title: Nurses' perspectives of a new individualized nursing care intervention for COPD patients in primary care settings: A mixed method study.
abstract: The major challenges in Chronic Obstructive Pulmonary Disease (COPD) care are guiding a patient in daily living with the consequences of the disease, reducing the impact of symptoms and improving Health Related Quality of Life (HRQoL). The new nurse-led COPD-Guidance, Research on an Illness Perception (COPD-GRIP) intervention translates the evidence concerning illness perceptions and Health Related Quality of Life (HRQoL) into a practice nurse intervention. The aim is to explore the nurses' experiences with applying the new COPD-GRIP intervention.
  
  
  
  An explanatory mixed-method study nested in a cluster randomized trial in primary care was conducted. Pre-intervention questionnaires were sent to all participating nurses (N=24) to identify expectations. Post-intervention questionnaires identified experiences after applying the intervention followed by two focus groups to further extend exploration of findings. Questionnaires were analyzed by descriptive analyses. To identify themes the audio-taped and transcribed focus groups were independently coded by two researchers.
  
  
  
  The nurses described the intervention as a useful, structured and individualized tool to guide COPD patients in living with the consequences of COPD. Applying the intervention took less time than the nurses initially expected. The intervention enables to provide patient-centered care and to address patient needs. Barriers were encountered, especially in patients with a lower social economic status, in patients with a lower health literacy and in patients with other cultural backgrounds than the Dutch background.
  
  
  
  Nurses perceived the COPD-GRIP intervention as a feasible, individualized tool. According to the nurses, the intervention is a valuable improvement in the care for COPD patients.
authors.affiliation: Department of Respiratory Diseases, Division Heart & Lungs, University Medical Center Utrecht, PO Box85500, 3508 GA Utrecht, The Netherlands. Electronic address: S.Weldam@umcutrecht.nl.
authors.forename: Saskia W M
authors.initials: SW
authors.lastname: Weldam
authors.affiliation: Department of Respiratory Diseases, Division Heart & Lungs, University Medical Center Utrecht, PO Box85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Jan-Willem J
authors.initials: JJ
authors.lastname: Lammers
authors.affiliation: Department of Respiratory Diseases, Division Heart & Lungs, University Medical Center Utrecht, PO Box85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Marieke
authors.initials: M
authors.lastname: Zwakman
authors.affiliation: Department of Rehabilitation, Nursing Science & Sports, University Medical Center Utrecht, PO Box85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Marieke J
authors.initials: MJ
authors.lastname: Schuurmans
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009740:Nursing Staff / Q000523:psychology*; D011320:Primary Health Care / Q000458:organization & administration*; D029424:Pulmonary Disease, Chronic Obstructive / Q000451:nursing*
keywords: Chronic Obstructive Pulmonary Disease (COPD); Clinical nursing research; Patient care management; Patient centered nursing; Primary care nursing