Patient perspectives on the Tailored intervention for Anxiety and Depression Management in COPD (TANDEM): a qualitative evaluation.
Autor: | Sohanpal R; Queen Mary University of London, London, UK. r.sohanpal@qmul.ac.uk., Mammoliti KM; University of Birmingham, Birmingham, UK., Barradell A; University Hospitals of Leicester NHS Trust, Leicester, UK., Kelly M; Queen Mary University of London, London, UK., Newton S; Queen Mary University of London, London, UK., Steed L; Queen Mary University of London, London, UK., Wileman V; King's College London, London, UK., Rowland V; Hertfordshire City Council, Hertfordshire, UK., Dibao-Dina C; University of Tours, Tours, France., Moore A; Barts Health NHS Trust, London, UK., Pinnock H; University of Edinburgh, Edinburgh, UK., Taylor SJC; Queen Mary University of London, London, UK. |
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Jazyk: | angličtina |
Zdroj: | BMC health services research [BMC Health Serv Res] 2024 Aug 21; Vol. 24 (1), pp. 960. Date of Electronic Publication: 2024 Aug 21. |
DOI: | 10.1186/s12913-024-11370-9 |
Abstrakt: | Background: Chronic obstructive pulmonary disease (COPD) is commonly associated with anxiety/depression which can affect self-management and quality of life. The TANDEM trial evaluated a cognitive behavioural approach intervention targeting COPD-related symptoms of anxiety and/or depression, comprising up to eight one-to-one sessions delivered by respiratory healthcare professionals prior to pulmonary rehabilitation (PR). The intervention showed no improvement in anxiety/depression or uptake/completion of PR. We present patient perspectives of the intervention to help understand these results. Method: Semi-structured individual interviews, using a semi-structured topic guide informed by Sekhon's Theoretical Framework of Acceptability, were conducted with 19 patients between September 2019 and April 2020. The interviews were audio-recorded, transcribed verbatim and analysed thematically. Results: The following could have limited the impact of the intervention: (1) The lives of patients were complex and commonly affected by competing comorbidities or other external stressors which they managed through previously adopted long-standing coping strategies. (2) Some patients were reluctant to talk about their mood despite the Facilitators' training and person centred-skills which aimed to enable patients to talk freely about mood. (3) The intervention handouts and 'home-practice' were perceived as helpful for some, but not suitable for all. (4) Many patients perceived improvements in their physical and mental health, but this was not sustained due to a mix of personal and external factors, and some did not perceive any benefits. (5) PR non-attendance/non-completion was a result of personal and PR service-related reasons. (6) Discussing COPD and mental health with the Facilitator was a novel experience. Many patients felt that TANDEM could be of benefit if it was offered earlier on/at different time points in the COPD illness journey. Conclusion: We found the delivery of TANDEM prior to PR was not helpful for patients with advanced COPD often experiencing other comorbidities, and/or difficult personal/external events. These patients already utilised long-standing coping strategies to manage their COPD. Holistic interventions, that address the impact of COPD in relation to wider aspects of a patients' life, may be more beneficial. Trial Registration: ISRCTN Registry 59,537,391. Registration date 20 March 2017. (© 2024. The Author(s).) |
Databáze: | MEDLINE |
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