title: Indicators of pulmonary exacerbation in cystic fibrosis: A Delphi survey of patients and health professionals.
abstract: BACKGROUND
  There is uncertainty about the most important indicators of pulmonary exacerbations in CF.
  
  
  METHODS
  Two parallel Delphi surveys in 13 CF centres (UK and Ireland). Delphi 1: 31 adults with CF, ≥ one exacerbation over 12 months. Delphi 2: 38 CF health professionals. Rounds 1 and 2 participants rated their level of agreement with statements relating to indicators of exacerbation; Round 3 participants rated the importance of statements which were subsequently placed in rank order.
  
  
  RESULTS
  Objective measurements were of higher importance to health professionals. Feelings of increased debility were rated most important by adults with CF.
  
  
  CONCLUSIONS
  There were clear differences in perspectives between the two groups as to the most important indicators of an exacerbation. This highlights that CF health professionals should take more cognisance of specific signs and symptoms reported by adults with CF, especially since these may be a precursor to an exacerbation.
authors.affiliation: Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health Research, University of Ulster, Northern Ireland BT37 OQB, United Kingdom. Electronic address: fiona.mccourt@nictu.hscni.net.
authors.forename: Fiona
authors.initials: F
authors.lastname: McCourt
authors.affiliation: Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health Research, University of Ulster, Northern Ireland BT37 OQB, United Kingdom.
authors.forename: Brenda
authors.initials: B
authors.lastname: O'Neill
authors.affiliation: Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health Research, University of Ulster, Northern Ireland BT37 OQB, United Kingdom.
authors.forename: Ian
authors.initials: I
authors.lastname: Logan
authors.affiliation: School of Psychology, University of Central Lancashire, Preston PR1 2HE, England, United Kingdom.
authors.forename: Janice
authors.initials: J
authors.lastname: Abbott
authors.affiliation: Cork Adult CF Centre, Cork University Hospital, University College Cork, Wilton, Cork, Ireland.
authors.forename: Barry
authors.initials: B
authors.lastname: Plant
authors.affiliation: Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health Research, University of Ulster, Northern Ireland BT37 OQB, United Kingdom.
authors.forename: Evie
authors.initials: E
authors.lastname: McCrum-Gardner
authors.affiliation: Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health Research, University of Ulster, Northern Ireland BT37 OQB, United Kingdom.
authors.forename: Stephanie
authors.initials: S
authors.lastname: McKeown
authors.affiliation: Centre for Infection and Immunity, Queen's University, Belfast BT9 7BL, Northern Ireland, United Kingdom.
authors.forename: J
authors.initials: J
authors.lastname: Stuart Elborn
authors.affiliation: Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health Research, University of Ulster, Northern Ireland BT37 OQB, United Kingdom; Department of Respiratory Medicine, Belfast Health and Social Care Trust, Belfast BT9 7AB, Northern Ireland, United Kingdom.
authors.forename: Judy M
authors.initials: JM
authors.lastname: Bradley
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000503:physiopathology*; D003697:Delphi Technique; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006282:Health Personnel; D006801:Humans; D015994:Incidence; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012129:Respiratory Function Tests; D018570:Risk Assessment; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D006113:United Kingdom; D055815:Young Adult
keywords: Cystic fibrosis; Delphi technique; Pulmonary exacerbation