2.50
Hdl Handle:
http://hdl.handle.net/10755/203200
Type:
Presentation
Title:
An EBP Model Guides Exploration of a COPD Self-Management Strategy
Abstract:
(Summer Institute) Problem: COPD was the sixth leading cause of death worldwide in 1990 and is expected to become the third leading cause of death by 2020. The magnitude of COPD, associated symptoms and complications of the disease, lead to an exploration of alternative management strategies that can augment or complement existing clinical management available to individuals with COPD. Evidence: An exhaustive literature search among multiple databases identified several breathing retraining techniques, such as, pursed lip breathing (PLB), to be associated with improving dyspnea in individuals with lung disease. Evidence supports PLB as the best intervention for addressing perception of dyspnea in COPD. Strategy: Breathing retraining as a self-management strategy incorporating Wagner’s chronic care model, self-efficacy and behavioral learning theories, depicts a model within Rosswurm and Larrabee’s evidence-based practice model. Using an evidence-based practice (EBP) model, a chronic disease self-management strategy - PLB, was explored in individuals with COPD. Practice Change: Incorporating PLB into ones daily regimen will lead to improved perception of dyspnea, functional performance, and self –efficacy while fostering self-empowerment. Evaluation: Over a 4 month period, 26 COPD clients were offered the opportunity to voluntarily participate with only 10 being willing to learn and practice PLB. Three pre- and post-testing scales were used to measure dyspnea, functional performance and self-efficacy. Participants were taught PLB, asked to practice PLB daily for 5 minutes for the first week, and then increase the daily practice time by 1 to 5 minutes each week thereafter. Results: When COPD clients practiced PLB on a regular basis their perception of dyspnea and self–efficacy were improved. Recommendations: Pursed lip breathing can easily be taught at routine COPD office visits of both primary care and specialty practices, and supports the use of chronic disease self-management strategies to augment the existing provider-client relationship. Lessons Learned: Clients need time to absorb the magnitude of any project before participating. Some clients are more motivated then others. Bibliography: Bandura, A. (1982). The assessment and predictive generality of self-percepts of efficacy. Journal of behavioral Theory Experimental Psychiatry, 13(3), 195-9. Bodenheimer, T, Lorig, K, Holman, H & Grumbach, K. (2002). Patient self management of chronic disease in primary care. JAMA, 288(19), 2469-2475. Bourbeau, J. & Nault, D. (2007). Self-management strategies in chronic obstructive pulmonary disease. Clinics in Chest Medicine, 28, 617-628. Bourbeau, J. & Barlett, S. J. (2008). Patient adherence in COPD. Thorax, 63(1), 831-838. Chang, A.T., Haines, T., Jackson, C., Yang, I., Nitz, J., Choy, N. L., & Vicenzino, B. (2007). Rationale and design of the PRSM study: Pulmonary rehabilitation or self-management for chronic obstructive pulmonary disease (COPD), what is the best approach? Contemporary Clinical Trials. 29, 796-800. Decchman, G. & Wilson, C. R. (2004). Evidence underlying breathing retraining in people with stable chronic obstructive pulmonary disease. Physical Therapy. 84(12), 1189-1197. Dickson, G. L. & Flynn. L. (2009). Nursing policy research: Turning evidence based research into health policy. New York: Springer Publishing Co, LTD. Foster, G., Taylor, S., Eldridge, S. E., Ramsey, J., &. Griffiths, C. J. (2008). Self-management education programs by lay leaders for people with chronic conditions. The Cochrane Library, 4. No page numbers. GOLD (2006). Global Initiative for Chronic Obstructive Pulmonary Disease, Executive Summary: Global Strategy for the Diagnosis, Management, and Prevention of COPD, 2006, Retrieved February 28, 2009 from www.goldcopd.com. Halbert, R. J., Natoli, J. L., Gano, A., Badamgarav, A. S., Buist, A. S., & Mannino, D. M. (2006). Global burden of COPD: Systematic review and meta-analysis. European Respiratory Journal, 28(3), 523-532. Hand, H. (2006). Promoting effective teaching and learning in the clinical setting. Nursing Standard, 20(39), 55-63. Healthy People (2010). Health Communication. Lippincott’s Case Management. 6(5), 11-1–25. Institute for Clinical Systems Improvement (ICIS) (2009). Retrieved March 1, 2010, from www.icis.org. Institute of Medicine (2001). Crossing the quality chasm: A new health system for the 21st century. Retrieved March 26, 2010, from http://www.iom.edu/Object.File/Master/27/184/Chasm-8pager.pd Institute of Medicine (2003). Health professions education: A bridge to quality. Retrieved March 1. 2010 from http://www.nap.edu/openbook.php?record_id=10681&page=1 Lopez, A. D., Shibuya, K., Rao, C., Mathers, C. D., Hansell, A. L., Held, L. S., Schmid, V., & Buist, S. (2006). Chronic obstructive pulmonary disease: Current burden and future projections. European Respiratory Journal, 27(2), 397-412. Make, B. (1994). Collaborative self-management strategies for patients with respiratory disease. Respiratory Care, 39(2), 566-574. Melnyk, B. M. & Fineout-Overholt, E. (Eds.), (2005). Evidence-based practice in nursing and Healthcare: A guide to best practice. Philadelphia: Lippincott, Williams. National Heart Lung and Blood Institute (2007). Morbidity and Mortality: 2007 Chart Book on Cardiovascular, Lung and Blood Disease. National Institutes of Health. Nield, M. A., Soo Hoo, G., W., Roper, J., M., & Santiago, S. (2007). Efficacy of pursed-lips breathing: A breathing pattern retraining strategy for dyspnea reduction. Journal of Cardiopulmonary Rehabilitation and Prevention, 27(4), 237-244. Norweg, A. M., Whiteson, J., Malgady, R., Mola, A., & Rey, M. (2005). The effectiveness of different pulmonary rehabilitation program components. Chest, 128(2), 663672. Nguyen, H. Q., Doneskky-Cuenco, D., Wolpin, S., Reinke, L. F., Benditt, J. O., Paul, S. M., & Carrieri-Kohlman, V. (2008). Randomized control trial of an internet based versus face to face dyspnea self-management program for patients with chronic obstructive pulmonary disease: Pilot study. Journal of Medical Internet Research, 10(2), 1 – 44. Rosswurm, M. A. & Larrabee, J. H. (1999). A model for change to practice evidence-based practice. Journal of Nursing Scholarship, 31(4), 317-322. Sassi-Dambron, D. E., Eakin, E. G., Ries, A. L., & Kaplan, R. M. (1995). Treatment of dyspnea in COPD, a controlled clinical trial of dyspnea management strategies. Chest, 107(3), 724-729. Stetler, C.B., Ritchie, J., Rycroft-Malone, J., Schultz, A., & Charms, M. (2007). Improving quality care through routine, successful implementation of evidence-based practice at the bedside: an organizational case study protocol using the Pettigrew and Whipp model of strategic change. Implementation Science, 2(3), 1-13. Wagner, E. H. (1998). Chronic disease management: What will it take to improve care for chronic illness? Effective Clinical Practice, 1(1), 2-4. [© Academic Center for Evidence-Based Practice, 2011. http://www.acestar.uthscsa.edu]
Keywords:
COPD; Self-Management
Repository Posting Date:
16-Jan-2012
Date of Publication:
3-Jan-2012
Sponsors:
UTHSCSA Summer Institute

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleAn EBP Model Guides Exploration of a COPD Self-Management Strategyen_GB
dc.identifier.urihttp://hdl.handle.net/10755/203200-
dc.description.abstract(Summer Institute) Problem: COPD was the sixth leading cause of death worldwide in 1990 and is expected to become the third leading cause of death by 2020. The magnitude of COPD, associated symptoms and complications of the disease, lead to an exploration of alternative management strategies that can augment or complement existing clinical management available to individuals with COPD. Evidence: An exhaustive literature search among multiple databases identified several breathing retraining techniques, such as, pursed lip breathing (PLB), to be associated with improving dyspnea in individuals with lung disease. Evidence supports PLB as the best intervention for addressing perception of dyspnea in COPD. Strategy: Breathing retraining as a self-management strategy incorporating Wagner’s chronic care model, self-efficacy and behavioral learning theories, depicts a model within Rosswurm and Larrabee’s evidence-based practice model. Using an evidence-based practice (EBP) model, a chronic disease self-management strategy - PLB, was explored in individuals with COPD. Practice Change: Incorporating PLB into ones daily regimen will lead to improved perception of dyspnea, functional performance, and self –efficacy while fostering self-empowerment. Evaluation: Over a 4 month period, 26 COPD clients were offered the opportunity to voluntarily participate with only 10 being willing to learn and practice PLB. Three pre- and post-testing scales were used to measure dyspnea, functional performance and self-efficacy. Participants were taught PLB, asked to practice PLB daily for 5 minutes for the first week, and then increase the daily practice time by 1 to 5 minutes each week thereafter. Results: When COPD clients practiced PLB on a regular basis their perception of dyspnea and self–efficacy were improved. Recommendations: Pursed lip breathing can easily be taught at routine COPD office visits of both primary care and specialty practices, and supports the use of chronic disease self-management strategies to augment the existing provider-client relationship. Lessons Learned: Clients need time to absorb the magnitude of any project before participating. Some clients are more motivated then others. Bibliography: Bandura, A. (1982). The assessment and predictive generality of self-percepts of efficacy. Journal of behavioral Theory Experimental Psychiatry, 13(3), 195-9. Bodenheimer, T, Lorig, K, Holman, H & Grumbach, K. (2002). Patient self management of chronic disease in primary care. JAMA, 288(19), 2469-2475. Bourbeau, J. & Nault, D. (2007). Self-management strategies in chronic obstructive pulmonary disease. Clinics in Chest Medicine, 28, 617-628. Bourbeau, J. & Barlett, S. J. (2008). Patient adherence in COPD. Thorax, 63(1), 831-838. Chang, A.T., Haines, T., Jackson, C., Yang, I., Nitz, J., Choy, N. L., & Vicenzino, B. (2007). Rationale and design of the PRSM study: Pulmonary rehabilitation or self-management for chronic obstructive pulmonary disease (COPD), what is the best approach? Contemporary Clinical Trials. 29, 796-800. Decchman, G. & Wilson, C. R. (2004). Evidence underlying breathing retraining in people with stable chronic obstructive pulmonary disease. Physical Therapy. 84(12), 1189-1197. Dickson, G. L. & Flynn. L. (2009). Nursing policy research: Turning evidence based research into health policy. New York: Springer Publishing Co, LTD. Foster, G., Taylor, S., Eldridge, S. E., Ramsey, J., &. Griffiths, C. J. (2008). Self-management education programs by lay leaders for people with chronic conditions. The Cochrane Library, 4. No page numbers. GOLD (2006). Global Initiative for Chronic Obstructive Pulmonary Disease, Executive Summary: Global Strategy for the Diagnosis, Management, and Prevention of COPD, 2006, Retrieved February 28, 2009 from www.goldcopd.com. Halbert, R. J., Natoli, J. L., Gano, A., Badamgarav, A. S., Buist, A. S., & Mannino, D. M. (2006). Global burden of COPD: Systematic review and meta-analysis. European Respiratory Journal, 28(3), 523-532. Hand, H. (2006). Promoting effective teaching and learning in the clinical setting. Nursing Standard, 20(39), 55-63. Healthy People (2010). Health Communication. Lippincott’s Case Management. 6(5), 11-1–25. Institute for Clinical Systems Improvement (ICIS) (2009). Retrieved March 1, 2010, from www.icis.org. Institute of Medicine (2001). Crossing the quality chasm: A new health system for the 21st century. Retrieved March 26, 2010, from http://www.iom.edu/Object.File/Master/27/184/Chasm-8pager.pd Institute of Medicine (2003). Health professions education: A bridge to quality. Retrieved March 1. 2010 from http://www.nap.edu/openbook.php?record_id=10681&page=1 Lopez, A. D., Shibuya, K., Rao, C., Mathers, C. D., Hansell, A. L., Held, L. S., Schmid, V., & Buist, S. (2006). Chronic obstructive pulmonary disease: Current burden and future projections. European Respiratory Journal, 27(2), 397-412. Make, B. (1994). Collaborative self-management strategies for patients with respiratory disease. Respiratory Care, 39(2), 566-574. Melnyk, B. M. & Fineout-Overholt, E. (Eds.), (2005). Evidence-based practice in nursing and Healthcare: A guide to best practice. Philadelphia: Lippincott, Williams. National Heart Lung and Blood Institute (2007). Morbidity and Mortality: 2007 Chart Book on Cardiovascular, Lung and Blood Disease. National Institutes of Health. Nield, M. A., Soo Hoo, G., W., Roper, J., M., & Santiago, S. (2007). Efficacy of pursed-lips breathing: A breathing pattern retraining strategy for dyspnea reduction. Journal of Cardiopulmonary Rehabilitation and Prevention, 27(4), 237-244. Norweg, A. M., Whiteson, J., Malgady, R., Mola, A., & Rey, M. (2005). The effectiveness of different pulmonary rehabilitation program components. Chest, 128(2), 663672. Nguyen, H. Q., Doneskky-Cuenco, D., Wolpin, S., Reinke, L. F., Benditt, J. O., Paul, S. M., & Carrieri-Kohlman, V. (2008). Randomized control trial of an internet based versus face to face dyspnea self-management program for patients with chronic obstructive pulmonary disease: Pilot study. Journal of Medical Internet Research, 10(2), 1 – 44. Rosswurm, M. A. & Larrabee, J. H. (1999). A model for change to practice evidence-based practice. Journal of Nursing Scholarship, 31(4), 317-322. Sassi-Dambron, D. E., Eakin, E. G., Ries, A. L., & Kaplan, R. M. (1995). Treatment of dyspnea in COPD, a controlled clinical trial of dyspnea management strategies. Chest, 107(3), 724-729. Stetler, C.B., Ritchie, J., Rycroft-Malone, J., Schultz, A., & Charms, M. (2007). Improving quality care through routine, successful implementation of evidence-based practice at the bedside: an organizational case study protocol using the Pettigrew and Whipp model of strategic change. Implementation Science, 2(3), 1-13. Wagner, E. H. (1998). Chronic disease management: What will it take to improve care for chronic illness? Effective Clinical Practice, 1(1), 2-4. [© Academic Center for Evidence-Based Practice, 2011. http://www.acestar.uthscsa.edu]en_GB
dc.subjectCOPDen_GB
dc.subjectSelf-Managementen_GB
dc.date.available2012-01-16T11:02:59Z-
dc.date.issued2012-01-03en_GB
dc.date.accessioned2012-01-16T11:02:59Z-
dc.description.sponsorshipUTHSCSA Summer Instituteen_GB
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