Ambulatory oxygen: why do COPD patients not use their portable systems as prescribed? A qualitative study

BMC Pulmonary Medicine

Research Article

Elizabeth Walker¹  Anne Bruton²  Maggie Donovan-Hall²  Elizabeth Arnold³  Angela Fenwick⁴  Bridget Dibb⁵ 

[1] Respiratory Centre, Queen Alexandra Hospital, Cosham, Portsmouth, Hampshire, UK;School of Health Sciences, Highfield Campus, University of Southampton, Hampshire, UK;School of Health Sciences, Highfield Campus, University of Southampton, Hampshire, UK;Portsmouth Community PCT, The Turner Centre, St James' Hospital, Portsmouth, Hampshire, UK;School of Medicine, Highfield Campus, University of Southampton, Hampshire, UK;School of Social Sciences, Brunel University, Uxbridge, Middlesex, UK;

关键词: National Health Service;    Local Research Ethic Committee;    Ground Theory;    Ground Theory Approach;    Long Term Oxygen Therapy;   

DOI  :  10.1186/1471-2466-11-9

 received in 2010-06-24, accepted in 2011-02-11,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundPatients 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.MethodsA 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 3.4 kg, a shoulder bag and nasal cannulae.ResultsParticipants 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.ConclusionsThese 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.

【 授权许可】

Unknown   
© Arnold et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.