Communication and self-management education at nurse-led COPD clinics in primary health care.
OBJECTIVE
The aim of the study was to explore the structure, content in communication and self-management education in patients' first consultations at nurse-led chronic obstructive pulmonary disease (COPD) clinics in primary healthcare.


METHODS
Thirty consultations performed by seven registered nurses were videotaped; structure and content in the consultation was analyzed using Pendleton's Consultation Map. Nurses' self-management education was assessed from the content of the conversation: whether important and relevant information and self-management education was given, and how investigations were performed.


RESULTS
Each consultation lasted for a mean time of 37.53 min. Communication about reasons for consultations concerned mainly medical and physical problems and to a certain extent patients' perceptions. Teaching about self-management and smoking cessation was of an informative nature. Two consultations ended with shared understanding, and none of the patients received an individual treatment-plan.


CONCLUSIONS
Nurses rarely planned the consultations on an individual basis and rarely used motivational dialogue in self-management education and in smoking cessation.


CONCLUSIONS
The findings could be used to help nurses to reflect on how to improve the structure of the visit, self-management education, smoking cessation and patient communication.
Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden. eoe@du.se
Eva
E
Osterlund Efraimsson
Eva
E
Osterlund Eraimsson
Osterlund Efraimsson
OE
Eva
Birgitta
B
Klang
Klang
K
Birgitta
Kjell
K
Larsson
Larsson
L
Kjell
Anna
A
Ehrenberg
Ehrenberg
E
Anna
Bjöörn
B
Fossum
Fossum
F
Bjöörn
D000328:Adult; D000368:Aged; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011320:Primary Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000451:nursing*; D012648:Self Care; D016540:Smoking Cessation; D013548:Sweden; D016896:Treatment Outcome