Feasibility of a New Individualized Nursing Care Intervention in COPD, the COPD-GRIP Intervention
Background: The new nurse-led COPD-Guidance, Research on an Illness Perception (COPD-GRIP) intervention translates the evidence concerning illness perceptions and Health Related Quality of Life (HRQoL) into a practical guide to guide COPD patients and to improve their HRQoL. Within three consultations illness perceptions are being assessed, discussed and linked to behaviour.
The aim: is to identify barriers and facilitators to improve the COPD-GRIP intervention and its implementation in clinical practice.
Method: An explanatory mixed-method study nested in a cluster randomized trial in primary care was conducted. Pre-questionnaires were sent to all participating practice nurses (PN)(N=24).Post-questionnaires identified experiences after applying the intervention. A more extended exploration was obtained by two focus groups. Questionnaires were analyzed by descriptive analyses. To identify themes the audio-taped and transcribed focus groups were independently coded by two researchers.
Results: The PN's described the intervention as an useful, structured and individualized tool. It enables them to enhance disease knowledge, understanding and awareness in COPD patients. Barriers were seen in applying the intervention in patients with a different cultural background(60%), a lower social economic status(60%), multimorbidity(60%) and in patients who do not visit the practice regularly(40%). It appeared to be difficult to accommodate three consultations for each individual patient within six weeks within the context of daily practice.
Conclusion: practice nurses perceived the COPD-GRIP intervention as a feasible, individualized tool to guide COPD patients in living with the consequences of COPD.
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