An exploratory qualitative study of patients’ and healthcare professionals’ views on self-management in bronchiectasis

Abstract

Introduction: Self-management (SM) interventions for many chronic respiratory diseases exist but, despite international guideline recommendations, evidence for SM in bronchiectasis is limited. Aim: To explore the views and preferences of SM in adults with bronchiectasis and healthcare professionals (HCPs) involved in their care. Methods: Three focus groups (17 adults with bronchiectasis) were conducted at three NHS sites. Additionally, semi-structured interviews were undertaken with 11 healthcare professionals (HCPs), including doctors, nurses, and physiotherapists. Thematic analysis identified key findings and verified by independent audit. Findings: Patients’ revealed four key themes: what is SM; the purpose and impact of SM; barriers to SM; and things that help SM. HCP themes were: characteristics of patients and HCPs; delivery and structure of SM; benefits and barriers to SM. HCPs recognised individual patient attributes as essential for SM. Although patients didn’t refer to distinct traits, demographics gave insight into physical activity levels relating to SM engagement. Patients valued peer learning whilst HCPs acknowledged individuals need different approaches and ‘it’s not one size fits all’. Patients and HCPs recognised common barriers though only patients referred to SM as time consuming. Both recognised the importance of access (or lack of) to resources including HCPs’ knowledge of the condition. Summary: Patients and HCPs share insights about SM in bronchiectasis. Both groups were positive about SM, but barriers were identified; a vital insight when designing SM programmes. HCPs knowledge of the disease is a recognised precursor to effective SM.