Evidence map›Paper›PMID 32156769›Full record

ArticleBMJ open2020

Facilitators and barriers to the self-management of COPD: a qualitative study from rural Nepal.

Uday Narayan Yadav, Jane Lloyd, Hassan Hosseinzadeh, Kedar Prasad Baral, Sagar Dahal, Narendra Bhatta, Mark Fort Harris

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In one paragraph

Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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  13. Effectiveness of case scenario-based teaching to transition international Master of Public Health students specialising in health promotion from memorization to critical thinking.Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals · 2022
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  15. Chronic obstructive pulmonary disease patients' experience using Trelegy as compared with other inhalers.Canadian journal of respiratory therapy : CJRT = Revue canadienne de la therapie respiratoire : RCTR · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Uday Narayan YadavReserach and Evaluation, Forum for Health Reserach and Development, Dharan, Nepal unyadav1@gmail.com.ORCID 0000-0002-6626-1604
Jane LloydCentre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia.
Hassan HosseinzadehSchool of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia.
Kedar Prasad BaralSchool of Public Health, Patan Academy of Health Sciences, Lalitpur, Nepal.
Sagar DahalMinistry of Health and Population, Government of Nepal, Kathmandu, Province III, Nepal.
Narendra BhattaDepartment of Pulmonary, Critical Care and Sleep Medicine, B.P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal.
Mark Fort HarrisCentre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia.ORCID 0000-0002-0705-8913

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo understand the facilitators and barriers to the self-management of chronic obstructive pulmonary disease (COPD) in rural Nepal. SETTINGS: Community and primary care centres in rural Nepal.

participantsA total of 14 participants (10 people with COPD and 4 health care providers) were interviewed. PRIMARY AND SECONDARY OUTCOME MEASURES: People with COPD and healthcare provider's experience of COPD self-management in rural Nepal.

resultsFacilitators and barriers affecting COPD self-management in Nepal operated at the patient-family, community and service provider levels. People with COPD were found to have a limited understanding of COPD and medications. Some participants reported receiving inadequate family support and described poor emotional health. At the community level, widespread use of complementary and alternative treatment was found to be driven by social networks and was used instead of western medicine. There were limited quality controls in place to monitor the safe use of alternative treatment. While a number of service level factors were identified by all participants, the pertinent concerns were the levels of trust and respect between doctors and their patients. Service level factors included patients' demands for doctor time and attention, limited confidence of people with COPD in communicating confidently and openly with their doctor, limited skills and expertise of the doctors in promoting behavioural change, frustration with doctors prescribing too many medicines and the length of time to diagnose the disease. These service level factors were underpinned by resource constraints operating in rural areas. These included inadequate infrastructure and resources, limited skills of primary level providers and lack of educational materials for COPD.

conclusionsThe study findings suggest the need for a more integrated model of care with multiple strategies targeting all three levels in order to improve the self-management practices among people with COPD.

Indexed as

AgedAged, 80 and overClinical CompetenceFemaleHealth PersonnelHumansMaleMiddle AgedNepalPrimary Health CarePulmonary Disease, Chronic ObstructiveQualitative ResearchQuality of LifeResource AllocationRural PopulationSelf-ManagementCOPDfacilitators and barriershealth literacyself-management practices

Identifiers

PMID32156769
PMCPMC7064074

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.