Enabling patients with advanced chronic obstructive pulmonary disease to identify and express their support needs to health care professionals: A qualitative study to develop a tool.

A Carole Gardener,Morag Farquhar,Gail Ewing

doi:10.1177/0269216319833559

A Carole Gardener, Morag Farquhar + Show 1 more

Open Access

https://doi.org/10.1177/0269216319833559

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Abstract

Background:Patients with advanced chronic obstructive pulmonary disease have difficulty reporting their holistic support needs to health care professionals, undermining delivery of person-centred care. We lack tools that directly support patients with this.Aim:To develop an evidence-based, designed-for-purpose, tool to enable patients to directly identify and express support needs to health care professionals.Design:Two-stage qualitative study. Stage 1: domains of support need were identified through a systematic review, analysis of an established qualitative dataset and patient/carer focus groups. Stage 2: draft tool developed using the identified domains of need and then refined through feedback from patients, carers and health care professionals, ensuring acceptability and suitability.Setting/participants:Stage 1 patients/carers recruited via four primary care practices and two patient support groups (East of England). Stage 2 health care professionals recruited via the Clinical Research Network and local community trust and patients/carers through two further practices and two additional support groups (East of England). In total, 57 patients, carers and health care professionals participated.Results:A comprehensive set of evidence-based support domains (for example: overcoming boredom or loneliness, knowing what to expect in the future) was identified and formulated into questions. The resulting tool asks patients to consider whether they need more support in 15 broad areas. Patients, carers and clinical stakeholders broadly endorsed the tool’s content and wording.Conclusion:The Support Needs Approach for Patients (SNAP) tool is a concise evidence-based tool designed to help patients with advanced chronic obstructive pulmonary disease identify and express their support needs to enable delivery of person-centred care.

Highlights

The study comprised two stages, as illustrated in Figure 1: (1) establishment of a comprehensive evidence-based typology of patient support needs in advanced chronic obstructive pulmonary disease (COPD) and (2) development and refinement of the tool
The findings provided the draft typology of patient support needs, which was applied to a further random sample (n = 20) of the remaining baseline interviews from the parent study (n = 215), to establish comprehensiveness
There was no evidence within the established dataset for the support domain relating to ‘work’, which was only found in the systematic review

Summary

Introduction

This study aimed to develop an evidence-based, designed-for-purpose, tool to enable patients directly identify and express their support needs to health care professionals. Aim: To develop an evidence-based, designed-for-purpose, tool to enable patients to directly identify and express support needs to health care professionals. Conclusion: The Support Needs Approach for Patients (SNAP) tool is a concise evidence-based tool designed to help patients with advanced chronic obstructive pulmonary disease identify and express their support needs to enable delivery of person-centred care

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