Support for older people with COPD in community settings: a systematic review of qualitative research.

Kirkpatrick, Pamela; Wilson, Ethel; Wimpenny, Peter

Abstract

There are an estimated three million people affected by Chronic Obstructive Pulmonary Disease (COPD) in the UK with only about 900,000 of these being diagnosed according to the Healthcare Commission, and prevalence is increasing. Significant progress has been made in respect of treatment and management of the disease. However, there is limited evidence related to the perspective of those with COPD despite an acknowledgement that lung function, as determined by spirometry, does not necessarily equate with pulmonary disease5 and subsequent functional level or disability. The impact of COPD on patients, their family, carers and healthcare services demands that better ill health prevention and disease maintenance strategies be employed. The objective of this review was to explore the common and shared experiences of those in caring partnership for patients with COPD receiving care and support in their community. For this review, the definition of support takes the view that support relates to ‘any activity or intervention aimed at improving or maintaining the health status of a patient with COPD’. The review focused on the experiences of patients, carers, family members, nurses and doctors involved in providing support to patients with COPD in their own home. Patients aged 65 years and over were included. The review considered studies that represented patient, carer, nursing and medical staff experiences and perceptions of support relating to COPD. The review considered evidence from qualitative research including phenomenology, grounded theory, and descriptive studies, where support for COPD in a community context was the focus. The search set out to find published studies in English from 1990-2010. The studies were appraised and findings extracted using the JBI critical appraisal tool for qualitative research. Three reviewers appraised the studies independently. 72 studies were critically appraised and 39 met the inclusion criteria. Findings from included papers were aggregated, categorised and synthesised. Three syntheses were extracted from the categorised findings: 1) Consistence in service provision. If those with COPD received more consistent support in relation to information, rehabilitation, end of life care and other service provision then their quality of life could be enhanced. 2) Home based care. Better planned and more integrated support for home based care around self-care/management and in managing exacerbations can reduce patient and carer anxiety and distress related to COPD. 3) Individualisation of care. Individualisation of care, which is not based on the patient's ‘disease state’ (i.e. physical parameters) but on assessed need, is a necessary part of care for those with COPD.

Citation

KIRKPATRICK, P., WILSON, E. and WIMPENNY, P., 2012. Support for older people with COPD in community settings: a systematic review of qualitative research. JBI database of systematic reviews and implementation reports [online], 10(57), pages 3649-3763. Available from: https://doi.org/10.11124/jbisrir-2012-6

• Journal Article Type: Article
• Acceptance Date: Dec 31, 2012
• Online Publication Date: Dec 31, 2012
• Publication Date: Dec 31, 2012
• Deposit Date: Jun 9, 2015
• Publicly Available Date: Jun 9, 2015
• Journal: JBI database of systematic reviews and implementation reports
• Electronic ISSN: 2202-4433
• Publisher: Joanna Briggs Institute
• Peer Reviewed: Peer Reviewed
• Volume: 10
• Issue: 57
• Pages: 3649-3763
• DOI: https://doi.org/10.11124/jbisrir-2012-6
• Keywords: COPD; Chronic obstructive lung disease; Chronic obstructive pulmonary disease; Chronic obstructive airways disease; Chronic bronchitis; Emphysema; Support; Qualitative research; Older people
• Public URL: http://hdl.handle.net/10059/1214
• Publisher URL: http://joannabriggslibrary.org/index.php/jbisrir/article/view/6