Implementing psychological interventions delivered by respiratory professionals for people with COPD. A stakeholder interview study

TY - JOUR

T1 - Implementing psychological interventions delivered by respiratory professionals for people with COPD. A stakeholder interview study

AU - Wileman, Vari

N1 - Funding Information: The authors are grateful for the contribution made by participants to provide important feedback and perspectives for implementation. This study is independent research, funded by the National Institute for Health Research Health Technology Assessment programme (project number 13/146/02). S.J.C.T. and V.W. are supported by the National Institute for Health Research ARC North Thames. The views expressed in this publication are those of the authors and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care. Funding Information: The study was funded by NIHR, and ethical approval was granted by the London-Queen Square Research Ethics Committee, reference 17/LO/0095. Written informed consent was obtained from all participants. The anonymised transcripts were stored digitally on an encrypted USB and audio files were subsequently deleted from the encrypted recorders. Acknowledgements Funding Information: S.J.C.T. is the chief investigator or co-investigator on multiple previous and current research grants from the UK National Institute for Health Research and CRC UK. H.P. is Associate Editor of npj Primary Care Respiratory Medicine. H.P. was not involved in the journal’s review of, or decisions related to, this manuscript. Co-authors declare no further competing interests. Publisher Copyright: © 2023, Springer Nature Limited.

PY - 2023/10/25

Y1 - 2023/10/25

N2 - Implementing psychological interventions in healthcare services requires an understanding of the organisational context. We conducted an interview study with UK National Health Service stakeholders to understand the barriers and facilitators for implementing psychological interventions for people with chronic obstructive pulmonary disorder (COPD). We used TANDEM as an exemplar intervention; a psychological intervention recently evaluated in a randomised controlled trial. Twenty participants providing care and/or services to people with COPD were purposively sampled from NHS primary/secondary care, and commissioning organisations. Participants were recruited via professional networks and referrals. Verbatim transcripts of semi-structured interviews were analysed using thematic analysis. Four themes were identified: (1) Living with COPD and emotional distress affects engagement with physical and psychological services; (2) Resource limitations affects service provision in COPD; (3) Provision of integrated care is important for patient well-being; and (4) Healthcare communication can be an enabler or a barrier to patient engagement. People need support with physical and psychological symptoms inherent with COPD and healthcare should be provided holistically. Respiratory healthcare professionals are considered able to provide psychologically informed approaches, but resources must be available for training, staff supervision and service integration. Communication between professionals is vital for clear understanding of an intervention’s aims and content, to facilitate referrals and uptake. There was widespread commitment to integrating psychological and physical care, and support of respiratory healthcare professionals’ role in delivering psychological interventions but significant barriers to implementation due to concerns around resources and cost efficiency. The current study informs future intervention development and implementation.

AB - Implementing psychological interventions in healthcare services requires an understanding of the organisational context. We conducted an interview study with UK National Health Service stakeholders to understand the barriers and facilitators for implementing psychological interventions for people with chronic obstructive pulmonary disorder (COPD). We used TANDEM as an exemplar intervention; a psychological intervention recently evaluated in a randomised controlled trial. Twenty participants providing care and/or services to people with COPD were purposively sampled from NHS primary/secondary care, and commissioning organisations. Participants were recruited via professional networks and referrals. Verbatim transcripts of semi-structured interviews were analysed using thematic analysis. Four themes were identified: (1) Living with COPD and emotional distress affects engagement with physical and psychological services; (2) Resource limitations affects service provision in COPD; (3) Provision of integrated care is important for patient well-being; and (4) Healthcare communication can be an enabler or a barrier to patient engagement. People need support with physical and psychological symptoms inherent with COPD and healthcare should be provided holistically. Respiratory healthcare professionals are considered able to provide psychologically informed approaches, but resources must be available for training, staff supervision and service integration. Communication between professionals is vital for clear understanding of an intervention’s aims and content, to facilitate referrals and uptake. There was widespread commitment to integrating psychological and physical care, and support of respiratory healthcare professionals’ role in delivering psychological interventions but significant barriers to implementation due to concerns around resources and cost efficiency. The current study informs future intervention development and implementation.

UR - http://www.scopus.com/inward/record.url?scp=85174972479&partnerID=8YFLogxK

U2 - 10.1038/s41533-023-00353-8

DO - 10.1038/s41533-023-00353-8

M3 - Article

SN - 2055-1010

VL - 33

JO - npj Primary Care Respiratory Medicine

JF - npj Primary Care Respiratory Medicine

IS - 1

M1 - 35

ER -