What are the needs of patients following discharge from hospital after an acute exacerbation of chronic obstructive pulmonary disease (COPD)?
OBJECTIVE
To identify patient needs following discharge from hospital after an exacerbation of COPD.


METHODS
Qualitative and semi-quantitative study using home-based structured interviews and focus groups involving 25 COPD patients after hospital discharge. Interviews were performed seven days and three months post-discharge. Quantitative data were analysed using descriptive statistics and were triangulated with the qualitative data from interviews and the focus groups.


RESULTS
There were high levels of depression (64%) and anxiety (40%). Feelings of anxiety after discharge were associated with the fear of another "attack" and with uncertainties about social and medical care provision, especially the provision of oxygen.


CONCLUSIONS
Interventions to reduce readmission for COPD exacerbations need to consider the psychosocial as well as the medical needs of patients. There appears to be a need for improved hospital discharge procedures and community follow-up - including the provision of pulmonary rehabilitation and encouragement of self-management strategies.
Box Surgery, Box, Wiltshire, SN13 8NA, UK. Kevin.Gruffydd-Jones@gp-J83013.nhs.uk
Kevin
K
Gruffydd-Jones
Carol
C
Langley-Johnson
Christopher
C
Dyer
Kathryn
K
Badlan
Sabbi
S
Ward
D000208:Acute Disease; D000368:Aged; D001007:Anxiety / Q000523:psychology*; D001294:Attitude to Health; D003863:Depression / Q000523:psychology*; D004739:England; D005260:Female; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010359:Patient Readmission; D011569:Psychiatric Status Rating Scales; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology*; D012648:Self Care / Q000523:psychology*; D013222:State Medicine; D013315:Stress, Psychological