Hanna Sandelowsky, Ingvar Krakau, Sonja Modin, Björn Ställberg, Anna Nager
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We aimed to assess the levels of patients' subjective needs for information about COPD before and after their general practitioners had taken part in a COPD education.</p><p><strong>Design: </strong>A secondary analysis of a cluster randomized controlled trial.</p><p><strong>Setting: </strong>22 PHCCs in Stockholm, Sweden.</p><p><strong>Subjects: </strong>Randomly selected primary care patients with COPD in GOLD stages 2 and 3 (<i>n</i> = 293).</p><p><strong>Outcome measures: </strong>Scores in the Lung Information Needs Questionnaire (LINQ) at baseline and 18 months, spirometry results, and self-reported, descriptive patient data.</p><p><strong>Results: </strong>GPs' improved skills in COPD did not affect patients' self-management skills over time. In general, patients' information needs remained great in issues concerning diet, exercise and self-management. However, 43% of the patients reported reduced and 57% increased or unchanged information needs, over time. Reduced information needs were mainly associated with a high level of information needs at baseline (OR = 3.17 [95% CI 1.93-5.23], <i>p</i> < .01) and establishing contact with a physiotherapist (OR = 2.26 [95% CI 1.05-4.86], <i>p</i> = .038). Patients in a mild or stable phase of COPD with no recent exacerbations reported greater needs than those with unstable, deteriorated COPD.</p><p><strong>Conclusion: </strong>Patients' information needs are substantial in most areas of self-management of COPD, and seem to covary with the patient's current clinical status. Care providers should thus continuously be vigilant about offering all patients with COPD support and education.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov, 10 August 2014, Identifier NCT02213809.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11001336/pdf/","citationCount":"0","resultStr":"{\"title\":\"Primary care patients with mild or stable chronic obstructive pulmonary disease need more support in disease management: a secondary analysis of a cluster randomized controlled trial.\",\"authors\":\"Hanna Sandelowsky, Ingvar Krakau, Sonja Modin, Björn Ställberg, Anna Nager\",\"doi\":\"10.1080/02813432.2023.2280039\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Patient education based on the patient's individual needs and circumstances is known to be associated with positive changes in clinical outcomes in chronic obstructive pulmonary disease (COPD). We aimed to assess the levels of patients' subjective needs for information about COPD before and after their general practitioners had taken part in a COPD education.</p><p><strong>Design: </strong>A secondary analysis of a cluster randomized controlled trial.</p><p><strong>Setting: </strong>22 PHCCs in Stockholm, Sweden.</p><p><strong>Subjects: </strong>Randomly selected primary care patients with COPD in GOLD stages 2 and 3 (<i>n</i> = 293).</p><p><strong>Outcome measures: </strong>Scores in the Lung Information Needs Questionnaire (LINQ) at baseline and 18 months, spirometry results, and self-reported, descriptive patient data.</p><p><strong>Results: </strong>GPs' improved skills in COPD did not affect patients' self-management skills over time. In general, patients' information needs remained great in issues concerning diet, exercise and self-management. However, 43% of the patients reported reduced and 57% increased or unchanged information needs, over time. Reduced information needs were mainly associated with a high level of information needs at baseline (OR = 3.17 [95% CI 1.93-5.23], <i>p</i> < .01) and establishing contact with a physiotherapist (OR = 2.26 [95% CI 1.05-4.86], <i>p</i> = .038). Patients in a mild or stable phase of COPD with no recent exacerbations reported greater needs than those with unstable, deteriorated COPD.</p><p><strong>Conclusion: </strong>Patients' information needs are substantial in most areas of self-management of COPD, and seem to covary with the patient's current clinical status. 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引用次数: 0
摘要
目的:基于患者个人需求和情况的患者教育已知与慢性阻塞性肺疾病(COPD)临床结果的积极变化相关。我们的目的是评估患者在全科医生参加COPD教育前后对COPD信息的主观需求水平。设计:对聚类随机对照试验进行二次分析。环境:22个phcc在瑞典斯德哥尔摩。受试者:随机选择COPD GOLD期2期和3期的初级保健患者(n = 293)。结果测量:基线和18个月时肺信息需求问卷(LINQ)得分、肺活量测定结果和自我报告的描述性患者数据。结果:全科医生COPD技能的提高并不会影响患者的自我管理技能。总体而言,患者在饮食、运动和自我管理方面的信息需求仍然很大。然而,随着时间的推移,43%的患者报告信息需求减少,57%的患者报告信息需求增加或不变。信息需求减少主要与基线时的高水平信息需求相关(OR = 3.17 [95% CI 1.93-5.23], p p = 0.038)。轻度或稳定期无近期加重的COPD患者报告的需求大于不稳定、恶化的COPD患者。结论:在COPD自我管理的大多数领域,患者的信息需求是巨大的,并且似乎与患者目前的临床状态相关。因此,护理提供者应持续保持警惕,为所有COPD患者提供支持和教育。试验注册:Clinicaltrials.gov, 2014年8月10日,编号NCT02213809。
Primary care patients with mild or stable chronic obstructive pulmonary disease need more support in disease management: a secondary analysis of a cluster randomized controlled trial.
Objective: Patient education based on the patient's individual needs and circumstances is known to be associated with positive changes in clinical outcomes in chronic obstructive pulmonary disease (COPD). We aimed to assess the levels of patients' subjective needs for information about COPD before and after their general practitioners had taken part in a COPD education.
Design: A secondary analysis of a cluster randomized controlled trial.
Setting: 22 PHCCs in Stockholm, Sweden.
Subjects: Randomly selected primary care patients with COPD in GOLD stages 2 and 3 (n = 293).
Outcome measures: Scores in the Lung Information Needs Questionnaire (LINQ) at baseline and 18 months, spirometry results, and self-reported, descriptive patient data.
Results: GPs' improved skills in COPD did not affect patients' self-management skills over time. In general, patients' information needs remained great in issues concerning diet, exercise and self-management. However, 43% of the patients reported reduced and 57% increased or unchanged information needs, over time. Reduced information needs were mainly associated with a high level of information needs at baseline (OR = 3.17 [95% CI 1.93-5.23], p < .01) and establishing contact with a physiotherapist (OR = 2.26 [95% CI 1.05-4.86], p = .038). Patients in a mild or stable phase of COPD with no recent exacerbations reported greater needs than those with unstable, deteriorated COPD.
Conclusion: Patients' information needs are substantial in most areas of self-management of COPD, and seem to covary with the patient's current clinical status. Care providers should thus continuously be vigilant about offering all patients with COPD support and education.
Trial registration: Clinicaltrials.gov, 10 August 2014, Identifier NCT02213809.
期刊介绍:
Scandinavian Journal of Primary Health Care is an international online open access journal publishing articles with relevance to general practice and primary health care. Focusing on the continuous professional development in family medicine the journal addresses clinical, epidemiological and humanistic topics in relation to the daily clinical practice.
Scandinavian Journal of Primary Health Care is owned by the members of the National Colleges of General Practice in the five Nordic countries through the Nordic Federation of General Practice (NFGP). The journal includes original research on topics related to general practice and family medicine, and publishes both quantitative and qualitative original research, editorials, discussion and analysis papers and reviews to facilitate continuing professional development in family medicine. The journal''s topics range broadly and include:
• Clinical family medicine
• Epidemiological research
• Qualitative research
• Health services research.