The asthmaCOPD nurses experience of educating patients with Chronic Obstructive Pulmonary Disease CO

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The asthma/COPD nurses experience of educating
patients with Chronic Obstructive Pulmonary
Disease (COPD) in primary health
careAnn-Britt Zakrisson, 1,2 District Nurse,
PhD student Doris Hägglund, 1,2 RNT, PhD, Senior
Lecturer.1Family Medicine Research Centre,
Örebro University. 2School of Health and Medical
Sciences, Örebro University, Sweden.ann-britt.
zakrisson_at_orebroll.se
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Background

• The prevalence of COPD is increasing (GOLD, 2007)
• COPD affects the patient in physical,
  psychological and social areas (Nici et al, 2006)
• Nursing care involves patient education
  (Kilgariff, 1999)

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Nurse-led clinics

• Function
• Enabler
• Educate
• Support
• Co-operate with patients and families
• (Stamler, 1996. Lindberg, 1999. Törnkvist, 2001.
  Lindberg, 2001. Eijkelberg,2002.)

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Patient education

• Primary goal is responsibility for their health
• Leads to self-care
• Not only mediating facts an emotional component
• Planned process
• Patient-centered
• Time for observation, identification, creating
  contact, listening
• Flexibility and respect
• Communication skills
• Participation
• (Stamler, 1996. Piredda, 2004. Tveiten,
  2005. Erdley, 2005. Yoon, 2006. Timmins, 2006.
  Powell, 2007.)

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Aim/Method/Analysis

• The aim was to describe the COPD nurses
  experience of educating patients with COPD
• Interviews with 12 COPD nurses
• Qualitative content analysis according to
  GraneheimLundman, (2004)

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Backgrounds for COPD nurses
One nurse stated as needed
 
on
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Findings

• Theme I
• A lack of support gives the nurse a feeling of
  insecurity, which makes it difficult to develop
  patient education.
• Well, I think that if you dont get any
  real support from the group of GPs, then they
  dont really know quite what Im doing, or what I
  can do, and what use I can be to them in that
  way. Its heavy work when you have to put your
  shoulder to the wheel alone, but I have to do the
  little I can, and no more gets done. I cant take
  over either the GPs or the physiotherapists
  job, its enough if I can manage my own tasks.

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• Theme II
• Receiving support results in a feeling of
  security, which enables the development of
  patient education.
• Last autumn I felt that I was getting the
  hang of the whole thing. When you are a little
  uncertain you often follow a set scheme, but I
  suddenly felt I could drop the scheme and
  encounter the actual patient. Thats the joy of
  it you feel secure enough in your work to modify
  the education using your own resources.

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Conclusion

• The COPD nurses are
• Fluctuated between insecurity and security
• Patient-focused
• The COPD nurses need support by
• Management and colleagues
• Guidelines
• Framework for patient education

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Important message

• The COPD nurses message
• More structured patient education
• Time
• Multidisciplinary collaboration
• Future research
• More research on multidisciplinary COPD
  rehabilitation in PHC