Differences between community professional and patient perceptions of chronic obstructive pulmonary disease treatment outcomes: a qualitative study

Abstract

This study aims to define, compare and order 'assessed needs and defined outcomes' of professional providers of chronic obstructive pulmonary disease services with patients' 'prioritised needs and defined outcomes' and relate these to service provision. Long-term morbidity and death rates from respiratory diseases in the UK are increasing. Few studies report patient views and perceptions of needs or priorities for respiratory conditions in primary care. None compare patient's and health professional's perceptions of patient needs, which may identify specific changes for service delivery. A qualitative study using focus group discussion and nominal group technique to define, compare and order professional's and patient's groups' statements to prioritise perceptions. Specialist professionals and patients with chronic obstructive pulmonary disease were recruited to focus groups using systematic purposive sampling. Nominal group ordering of agreed statements occurred after the discussions followed by presentation of results to groups for validation. Four key perceptions ordered and compared show both professionals and patients agreed that access to equitably provided services included more respiratory rehabilitation; other priorities indicate key differences between professional's and patient's perceptions of financial support, the communication of health education and the need for better provision of palliative care at end of life. The study offers new knowledge about what patients in all stages of the disease process consider important for services that will retain their independence. This qualitative study illuminates and compares professional's and patient's priorities for service delivery and their perceptions of chronic obstructive pulmonary disease services. Changing respiratory services to support patient's perceived needs enhances their independence.