"abstract":"Background: –The National Asthma and COPD Audit Programme (NACAP) aims to drive improvements in the quality of care and services provided forRespiratory patients in England and Wales (RCP / BTS 2017) –Part of this programme is the continuous audit of admission to hospital for those patients with COPD –This commenced in April 2017 and currently is scheduled to continue until March 2019 –Best Practice Tariff (BPT) was introduced to improve the proportion of patients who receive specialist respiratory input to their care within 24 hours of admission and completion of a COPD discharge bundle. Aims: –Primary aim was to deliver on the COPD BPT –Secondary aim was to improve the inpatient experience and deliver evidence based care –This would be evidenced by length of stay, readmission rates and inpatient mortality rates Methods: Recruited Associate Practitioners, Registered Nurse and Physiotherapist to into Specialist Practioner Roles. Results: Development of an Inpatient Respiratory Practitioner Team has enabled the Trust to achieve the required 60% for BPT by quarter 3 (Oct-Dec 2017) and thus qualification for the enhanced tariff","PeriodicalId":76252,"journal":{"name":"Nurses Lamp","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89145258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa1265
M. Clari, Roberto Fontanella, D. Ivziku, V. Dimonte, M. Matarese
Introduction: A growing number of qualitative and quantitative studies have been conducted applying mindfulness-based interventions (MBIs) to treat psychological and physical manifestations in people with Chronic Obstructive Pulmonary Disease (COPD). Evidence on their effectiveness is still conflicting. Understanding the experiences of people affected by COPD attending the MBI program could help to design interventions suitable to these population and improve their effectiveness. Aim: A qualitative systematic review was conducted aimed at exploring the barriers and facilitators at the participation of MBI programs from the perspective of people with COPD. Methods: Systematic research on relevant databases was conducted including COPD individuals at any disease stage and any MBI program. Qualitative study designs were included. A meta-aggregative approach was used following the Joanna Briggs Institute approach. Results: Three qualitative and two mixed methods studies were identified and included. The participation at mindfulness-based programs was hampered by psychological barriers, such as disbelief and lack of trust, and practical barriers, such as difficulties in attending the classes. Also, cultural barriers hinder trusting the programs Having shorter sessions, distance session via skype and compassionate coaches could promote the retention and the adherence at the mindfulness practice. The absence of group physical presence could deter individuals to continuing the programs. Conclusion: Specific MBI programs considering COPD patients’ preferences should be tested to optimise the retention and adherence and to maximise their effectiveness.
{"title":"Barriers and facilitators at attending mindfulness-based intervention programs of people with COPD. A systematic qualitative review","authors":"M. Clari, Roberto Fontanella, D. Ivziku, V. Dimonte, M. Matarese","doi":"10.1183/13993003.congress-2019.pa1265","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1265","url":null,"abstract":"Introduction: A growing number of qualitative and quantitative studies have been conducted applying mindfulness-based interventions (MBIs) to treat psychological and physical manifestations in people with Chronic Obstructive Pulmonary Disease (COPD). Evidence on their effectiveness is still conflicting. Understanding the experiences of people affected by COPD attending the MBI program could help to design interventions suitable to these population and improve their effectiveness. Aim: A qualitative systematic review was conducted aimed at exploring the barriers and facilitators at the participation of MBI programs from the perspective of people with COPD. Methods: Systematic research on relevant databases was conducted including COPD individuals at any disease stage and any MBI program. Qualitative study designs were included. A meta-aggregative approach was used following the Joanna Briggs Institute approach. Results: Three qualitative and two mixed methods studies were identified and included. The participation at mindfulness-based programs was hampered by psychological barriers, such as disbelief and lack of trust, and practical barriers, such as difficulties in attending the classes. Also, cultural barriers hinder trusting the programs Having shorter sessions, distance session via skype and compassionate coaches could promote the retention and the adherence at the mindfulness practice. The absence of group physical presence could deter individuals to continuing the programs. Conclusion: Specific MBI programs considering COPD patients’ preferences should be tested to optimise the retention and adherence and to maximise their effectiveness.","PeriodicalId":76252,"journal":{"name":"Nurses Lamp","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89356451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa1270
Valentina Fiket, A. Savovic
Background: Does type of inhalation and stages of COPD influence on quality of cells in induced sputum. Aims and Objectives: Determination of the performance of induced sputum by the amount and quality of cells in patients at COPD gold stages and in healthy populations. Methods: The study was conducted from Mar 2014 to Jun 2016. In the study participated 210 patients. The population of patients suffering from all four stages of COPD and a healthy population was included. Criteria were: population older than 40 years, FEV1 above 0.8 l, absence of other comorbidities. We collected sputum by induction using an inhaler with 0.9% NaCl solution, 3%, 4% and 5% hypertonic solution. Each inhalation lasted 7 minutes, and the patient was coughing between and after each inhalation. Results: 1) Distribution of patients by categories; GOLD 1 (27%), GOLD 2 (27%), GOLD 3 (22%), GOLD 4 (4%) and control group (20%) (N=146). 2) 80% of respondents managed to give an adequate sputum sample (N=146). 3) Distribution of patients by categories that managed to give an adequate sputum sample; GOLD 1 (67%), GOLD 2 (80%), GOLD 3 (97%), GOLD 4 (83%) and control group (79%) (N=146). Conclusion: Based on the results, there were no major differences in the percentage of patients who managed to give an adequate sputum sample. Only a small number of patients in the GOLD 1 category could successfully provide an adequate sputum pattern.
{"title":"The success of obtaining the induced sputum of patients with COPD","authors":"Valentina Fiket, A. Savovic","doi":"10.1183/13993003.congress-2019.pa1270","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1270","url":null,"abstract":"Background: Does type of inhalation and stages of COPD influence on quality of cells in induced sputum. Aims and Objectives: Determination of the performance of induced sputum by the amount and quality of cells in patients at COPD gold stages and in healthy populations. Methods: The study was conducted from Mar 2014 to Jun 2016. In the study participated 210 patients. The population of patients suffering from all four stages of COPD and a healthy population was included. Criteria were: population older than 40 years, FEV1 above 0.8 l, absence of other comorbidities. We collected sputum by induction using an inhaler with 0.9% NaCl solution, 3%, 4% and 5% hypertonic solution. Each inhalation lasted 7 minutes, and the patient was coughing between and after each inhalation. Results: 1) Distribution of patients by categories; GOLD 1 (27%), GOLD 2 (27%), GOLD 3 (22%), GOLD 4 (4%) and control group (20%) (N=146). 2) 80% of respondents managed to give an adequate sputum sample (N=146). 3) Distribution of patients by categories that managed to give an adequate sputum sample; GOLD 1 (67%), GOLD 2 (80%), GOLD 3 (97%), GOLD 4 (83%) and control group (79%) (N=146). Conclusion: Based on the results, there were no major differences in the percentage of patients who managed to give an adequate sputum sample. Only a small number of patients in the GOLD 1 category could successfully provide an adequate sputum pattern.","PeriodicalId":76252,"journal":{"name":"Nurses Lamp","volume":"96 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80232735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa1263
C. Stridsman, H. Backman, L. Hedman, E. Rönmark
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Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.oa271
V. McDonald, Vanessa L. Clark, Olivia J Mcdonald, P. Gibson
Background: Despite major advances in severe asthma management, patients continue to suffer an excessive symptom burden and impaired quality of life (QoL). We sought to determine the most important problems related to severe asthma from the patients’ perspective. Methods: People (n=140) with severe refractory asthma were recruited to a cross sectional study and underwent a multidimensional assessment of their disease. As part of the assessment participants were asked “What is/are the biggest problem/s you experience as a result of your breathing problem?”. Results: Participants were predominately female (62.1%), with a mean (SD) age of 55.7 (14.7) years. They had experienced 3.1 (3.2) exacerbations in the past year, and had a mean asthma control questionnaire score (ACQ-5) of 2.0 (1.1). Patients most frequently offered dyspnoea (39.0%), limited activity (17.1%), and cough (10.3%) as their primary problem of importance. These symptoms were often presented as a cluster. At least one symptom from this cluster was reported in 51.4% of participants, 29.3% reported two and 2.9% reported all three symptoms. The self-identification of two or more of these symptoms compared to one or no symptoms, was associated with significant impairment in asthma control, ACQ-5 2.3 (1.2) vs 1.9 (1.1) p=0.04; increased depression score 6.0 (3.9) vs 4.3 (3.3) p=0.01; worse asthma QoL, AQLQ 4.4 (1.3) vs 5.1 (1.1) p=0.02, and more comorbidities, 6.7 (2.5) vs 5.6 (2.7) p=0.02. Conclusion: Dyspnoea, limited activity and cough were problems of most importance to patients with severe asthma. Few interventions have been tested in severe asthma that specifically target these symptoms, suggesting a need to develop new targeted approaches.
{"title":"Problems of Importance in Severe Asthma: A Patient Perspective","authors":"V. McDonald, Vanessa L. Clark, Olivia J Mcdonald, P. Gibson","doi":"10.1183/13993003.congress-2019.oa271","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.oa271","url":null,"abstract":"Background: Despite major advances in severe asthma management, patients continue to suffer an excessive symptom burden and impaired quality of life (QoL). We sought to determine the most important problems related to severe asthma from the patients’ perspective. Methods: People (n=140) with severe refractory asthma were recruited to a cross sectional study and underwent a multidimensional assessment of their disease. As part of the assessment participants were asked “What is/are the biggest problem/s you experience as a result of your breathing problem?”. Results: Participants were predominately female (62.1%), with a mean (SD) age of 55.7 (14.7) years. They had experienced 3.1 (3.2) exacerbations in the past year, and had a mean asthma control questionnaire score (ACQ-5) of 2.0 (1.1). Patients most frequently offered dyspnoea (39.0%), limited activity (17.1%), and cough (10.3%) as their primary problem of importance. These symptoms were often presented as a cluster. At least one symptom from this cluster was reported in 51.4% of participants, 29.3% reported two and 2.9% reported all three symptoms. The self-identification of two or more of these symptoms compared to one or no symptoms, was associated with significant impairment in asthma control, ACQ-5 2.3 (1.2) vs 1.9 (1.1) p=0.04; increased depression score 6.0 (3.9) vs 4.3 (3.3) p=0.01; worse asthma QoL, AQLQ 4.4 (1.3) vs 5.1 (1.1) p=0.02, and more comorbidities, 6.7 (2.5) vs 5.6 (2.7) p=0.02. Conclusion: Dyspnoea, limited activity and cough were problems of most importance to patients with severe asthma. Few interventions have been tested in severe asthma that specifically target these symptoms, suggesting a need to develop new targeted approaches.","PeriodicalId":76252,"journal":{"name":"Nurses Lamp","volume":"154 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86990856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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