Figures
- Fig. 1—
Focus group recruitment and profiles. Data are expressed as median (range).
Tables
- Table 1—
Focus group profiles
Group 1 Group 2 Group 3 Group 4 Subjects n 9 8 5 10 Sex Male Female Male Female Age yrs 18–64 ≥65 ≥65 18–64 Lung function category n# Mild 0 0 0 0 Moderate 4 2 3 8 Severe 5 5 1 1 Very severe 0 1 1 1 Hospital admissions n¶ 1 3 1 1 Respiratory clinic visits¶ 1 (0–3) 1 (0–1) 2 (0–6) 1 (0–8) Antibiotic courses¶ 4 (3–4) 1.5 (1–3) 4 (0–6) 4 (0–8) Data are presented as median (range), unless otherwise stated. #: according to Global Initiative for Chronic Obstructive Lung Disease guidelines 13; ¶: within the previous 6 months.
- Table 2—
Schedule of topics for focus group study
1. What does self-management mean to you? 2. What aspects of your bronchiectasis are currently easy to self-manage? 3. What aspects of your bronchiectasis are currently difficult to self-manage? 4. How could self-management be improved in relation to information about medication, physiotherapy, nutrition, exercise and hospital admissions? 5. What contact do you currently have with the bronchiectasis service? What is good about that contact? What is not so good about that contact? 6. How could the bronchiectasis service help you manage your bronchiectasis better at home? 7. Are there other measures that could help you manage your bronchiectasis better at home e.g. childcare, care of elderly relatives, assistance from other agencies? 8. Why would you like to be able to self-manage? 9. What sorts of issues limit self-management generally? - Table 3—
Core category: physical and psychosocial impact of bronchiectasis
Physical impact subcategories Reduced ability to do house work, reduced ability to do leisure activities Psychosocial impact subcategories Depression, worry, annoyance, fear, nervousness, embarrassment, reduced confidence, low self-esteem, poor self-image, relocation, difficulty in planning events, altered relationships with family and work colleagues, increased time off work for hospital appointments and illness, increased holiday insurance - Table 4—
Core category: self-management strategies currently used by patients with bronchiectasis
Adherence to medical treatments subcategories Self-administration of intravenous antibiotics, having reserve oral antibiotics, performing airway clearance, using inhaled and nebulised therapies, receiving vaccinations Prevention of ill health/promotion of good health subcategories Monitoring of symptoms and signs, sending a sputum sample for testing, exercising, dietary changes, reducing alcohol intake, smoking cessation, avoidance of irritants, complementary and alternative medicine Dealing with psychological and social needs subcategories Attending a psychiatrist, acceptance, problem solving, attending an evening class, employing a housekeeper Communication subcategories Contacting the bronchiectasis multidisciplinary team, general practitioner, pharmacist, social services, ambulance service, insurance company - Table 5—
Core category: perceived obstacles to self-management of bronchiectasis
Disease-related obstacles subcategories Disease severity/stability, health service policies, lack of information on disease process, side-effects of treatment, complications of bronchiectasis, other medical conditions, advancing age Psychological obstacles subcategories Fear, lack of confidence, lack of competence, lack of motivation, lack of support Social obstacles subcategories Personal circumstances, lifestyle preferences, financial reasons, lack of time, adverse weather conditions - Table 6—
Core category: perceived sources of support for self-management of bronchiectasis
Health service resources subcategories Information and guidance on the disease, accessibility to healthcare, medical reviews, familiar healthcare practitioner, experience of benefits of treatments, health service policies, government initiatives, accessibility to leisure facilities, home help, support groups Family sources subcategories Role within family, practical help from family, advice from family Information sources subcategories Medical literature, Internet, newspapers Self subcategory Intuition
