Abstract
Aim:
The aim was to describe evidence-based knowledge regarding care and management of patients at nurse-led COPD-clinics in Swedish primary health care. Method: A literature review included ten studies, three qualitative, six quantitative and one both qualitative and quantitative. The search was carried out in Pub Med/MEDLINE and CINAHL between year 1999 and 2012 with the search-words: COPD, nurse-led clinics, patient education, primary healthcare, quality of life, self management, smoking cessation and Sweden.Two reviewers rated independently and extracted data from the articles. Results: At nurse-led COPD-clinics in Swedish primary health care, nurses ran structured investigations including measurements according to medical guidelines, and gave information about self-management and smoking cessation. The COPD-clinics allotted sufficient time according to the guidelines: when the nurse had been trained in COPD care, more patients were diagnosed with COPD and fewer exacerbations were noted among COPD-patients. If structured programs for smoking cessation and/or self-management were used, an increased number of patients stopped smoking and patients' quality of life was improved. COPD nurses showed shortcomings in self-management and smoking cessation concerning individualized care, the involvement of patients in shared understanding and responsibility and motivational dialogue. Conclusion: Structured self-management and smoking cessation programs were effective and improved patients' quality of life. For COPD-nurses and COPD–clinics to reach their full potential, more teamwork and training for the nurses in self-management education and smoking cessation are needed.
- © 2012 ERS