Health care experiences of adults with Chronic Obstructive Pulmonary Disease (COPD) across health care settings: a meta-ethnography

Problem

Chronic obstructive pulmonary disease (COPD) is a preventable, progressive respiratory illness and a major source of morbidity and mortality internationally and in the Australian community. Current studies that have explored lived experiences of COPD patients raise important concerns regarding experiences in health care settings and interactions with health care professionals; interactions that may not bring the support patients living with chronic respiratory illness had hoped.

People who smoke often describe feelings of guilt and shame associated with their COPD and may consequently experience stigma and a poor experience of care that may affect health-related outcomes.

Poor patient experience can interfere with the delivery of evidence based treatment and result in this group of patients being treated unequally, potentially exacerbating negative experiences or threat (anticipation) of stigma.

The aim of this study is to systematically scope, identify and synthesise findings from peer-reviewed qualitative studies published in academic journals describing health care experiences of patients living with COPD across a variety of health care settings.

Approach

The methodology followed the seven steps for meta-ethnography described by Noblit and Hare (1988). These include identifying a refined research question, defining focus of synthesis and locating relevant studies, reading the studies, determining how the studies are related, translating studies into one another, synthesising translations and expressing the synthesis. We searched Ovid MEDLINE, PsychINFO, Ovid Emcare, CINAHL Plus and Sociological Abstracts for relevant articles. A search strategy for each database was developed in consultation with a university subject librarian.

Peer-reviewed qualitative studies published in academic journals, drawing upon any interpretative methodology (eg. phenomenology, grounded theory) that described experiences of care of patients living with COPD were included. Studies identified from these searches were uploaded to COVIDENCE to support selection and appraisal of studies.

Findings

A total of n= 5870 papers were identified in our initial search after duplicates were removed. Following title and abstract screening, papers will be downloaded in full and appraised for quality. Data will be extracted from eligible studies using a data extraction form developed for this review. Sub-group analyses will be conducted across health care settings and by smoking status to explore these dimensions of COPD patient experiences of care.

Consequences

Qualitative syntheses such as the meta-ethnography, provides evidence for the lived experiences of disease conditions, including how patients experience a condition. Individual qualitative studies are invaluable for exploring and describing experience of care, however ‘synthesis’ of qualitative evidence from multiple studies provides the opportunity to identify and highlight important themes in the lived experiences of patients and the underlying reasons and context associated with these experiences.