%0 Journal Article %A Hilary Pinnock %A Marilyn Kendall %A Susan Buckingham %A Susie Ferguson %A Aziz Sheikh %A William MacNee %A Patrick White %A Allison Worth %A Kirsty Boyd %A Scott Murray %T HELP-COPD: A qualitative study of need in people with severe COPD %D 2014 %J European Respiratory Journal %P P3820 %V 44 %N Suppl 58 %X Aim: Despite apparent unmet needs, people with COPD rarely ask for help. We explored the concept of need in this group, from patient/carer and professional perspectives.Method: We recruited inpatients at 2 NHS Lothian hospitals to the HELP-COPD pilot: a structured, holistic review of care needs delivered at home by a respiratory nurse. We explored the views of patients, carers and professionals on the intervention and its utility in identifying/meeting needs. Thematic analysis used Bradshaw's classification of felt, expressed, normative and comparative needResults: 14 patients, 3 carers, 28 professionals provided 41 interviews. Professionals identified some practical 'normative' needs which were often addressed during discharge planning. Although other needs (physical limitations, social/financial concerns, existential concerns) were 'felt' by patients and carers, adaptation to the disabilities meant they were often accepted rather than actively 'expressed' as needing action. Patients often prioritised retaining their sense of independence, preferring to accept care from family members rather than from formal agencies. Few unmet needs were identified by our intervention and few actions planned.Conclusion: In contrast to professionally-defined 'normative' needs, patients generally did not perceive themselves as needy, accepting their 'felt' needs as the result of a disability to which they had now adapted. Sensitive approaches that foster independence may enable patients to 'express' needs that are amenable to help without disturbing the adaptive equilibrium they have achieved. Primary care, with its ongoing relationship with patients and families, may be best placed to provide this.Funding: Dunhill Medical Trust. %U