Örebro Studies in Medicine 59
örebro 2011
Doctoral Dissertation
Management of patients with
Chronic Obstructive Pulmonary Disease
in Primary Health Care
A study of a nurse-led multidisciplinary
programme of pulmonary rehabilitation
Ann-Britt Zakrisson Medical Science 2011
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ÖREBRO STUDIES IN MEDIcINE 59 Ann-Britt Zakrisson is a registered nurse,special-ized in public health care since 1992 and asthma/COPD care since 1998. During the last six years she has, along-side her doctoral studies at the Family Medicine Research Centre, Örebro University, worked as an asthma/COPD nurse in primary health care and also had a part time position at CAMTÖ (Centre for Assessment of Medi-cal Technology in Örebro), Örebro County Council. As an asthma/COPD nurse, the author experienced treating patients with COPD as frustrating. The patients were seriously ill, they suffered from breathlessness and exhaustion and the author thought she had nothing to offer. The existing reports on the management of COPD came from special clinics in hospital settings, but what could be done for the patients with COPD in primary health care? This was the question that led the author to embark on the research journey.
The purpose of interventions in care of patients with COPD is to improve their function in everyday life. It is well known that pulmonary rehabilitation can reduce exacerbations, increase functional capacity and increase health related quality of life in patients with COPD when performed in a hospital setting. However, pulmonary rehabilitation has not been adequately investigated in primary health care where the majority of the patients are cared for. The overall aim of this doctoral thesis is threefold; to modify and evaluate the effects as well as to describe the experiences in a nurse-led multidisciplinary programme of pulmonary rehabilitation from the perspective of patients and their next of kin. The needs of COPD-nurses in primary health care were surveyed in advance of the intervention and were taken into account when developing the multidisciplinary programme. With COPD greatly on the increase the demands on the resources of primary health care is growing and the health care system must be prepared to manage it. The results from the present thesis provide implications for the care for patients with COPD and their next of kin in primary health care.
issn 1652-4063 isbn 978-91-7668-819-9
