Anand S. Iyer MD, MSPH, Rachel D. Wells PhD, MSN, RN, Avery C. Bechthold PhD, BSN, RN, Margaret Armstrong MSN, MEd, RN, Ronan O'Beirne EdD, Jun Y. Byun PhD, MSN, Jazmine Coffee-Dunning MA, Ed, J. Nicholas Odom PhD, RN, Russell G. Buhr MD, PhD, Angela O. Suen MD, Ashwin A. Kotwal MD, MS, Leah J. Witt MD, Cynthia J. Brown MD, MSPH, Mark T. Dransfield MD, Marie A. Bakitas DNSc, NP-C
{"title":"识别患有慢性阻塞性肺病的老年人面临的首要挑战：多阶段干预改进研究。","authors":"Anand S. Iyer MD, MSPH, Rachel D. Wells PhD, MSN, RN, Avery C. Bechthold PhD, BSN, RN, Margaret Armstrong MSN, MEd, RN, Ronan O'Beirne EdD, Jun Y. Byun PhD, MSN, Jazmine Coffee-Dunning MA, Ed, J. Nicholas Odom PhD, RN, Russell G. Buhr MD, PhD, Angela O. Suen MD, Ashwin A. Kotwal MD, MS, Leah J. Witt MD, Cynthia J. Brown MD, MSPH, Mark T. Dransfield MD, Marie A. Bakitas DNSc, NP-C","doi":"10.1111/jgs.19158","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Identifying priority challenges of older adults with chronic obstructive pulmonary disease (COPD) is critical to designing interventions aimed at improving their well-being and independence.</p>\n </section>\n \n <section>\n \n <h3> Objective</h3>\n \n <p>To prioritize challenges of older adults with COPD and those who care for them to guide refinement of a telephonic nurse coach intervention for patients with COPD and their family caregivers (EPIC: <span>E</span>mpowering <span>P</span>eople to <span>I</span>ndependence in <span>C</span>OPD).</p>\n </section>\n \n <section>\n \n <h3> Design</h3>\n \n <p>Multiphase study guided by Baltes Theory of Successful Aging and the 5Ms Framework: <i>Phase 1</i>: Nominal group technique (NGT), a structured process of prioritizing responses to a question through group consensus. <i>Phase 2</i>: Rapid qualitative analysis. <i>Phase 3</i>: Intervention mapping and refinement.</p>\n </section>\n \n <section>\n \n <h3> Setting</h3>\n \n <p>Ambulatory, virtual.</p>\n </section>\n \n <section>\n \n <h3> Participants</h3>\n \n <p>Older adults with COPD, family caregivers, clinic staff (nurses, respiratory therapists), clinicians (physicians, nurse practitioners), and health system leaders.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>NGT sessions were conducted by constituency group with 37 participants (<i>n</i> = 7 patients, <i>n</i> = 6 family caregivers, <i>n</i> = 8 clinic staff, <i>n</i> = 9 clinicians, <i>n</i> = 7 health system leaders) (<i>Phase 1</i>). Participants generated 92 statements across five themes (<i>Phase 2</i>): (1) “Barriers to care”, (2) “Family caregiver needs”, (3) “Functional status and mobility issues”, (4) “Illness understanding”, and (5) “COPD care complexities”. Supplemental oxygen challenges emerged as a critical problem, and prioritized challenges differed by group. Patients and clinic staff prioritized “Functional status and mobility issues”, family caregivers prioritized “Family caregiver needs”, and clinicians and health system leaders prioritized “COPD care complexities”. Intervention mapping (<i>Phase 3</i>) guided EPIC refinement focused on meeting patient priorities of independence and mobility but accounting for all priorities.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Diverse constituency groups identified priority challenges for older adults with COPD. Functional status and mobility issues, particularly related to supplemental oxygen, emerged as patient prioritized challenges.</p>\n </section>\n \n <section>\n \n <h3> Implications</h3>\n \n <p>Patient-centered interventions for older adults with COPD must account for their prioritized functional and supplemental oxygen needs and explore diverse constituent perspectives to facilitate intervention enrichment.</p>\n </section>\n </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"72 11","pages":"3346-3359"},"PeriodicalIF":4.3000,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Identifying priority challenges of older adults with COPD: A multiphase intervention refinement study\",\"authors\":\"Anand S. Iyer MD, MSPH, Rachel D. Wells PhD, MSN, RN, Avery C. Bechthold PhD, BSN, RN, Margaret Armstrong MSN, MEd, RN, Ronan O'Beirne EdD, Jun Y. Byun PhD, MSN, Jazmine Coffee-Dunning MA, Ed, J. Nicholas Odom PhD, RN, Russell G. Buhr MD, PhD, Angela O. Suen MD, Ashwin A. Kotwal MD, MS, Leah J. Witt MD, Cynthia J. Brown MD, MSPH, Mark T. Dransfield MD, Marie A. Bakitas DNSc, NP-C\",\"doi\":\"10.1111/jgs.19158\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Identifying priority challenges of older adults with chronic obstructive pulmonary disease (COPD) is critical to designing interventions aimed at improving their well-being and independence.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>To prioritize challenges of older adults with COPD and those who care for them to guide refinement of a telephonic nurse coach intervention for patients with COPD and their family caregivers (EPIC: <span>E</span>mpowering <span>P</span>eople to <span>I</span>ndependence in <span>C</span>OPD).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Design</h3>\\n \\n <p>Multiphase study guided by Baltes Theory of Successful Aging and the 5Ms Framework: <i>Phase 1</i>: Nominal group technique (NGT), a structured process of prioritizing responses to a question through group consensus. <i>Phase 2</i>: Rapid qualitative analysis. <i>Phase 3</i>: Intervention mapping and refinement.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Setting</h3>\\n \\n <p>Ambulatory, virtual.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Participants</h3>\\n \\n <p>Older adults with COPD, family caregivers, clinic staff (nurses, respiratory therapists), clinicians (physicians, nurse practitioners), and health system leaders.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>NGT sessions were conducted by constituency group with 37 participants (<i>n</i> = 7 patients, <i>n</i> = 6 family caregivers, <i>n</i> = 8 clinic staff, <i>n</i> = 9 clinicians, <i>n</i> = 7 health system leaders) (<i>Phase 1</i>). Participants generated 92 statements across five themes (<i>Phase 2</i>): (1) “Barriers to care”, (2) “Family caregiver needs”, (3) “Functional status and mobility issues”, (4) “Illness understanding”, and (5) “COPD care complexities”. Supplemental oxygen challenges emerged as a critical problem, and prioritized challenges differed by group. Patients and clinic staff prioritized “Functional status and mobility issues”, family caregivers prioritized “Family caregiver needs”, and clinicians and health system leaders prioritized “COPD care complexities”. Intervention mapping (<i>Phase 3</i>) guided EPIC refinement focused on meeting patient priorities of independence and mobility but accounting for all priorities.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Diverse constituency groups identified priority challenges for older adults with COPD. Functional status and mobility issues, particularly related to supplemental oxygen, emerged as patient prioritized challenges.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Implications</h3>\\n \\n <p>Patient-centered interventions for older adults with COPD must account for their prioritized functional and supplemental oxygen needs and explore diverse constituent perspectives to facilitate intervention enrichment.</p>\\n </section>\\n </div>\",\"PeriodicalId\":17240,\"journal\":{\"name\":\"Journal of the American Geriatrics Society\",\"volume\":\"72 11\",\"pages\":\"3346-3359\"},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2024-08-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the American Geriatrics Society\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/jgs.19158\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Geriatrics Society","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jgs.19158","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
Identifying priority challenges of older adults with COPD: A multiphase intervention refinement study
Background
Identifying priority challenges of older adults with chronic obstructive pulmonary disease (COPD) is critical to designing interventions aimed at improving their well-being and independence.
Objective
To prioritize challenges of older adults with COPD and those who care for them to guide refinement of a telephonic nurse coach intervention for patients with COPD and their family caregivers (EPIC: Empowering People to Independence in COPD).
Design
Multiphase study guided by Baltes Theory of Successful Aging and the 5Ms Framework: Phase 1: Nominal group technique (NGT), a structured process of prioritizing responses to a question through group consensus. Phase 2: Rapid qualitative analysis. Phase 3: Intervention mapping and refinement.
Setting
Ambulatory, virtual.
Participants
Older adults with COPD, family caregivers, clinic staff (nurses, respiratory therapists), clinicians (physicians, nurse practitioners), and health system leaders.
Results
NGT sessions were conducted by constituency group with 37 participants (n = 7 patients, n = 6 family caregivers, n = 8 clinic staff, n = 9 clinicians, n = 7 health system leaders) (Phase 1). Participants generated 92 statements across five themes (Phase 2): (1) “Barriers to care”, (2) “Family caregiver needs”, (3) “Functional status and mobility issues”, (4) “Illness understanding”, and (5) “COPD care complexities”. Supplemental oxygen challenges emerged as a critical problem, and prioritized challenges differed by group. Patients and clinic staff prioritized “Functional status and mobility issues”, family caregivers prioritized “Family caregiver needs”, and clinicians and health system leaders prioritized “COPD care complexities”. Intervention mapping (Phase 3) guided EPIC refinement focused on meeting patient priorities of independence and mobility but accounting for all priorities.
Conclusions
Diverse constituency groups identified priority challenges for older adults with COPD. Functional status and mobility issues, particularly related to supplemental oxygen, emerged as patient prioritized challenges.
Implications
Patient-centered interventions for older adults with COPD must account for their prioritized functional and supplemental oxygen needs and explore diverse constituent perspectives to facilitate intervention enrichment.
期刊介绍：
Journal of the American Geriatrics Society (JAGS) is the go-to journal for clinical aging research. We provide a diverse, interprofessional community of healthcare professionals with the latest insights on geriatrics education, clinical practice, and public policy—all supporting the high-quality, person-centered care essential to our well-being as we age. Since the publication of our first edition in 1953, JAGS has remained one of the oldest and most impactful journals dedicated exclusively to gerontology and geriatrics.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
