Patient perceived impact of nurse-led self-management interventions for COPD: A systematic review of qualitative research

Background: Self-management interventions are increasingly implemented to manage the health impact and economic burden of the growing prevalence of chronic obstructive pulmonary disease. Nurses are the primary providers of self-management education, yet there have been few attempts to assess their contribution in delivering these programmes. Qualitative evidence that explores patients' perceptions of the benefits of self-management is limited. Objective: To synthesize qualitative evidence on patient perceived benefits of nursing interventions to support self-management. Design: Systematic review and qualitative synthesis. Methods: Data were collected from six electronic databases: British Nursing Index (BNI, Proquest), MEDLINE (Ovid), CINAHL (EBSCO), AMED (Ovid), Embase (Ovid), and PsycINFO (Ovid). Pre-defined keywords were used to identify qualitative or mixed methods English-language studies published in any year. The included studies were selected by screening titles, abstracts and full-texts against inclusion and exclusion criteria that were established a priori. The Critical Appraisal Skills Programme tool was used to undertake a quality review. Data were analysed with a framework approach using categories of self management outcomes reported in a previous review as a coding structure. Results: Fourteen articles were included in the review. Four key themes were identified from the original research: Empowerment through new knowledge, Psychological wellbeing, Expanding social worlds and Increased physical activity. Conclusions: When provided with adequate knowledge and support, patients gained self-confidence and their coping behaviour increased. Social and psychological support were identified as key aspects of self management interventions that patients found improved their sense of wellbeing. Group exercise components of self-management programmes were also favourably evaluated due to a perceived sense of increased well-being and enhanced social interaction. (C) 2019 Elsevier Ltd. All rights reserved.