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Int J Chron Obstruct Pulmon Dis ; 12: 2955-2967, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29070947

RESUMO

BACKGROUND: COPD has significant psychosocial impact. Self-management support improves quality of life, but programs are not universally available. IT-based self-management interventions can provide home-based support, but have mixed results. We conducted a case series of an off-the-shelf Internet-based health-promotion program, The Preventive Plan (TPP), coupled with nurse-coach support, which aimed to increase patient activation and provide self-management benefits. MATERIALS AND METHODS: A total of 19 COPD patients were recruited, and 14 completed 3-month follow-up in two groups: groups 1 and 2 with more and less advanced COPD, respectively. Change in patient activation was determined with paired t-tests and Wilcoxon signed-rank tests. Benefits and user experience were explored in semistructured interviews, analyzed thematically. RESULTS: Only group 1 improved significantly in activation, from a lower baseline than group 2; group 1 also improved significantly in mastery and anxiety. Both groups felt significantly more informed about COPD and reported physical functioning improvements. Group 1 reported improvements in mood and confidence. Overall, group 2 reported fewer benefits than group 1. Both groups valued nurse-coach support; for group 1, it was more important than TPP in building confidence to self-manage. The design of TPP and lack of motivation to use IT were barriers to use, but disease severity and poor IT skills were not. DISCUSSION: Our findings demonstrate the feasibility of combining nurse-coach support aligned to an Internet-based health resource, TPP, in COPD and provide learning about the challenges of such an approach and the importance of the nurse-coach role.


Assuntos
Aconselhamento/métodos , Pulmão/fisiopatologia , Papel do Profissional de Enfermagem , Equipe de Assistência ao Paciente , Doença Pulmonar Obstrutiva Crônica/enfermagem , Autocuidado/métodos , Telemedicina/métodos , Idoso , Idoso de 80 Anos ou mais , Estudos de Viabilidade , Feminino , Volume Expiratório Forçado , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Participação do Paciente , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/psicologia , Qualidade de Vida , Fatores de Tempo , Resultado do Tratamento , Capacidade Vital
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