Ambulatory oxygen: why do patients with COPD not use their portable systems as prescribed? A qualitative study
Patients with COPD on long term oxygen therapy frequently do not adhere to their prescription, and they frequently do not use their ambulatory oxygen systems as intended. Reasons for this lack of adherence are not known.
The aim of this study was to obtain in-depth information about perceptions and use of prescribed ambulatory oxygen systems from patients with COPD to inform ambulatory oxygen design, prescription and management.
Methods:
A qualitative design was used, involving semi-structured face-to-face interviews informed by a grounded theory approach. Twenty-seven UK community-dwelling COPD patients using NHS prescribed ambulatory systems were recruited.
Ambulatory oxygen systems comprised cylinders weighing 3.4kg, a shoulder bag and nasal cannulae.
Results:
Participants reported that they: received no instruction on how to use ambulatory oxygen; were uncertain of the benefits; were afraid the system would run out while they were using it (due to lack of confidence in the cylinder gauge); were embarrassed at being seen with the system in public; and were unable to carry the system because of the cylinder weight. The essential role of carers was also highlighted, as participants with no immediate carers did not use ambulatory oxygen outside the house.
Conclusions:
These participants highlighted previously unreported problems that prevented them from using ambulatory oxygen as prescribed.
Our novel findings point to: concerns with the lack of specific information provision; the perceived unreliability of the oxygen system; important carer issues surrounding managing and using ambulatory oxygen equipment. All of these issues, as well as previously reported problems with system weight and patient embarrassment, should be addressed to improve adherence to ambulatory oxygen prescription and enhance the physical and social benefits of maintaining mobility in this patient group.
Increased user involvement in both system development and service provision planning, could have avoided many of the difficulties highlighted by this study.
Author: Elizabeth ArnoldAnne BrutonMaggie Donovan-HallAngela FenwickBridget DibbElizabeth Walker
Credits/Source: BMC Pulmonary Medicine 2011, 11:9
Published on: 2011-02-11
Copyright by the authors listed above - made available via BioMedCentral (Open Access). Please
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sats when rested and seated - they were 92%. But they were dropping into the 70's regularly just walking and daily living, and dropped as low as 64% on my walk to work. Even when my son and daughter in law contacted the BLF 'respiratory nurse' extremely worried by my blue lips and hands and loss of bladder control, they were told that I should just trust my GP!
Thankfully, after 9 months in this state, I saw a repiratory doc who hit the roof and was disgusted that I hadn't been referred for 02 sooner. I have DR. Tom Petty's freely downloadable book to thank for my knowledge, understanding and appreciation of 02. I think more UK GP's and respiratory nurses would do well to acquaint themselves with it.
In support of the UK's NHS though, I must say that care generally is excellent, and I am thankful on a daily basis that I can have all my meds , treatment and 02 completely free of charge.
murtycv
"Lyn"
(Roxlyn G. Cole) Littleton, CO google for information or my name to find my Pulmonary rehab and AFTER blog on Wellsphere or Yahoo