Quality of Life in Chronic Obstructive Pulmonary Disease: An Evolutionary Concept Analysis

Therapeutic Relational Connection in Telehealth: Concept Analysis

BACKGROUND

Therapeutic relational connection (TRC) in telehealth is a new concept that refers to the intentional use of relationship connection between health care providers and their patients as both parties work toward a therapeutic aim. It has been demonstrated that TRC positively affects patient-centered outcomes including adherence, self-management, and satisfaction with care. What is not known are best practices for establishing TRC during telehealth visits. The rapid emergence of telehealth during the COVID-19 pandemic has identified a number of challenges. These challenges include lack of human contact, distance creating mistrust, the inability to rely on nonverbal communication, and a sense of depersonalization. Training for health care providers in these interpersonal communication skills needed to establish TRC during telehealth visits is needed.

OBJECTIVE

This paper aims to explore the evolutionary concept of TRC in telehealth. The purpose of this paper is to provide a concept analysis of TRC during telehealth interactions between providers and patients through a comprehensive review of the existing published literature.

METHODS

Rodgers' evolutionary concept analysis method was used to guide this study. PubMed, Embase, PsycINFO, and CINAHL were used to search for relevant publications. An integrative review strategy aided by Rayyan software was used to identify a final sample of 13 papers for analysis.

RESULTS

The proposed definition of TRC in telehealth is the experience of a mutually responsive patient-provider relationship that is built on mutual respect and understanding and informed by cultural humility, presence, empathy, and the ability to effectively evaluate patient concerns to work toward a therapeutic aim. The key attributes of TRC in telehealth are the provider's ability to evaluate patient concerns, interpersonal communication, cultural humility, mutual trust and respect, presence, empathy, and building relationships. Clinical presence, proper environment, knowledge about the use of technology (both patient and provider), use of verbal and nonverbal communication, and knowledge about community and culture are important antecedents of TRC. Consequences of TRC include improved communication resulting in mutual respect and caring, adherence to follow-up recommendations, increased coping, collaborative decision-making, and satisfaction with care.

CONCLUSIONS

Telehealth visits necessitate alternative approaches to establishing TRC as compared to in-person clinic visits. With the rapid expansion of telehealth platforms and a heightened acceptance of the technology, there is a need to integrate knowledge and provide a clear conceptualization of TRC in telehealth as TRC has been demonstrated to result in positive patient-centered outcomes. Identifying the attributes and antecedents of TRC in telehealth allows us the opportunity to develop guidelines and educational interventions aimed at training health care providers in the skills needed to establish TRC during telehealth visits.

Quality of Life in Psychogenic Nonepileptic Seizures: An Evolutionary Concept Analysis

Psychogenic nonepileptic seizures (PNES) pose a serious threat to quality of life (QOL) in patients who battle the disorder. As psychological treatment options have progressed, improvement in QOL has become a more common desired outcome. Despite its relevance in PNES research and treatment, QOL has not been defined in the PNES population. Rodgers' Evolutionary Method of concept analysis was used to analyze 47 articles and clarify the concept of QOL in PNES. QOL in PNES is subjective, multidimensional, associated with symptoms, and dynamic in nature. This conceptualization of QOL in PNES may be useful in future PNES research and treatment.

Effect of therapeutic touch on sleep quality and anxiety in individuals with chronic obstructive pulmonary disease: A randomized controlled trial

PURPOSE

The purpose is to determine the effect of therapeutic touch (TT) on the sleep quality and anxiety of individuals with chronic obstructive pulmonary (COPD) disease.

METHODS

103 patients were randomized in to the two groups: the experimental group, and the control group. In this randomized control study, the patients with COPD in the experimental group were given TT for 10 min between 18:00 and 20:00, one session every day for three consecutive days.

RESULTS

When the experimental group was compared to control group following the intervention, the decrease in the levels of anxiety (p < 0.001) and increase in the sleep quality (p < 0.001) were found to be significant.

CONCLUSION

As a result of the study, it was determined that TT reduced anxiety level and improved sleep quality in individuals with chronic obstructive pulmonary disease. The Clinical Trial Registration Number: NCT04842903.

The relation between self-efficacy in patients with chronic obstructive pulmonary disease and caregiver burden

AIM

The study was conducted to examine the relation between self-efficacy in patients with chronic obstructive pulmonary disease (COPD) and caregiver burden.

MATERIAL AND METHODS

This descriptive, cross-sectional study included 200 patients with stage II and III COPD presenting to hospital between June and November in 2017 and their caregivers. Data were gathered with a questionnaire, COPD Assessment Test and COPD Self-Efficacy Scale from the patients. A questionnaire and Caregiver Burden Scale was used to collect data from the caregivers. Obtained data were analysed with the descriptive statistics numbers, percentages, mean, median and standard deviation. Spearman's correlation analysis was utilised to examine the relation between paired groups.

RESULTS

The mean age of the patients with COPD was 63.53 years and 51.1% of the patients were female. The mean age of the caregivers was 48.88 ± 14.09 years. 54.4% of the caregivers were aged 40-60 years, and 59.9% of the caregivers were female. The mean score was 26.97 ± 5.25 for COPD Assessment Test and 2.32 ± 0.43 for COPD Self-Efficacy Scale. Of all the caregivers, 64.8% had mild caregiving burden and 18.1% had moderate caregiving burden. The mean score for Caregiver Burden Scale had a significant, moderate relation with the mean score for the subscale physical effort in COPD Self-Efficacy Scale (r = -0.42; p < 0.01) and had a significant, weak, negative relation with the mean total score for COPD Self-Efficacy Scale and the mean scores for its subscales. There was a significant, moderate, positive relation between the mean scores for Caregiver Burden and COPD Assessment Test (r = 0.51; p < 0.001) and a significant, negative relation between the scores for COPD Self-Efficacy Scale and its subscales and the scores for CAT (r = -0.26 - r = -0.52; p < 0.05).

CONCLUSION

As self-efficacy in COPD patients increases, their health and daily lives are affected less by COPD and caregiver burden decreases.

The central question and the scope of nursing research

As nursing continues to develop as a professional discipline, it is important for nurses to have a central question to guide their research. Since the 1800s, nursing practice and research have covered a wide scope in cooperation with other disciplines. This wide area of nursing practice and research has led to the proposal that the central question be: How can the well-being of a person, family, community, or population be improved? The proposed question must remain flexible and open to revision because nurses will continue to adapt to the changing needs of their patients and populations and to their complex and evolving work environments.

Comfort, well-being and quality of life: Discussion of the differences and similarities among the concepts

Highlights

The distinction among the concepts of comfort, well-being and QoL is often unclear.This ambiguity can lead to redundancies, gaps, and knowledge dispersion.The concepts are not surrogate terms but related concepts sharing common attributes.

Aim

To analyze the differences and similarities of the concepts of comfort, well-being and quality of life (QoL).

Methods

Review of concept analysis research on PubMed, Cinahl (full text) and Scielo, using the search terms "Comfort", "Well-being", "Quality of Life" and "Concept Analysis".

Results

Eighteen studies were included. Comfort is a broader holistic concept while well-being is mainly related to psycho-spiritual dimensions. QoL reflects the individual perception of satisfaction with life.

Conclusions

The concepts are not surrogate terms, but related concepts sharing common attributes. Caution should be taken in further research, particularly as regards the correct use and framing of the concepts.

Sleep and Quality of Life in People With COPD

Sleep disorders are very common in patients with chronic obstructive pulmonary disease (COPD). However, it is not clear how sleep disorders and quality of life (QoL) affect each other in the different stages of disease progression. This descriptive-correlational study investigated the relationship between QoL, quality of sleep, and degree of disease progression in 102 outpatients with COPD. The results showed that the QoL in patients with COPD is compromised and worsens with disease progression, and the quality of sleep is significantly associated with QoL and worsened as the disease progressed. The early identification of a risk of alteration of the quality of sleep, especially in nursing care, could facilitate a preventive approach for COPD patients that could positively affect their QoL.