Examining a social network approach to self-management support in people with Chronic Obstructive Pulmonary Disease

Abstract

Self-management support [SMS] is fundamental in the management of Chronic Obstructive Pulmonary Disease [COPD]. However, personal engagement and effectiveness of SMS is currently suboptimal. SMS for COPD based on action planning alone, is limited, and confounded by multiple complex, frightening symptoms that are challenging to negotiate alone. Suggesting the need for a more elaborate approach to SMS in COPD. In other long-term conditions, SMS has been influenced positively by promoting access to connections and resources through social networks. Therefore, a social network approach, promoting peer relationships has the potential to offer enhanced support, improve SMS personal capability and increase social capital in people with COPD.

Explored here is the implementation and evaluation of a social network approach to SMS in a community-based COPD population. Three interlinked studies with mixed methods were employed. A qualitative meta-synthesis; to capture the personal enactment of SMS in COPD. An empirical pilot study evaluated the implementation of Generating Engagement in Network Involvement (GENIE), social network tool. A further nested feasibility study, guided theory concepts to explore the acceptability of GENIE in community NHS services.
The qualitative meta-synthesis of COPD SMS practices suggests that this is a complicated social phenomenon; comprised of personally valued practices, activities and experiences. People with COPD negotiate complex health situations across multiple social platforms. The GENIE intervention was acceptable to clinicians and people with COPD. Findings suggest that the intervention may have a protective effect against decline in diet quality and activity in people with COPD. People using the GENIE tool-maintained health status and clinical symptoms, increased quality of life, decreased anxiety and reduced costs in NHS service utilisation.
Enactment of SMS in COPD is influenced by personal experience and a fear of dependence. SMS in COPD requires readdressing to embrace social network approaches as part of the COPD care pathway.

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ORCID for Lindsay Welch: orcid.org/0000-0001-5564-2252

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