A shared decision-making intervention for individuals living with chronic obstructive pulmonary disease who are considering the menu of pulmonary rehabilitation treatment options; a feasibility study.

IF 3.5 3区医学 Q2 RESPIRATORY SYSTEM

Chronic Respiratory Disease Pub Date : 2024-01-01 DOI:10.1177/14799731241238428

A C Barradell,G Doe,H L Bekker,L Houchen-Wolloff,N Robertson,S J Singh

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Abstract

OBJECTIVES Shared Decision Making (SDM) has potential to support Pulmonary Rehabilitation (PR) decision-making when patients are offered a menu of centre- and home-based options. This study sought to evaluate the feasibility and acceptability of a three-component PR SDM intervention for individuals with Chronic Obstructive Pulmonary Disease (COPD) and PR healthcare professionals. METHODS Participants were recruited from Dec 2021-Sep 2022. Healthcare professionals attended decision coaching training and used the consultation prompt during consultations. Individuals received the Patient Decision Aid (PtDA) at PR referral. Outcomes included recruitment capability, data completeness, intervention fidelity, and acceptability. Questionnaires assessed patient activation and decisional conflict pre and post-PR. Consultations were assessed using Observer OPTION-5. Optional interviews/focus groups were conducted. RESULTS 13% of individuals [n = 31, 32% female, mean (SD) age 71.19 (7.50), median (IQR) MRC dyspnoea 3.50 (1.75)] and 100 % of healthcare professionals (n = 9, 78% female) were recruited. 28 (90.32%) of individuals completed all questionnaires. SDM was present in all consultations [standardised scores were mean (SD) = 36.97 (21.40)]. Six healthcare professionals and five individuals were interviewed. All felt consultations using the PtDA minimised healthcare professionals' bias of centre-based PR, increased individuals' self-awareness of their health, prompted consideration of how to improve it, and increased involvement in decision-making. DISCUSSION Results indicate the study processes and SDM intervention is feasible and acceptable and can be delivered with fidelity when integrated into the PR pathway.

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为正在考虑肺康复治疗方案的慢性阻塞性肺病患者提供共同决策干预；可行性研究。

目的当患者可在中心和家庭进行选择时，共享决策（SDM）有可能为肺康复（PR）决策提供支持。本研究旨在评估由三部分组成的肺康复 SDM 干预对慢性阻塞性肺病（COPD）患者和肺康复医护人员的可行性和可接受性。医护人员参加了决策指导培训，并在咨询过程中使用了咨询提示。患者在转诊时会收到患者决策辅助工具（PtDA）。结果包括招募能力、数据完整性、干预忠实性和可接受性。问卷调查评估了患者转诊前和转诊后的积极性和决策冲突。使用观察者 OPTION-5 对会诊情况进行评估。结果13%的个体[n = 31，32% 为女性，平均（标清）年龄 71.19 (7.50)，MRC 呼吸困难中位数（IQR）3.50 (1.75)]和 100% 的医护人员（n = 9，78% 为女性）被招募。28人（90.32%）完成了所有问卷。所有会诊中均存在 SDM [标准化评分的平均值（标准差）= 36.97 (21.40)]。六名医护人员和五名患者接受了访谈。结果表明，研究过程和 SDM 干预是可行的、可接受的，在整合到公关路径中时可以忠实地实施。

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来源期刊

Chronic Respiratory Disease RESPIRATORY SYSTEM-

CiteScore

5.90

自引率

7.30%

发文量

审稿时长

11 weeks

期刊介绍： Chronic Respiratory Disease is a peer-reviewed, open access, scholarly journal, created in response to the rising incidence of chronic respiratory diseases worldwide. It publishes high quality research papers and original articles that have immediate relevance to clinical practice and its multi-disciplinary perspective reflects the nature of modern treatment. The journal provides a high quality, multi-disciplinary focus for the publication of original papers, reviews and commentary in the broad area of chronic respiratory disease, particularly its treatment and management.