Assessing and responding to stress related to pulmonary function testing in cystic fibrosis through quality improvement
| Autor: | Elizabeth Koch, Jeanne Weiland, Julie F. Feldstein, Thomas F. Boat, Stephanie S. Filigno, Elizabeth A. Hente, L. Mullen, Christopher Siracusa, Kelsey B. Nusbaum |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Stress management medicine.medical_specialty Quality management Adolescent Cystic Fibrosis Psychological intervention Cystic fibrosis Article Pulmonary function testing Likert scale 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Intervention (counseling) Humans Outpatient clinic Medicine Mind-Body Therapies business.industry medicine.disease Quality Improvement Respiratory Function Tests 030228 respiratory system Pediatrics Perinatology and Child Health Physical therapy Female business Stress Psychological |
| Zdroj: | Pediatr Pulmonol |
| ISSN: | 1099-0496 8755-6863 |
| DOI: | 10.1002/ppul.24673 |
| Popis: | Background Pulmonary function tests (PFTs) are performed routinely to evaluate lung function in patients with cystic fibrosis (CF). Staff at the Cincinnati Children's Hospital Medical Center CF Center observed stress in patients before PFTs. An interdisciplinary quality improvement (QI) team was assembled to address this clinical issue. Methods The Plan-Do-Study-Act method of QI was used to investigate feasibility of assessing stress and offering brief interventions to reduce stress before PFTs. Interventions included listening to music, covering the PFT screen, or doing breathing meditation before PFTs. Patients rated stress levels on a 1 to 5 Likert scale before and after testing. Results Of 75 patient encounters, interventions were trialed in 20. Fifteen patients who tried an intervention reported wanting to use the intervention again (five encounters had missing data); patients reported that the intervention benefited performance on PFTs in eight encounters (40%). The average pre-PFT stress rating for encounters that trialed an intervention was 2.1 and post-PFT rating was 2.0. Average stress pre-PFT and post-PFT ratings were 1.7 and 1.6 respectively, for encounters that did not trial an intervention. Median length of PFT encounter was 15 minutes regardless of whether intervention was trialed. Conclusion Some patients with CF utilized interventions, while many opted out. This QI effort identified feasible outpatient clinic interventions that did not negatively impact clinic flow. Finding ways to reduce stress associated with PFTs could have a meaningful impact on patient performance and emotional well-being for a subset of patients. |
| Databáze: | OpenAIRE |
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