Nursing clinical practice changes to improve self-management in chronic obstructive pulmonary disease

Area of Science:

• Nursing Practice
• Health Behavior Change
• Patient Self-Management

Background:

• Chronic obstructive pulmonary disease (COPD) significantly impacts morbidity, quality of life, and mortality.
• Effective self-management is crucial but challenging for COPD patients, with limited evidence on nursing interventions.

Purpose of the Study:

• To propose and evaluate nursing clinical practice changes to improve patient self-management.
• To identify key elements in nursing practice that can foster self-management skills.

Main Methods:

• Participatory action research conducted in a Portuguese hospital (inpatient and outpatient units).
• Data collected via interviews, participant observation, and content analysis.
• Involved 52 nurses and 99 patients.

Main Results:

• Identified key areas for improvement: healthcare model, organization, and decision-support documentation.
• Specific guidelines, decision-support materials, and optimized information sharing positively influenced change.
• Improved self-management skills including awareness, hope, involvement, knowledge, and abilities.

Conclusions:

• Implemented nursing practice changes enhanced health-related behaviors and clinical outcomes.
• A portfolio of techniques and tools is relevant for supporting patient self-management.
• Joint nurse-patient involvement in policy change is fundamental for improving care quality.