Consumer experiences of Chronic Obstructive Pulmonary Disease in regional Australia A mixed methods study and logic model to identify consumer-experience mechanisms to avoid hospital and enhance outcomes

摘要

The objective of this study to explore consumer experiences of their care for Chronic Obstructive Pulmonary Disease (COPD) in a regional Australian hospital and to ascertain consumer identified contexts and mechanisms that can enhance consumer-experience outcomes.A sequential, explanatory mixed methods design was employed including a retrospective audit of COPD admissions and re-admissions and semi-structured interviews with a sample of consumers (n=12).Themes were synthesised using a realist framework and the Expanded Chronic Care Model to develop a logic model.Audit data identified above national average hospital admission rates and length of stay for treatment of COPD.Interview data revealed three key themes namely contexts of care, mechanisms for providing care, and outcomes of care.A logic model was constructed to highlight the necessary contexts and consumer-identified mechanisms that can be enacted to achieve consumer-valued outcomes.The model outlined factors at individual, provider and system levels in a regional and rural setting including interaction and relationships with health care providers; consumer capability; workforce; care pathway; capacity to offer services and support; and continuity of care.This research identifies that positive and continuous relationships are one of the most important consumer-identified mechanisms for influencing COPD consumer experience of their care and capacity to self-manage to stay out of hospital.This research challenges regional and rural health services to harness relationships and connectedness to improve consumer experiences and the impact of care for COPD consumers.The logic model provides a template to assist health services to rise to this challenge.Experience Framework This article is associated with the Patient, FamilyandCommunity Engagement lens of The Beryl Institute Experience Framework.(http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens.Access other resources related to this lens.