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. 2023 Mar 2:18:207-218.
doi: 10.2147/COPD.S393645. eCollection 2023.

Prevention of Re-Hospitalization for Acute Exacerbations: Perspectives of People with Chronic Obstructive Pulmonary Disease: A Qualitative Study

Anna Hobman  1 , William M M Levack  1 , Bernadette Jones  1 , Tristram R Ingham  1 , James Fingleton  2 , Mark Weatherall  1 , Amanda A McNaughton  3 , Harry K McNaughton  3
Affiliations

Prevention of Re-Hospitalization for Acute Exacerbations: Perspectives of People with Chronic Obstructive Pulmonary Disease: A Qualitative Study

Anna Hobman et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Purpose: Current guidelines for prevention of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) reflect clinical understanding of the causes of exacerbations but with a limited recognition of person-specific contributing factors. As part of a randomized trial of a person-centered intervention aiming to promote self-determination, we describe personal perspectives of those with chronic obstructive pulmonary disease (COPD) on what they saw as the causes and best ways to stay well and prevent rehospitalization after an AECOPD.

Patients and methods: Twelve participants (mean age 69.3 years, six female, six male; eight New Zealand European, two Māori, one Pacific, and one other) were interviewed about their experiences of staying well and out of hospital. Data were collected via individual semi-structured interviews one year following an index hospital admission for AECOPD and focused on the participants' views and experiences of their health condition, their beliefs about staying well, and the causes of and factors preventing further exacerbations and hospitalizations. Data were analyzed using constructivist grounded theory methods.

Results: Three main themes were identified that described participants' views on what helped or hindered them to stay well and out of hospital: 1) Being Positive: The importance of having a positive mindset; 2) Being Proactive: Practical steps to reduce the risk of, and consequences from, episodes of AECOPD; and 3) Being in Control: Feeling in command of one's life and health. Each of these was affected by Being Connected: The influence of significant others, particularly close family.

Conclusion: This research expands our understanding of how patients manage COPD and adds patient perspectives to current knowledge on how to prevent recurrent AECOPD. Programs which promote self-efficacy and positivity would be beneficial additions to AECOPD prevention strategies, as could the inclusion of family or significant others in wellbeing plans.

Keywords: COPD; lived experience; rehospitalization; self-efficacy; self-management; taking charge.

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Conflict of interest statement

William MM Levack and Tristram R Ingham report grants from Health Research Council of New Zealand, during the conduct of the study. Bernadette Jones reports grants from Health Research Council New Zealand, outside the submitted work. The authors reports no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Factors attributed by people with COPD to staying well, preventing recurrence of AECOPD, and preventing rehospitalization.
See this image and copyright information in PMC

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