Nurses’ perspectives concerning caring for and improving self-management in patients with COPD who are repeatedly admitted to a pulmonary ward

Abstract

Background; Chronic Obstructive Pulmonary Disease (COPD) is a public health problem. COPD can change on a daily basis, patients can have recurring exacerbations and severe exacerbations results in hospital admission. By administering self-management patients can minimize the severity and/or length of the exacerbation. Unfortunately, many COPD patients find it hard to achieve self-management. This can cause re-admission. Nurses may struggle with their feelings when patients are re-admitted. They might be less motivated to care for and guide these patients. However, little is known about the care that nurses provide and how they stay motivated to treat COPD patients who are repeatedly admitted to a hospital. Aim and research question; Collect information about nurses’ perspectives concerning caring for and improving self-management in patients with COPD who are repeatedly admitted to a pulmonary ward. Method; A qualitative descriptive study. Participants came from a purposeful sample of 58 nurses, working in two general hospitals, on two pulmonary wards. Semi-structured interviews were held. Thematic content analysis was used to make inferences about the perspectives. Results; Twelve nurses were interviewed. During the analysis three main themes emerged; perspectives, feelings and motivation. These main themes influence the care nurses give to and the guiding in improving self-management in patients with COPD. Conclusion; Nurses’ care for and improving self-management in patients with COPD is influenced by their perspectives, e.g. patients have low learning competencies, feelings, e.g. powerlessness and frustration, and their motivations. Recommendations; Barriers, like feeling frustration and not having the motivation to improve self-management, are made visible and these barriers should be taken into account when a training is developed to improve the care nurses give to patients with COPD.