title: Important, misunderstood, and challenging: a qualitative study of nurses' and allied health professionals' perceptions of implementing self-management for patients with COPD.
abstract: BACKGROUND
  In light of the growing burden of COPD, there is increasing focus on the role of self-management for this population. Currently, self-management varies widely. Little is known either about nurses' and allied health professionals' (AHPs') understanding and provision of self-management in clinical practice. This study explores nurses' and AHPs' understanding and implementation of supported COPD self-management within routine clinical practice.
  
  
  METHODS
  Nurses and AHPs participated in face-to-face semistructured interviews to explore their understanding and provision of COPD self-management, as well as their perceptions of the challenges to providing such care. Purposive sampling was used to select participants from a range of professions working within primary, community, and secondary care settings. Three researchers independently analyzed each transcript using a thematic approach.
  
  
  RESULTS
  A total of 14 participants were interviewed. Nurses and AHPs viewed self-management as an important aspect of COPD care, but often misunderstood what it involved, leading to variation in practice. A number of challenges to supporting self-management were identified, which related to lack of time, lack of insight regarding training needs, and assumptions regarding patients' perceived self-management abilities.
  
  
  CONCLUSIONS
  Nurses and AHPs delivering self-management require clear guidance, training in the use of effective self-management skills, and education that challenges their preconceptions regarding patients. The design of health care services also needs to consider the practical barriers to COPD self-management support for the implementation of such interventions to be successful.
authors.affiliation: National Institute of Health Research CLAHRC-LNR Pulmonary Rehabilitation Research Group, University Hospitals of Leicester NHS Trust, Leicester, UK.
authors.forename: Hannah M L
authors.initials: HM
authors.lastname: Young
authors.affiliation: National Institute of Health Research CLAHRC-LNR Pulmonary Rehabilitation Research Group, University Hospitals of Leicester NHS Trust, Leicester, UK.
authors.forename: Lindsay D
authors.initials: LD
authors.lastname: Apps
authors.affiliation: National Institute of Health Research CLAHRC-LNR Pulmonary Rehabilitation Research Group, University Hospitals of Leicester NHS Trust, Leicester, UK.
authors.forename: Samantha L
authors.initials: SL
authors.lastname: Harrison
authors.affiliation: National Institute of Health Research CLAHRC-LNR Pulmonary Rehabilitation Research Group, University Hospitals of Leicester NHS Trust, Leicester, UK.
authors.forename: Vicki L
authors.initials: VL
authors.lastname: Johnson-Warrington
authors.affiliation: School of Applied Social Sciences, De Montfort University, Leicester, UK.
authors.forename: Nicky
authors.initials: N
authors.lastname: Hudson
authors.affiliation: National Institute of Health Research CLAHRC-LNR Pulmonary Rehabilitation Research Group, University Hospitals of Leicester NHS Trust, Leicester, UK ; Applied Research Centre in Health and Lifestyle Interventions, Coventry University, Coventry, UK.
authors.forename: Sally J
authors.initials: SJ
authors.lastname: Singh
mesh_terms: D000488:Allied Health Personnel / Q000523:psychology*; D001291:Attitude of Health Personnel; D032882:Comprehension; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009726:Nurses / Q000523:psychology*; D010353:Patient Education as Topic; D010465:Perception; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D036301:Qualitative Research; D012648:Self Care
keywords: COPD; allied health professionals; interviews; nurses; qualitative; self-management