P256 Patients’ perceptions of COPD exacerbations leading to hospitalisation

BackgroundThere is much attention around the physiological factors around the admission but psychological factors, especially the patients voice and perceptions are often poorly considered. These issues could hold vital clues which need to be considered in their long-term care of their COPD.AimTo uncover the patient voice and perceptions of why they were admitted to hospital with an acute exacerbation of COPD.MethodsA random selection of patients who were readmitted within a 30-day period over 4 months of winter 18/19, undertook a semi-structured interview about self management/pre admissions factors and asked to complete the Hospital Anxiety and Depression score (HADs), Ways of Coping Checklist (WOC) and Multi-Dimensional Health Locus of Control (MDHLOC) questionnaires. The group was spilt into those who scored highly in the HADS for anxiety and depression (score above 15 on the scales) and those who did not.ResultsAll 24 contacted patients agreed to participate; M:F 1:1, with a mean age of 72.3 years. (see results table 1). All reported feeling frightened by their increased breathlessness and felt the only thing to do was to phone for an ambulance. They responded overwhelmingly that they did not want to self-manage their condition with plans and rescue medications and that they felt the only solution would be to get to the hospital or they might die from their exacerbation. There was an overwhelming fear of death, despair and despondency with their condition and the resultant admissions. Those with co morbid anxiety or depression felt a lack of support for their conditions which they felt were never considered in relation to their overall management of their COPD.ConclusionsThe patient voice is strong and should be listened to. These findings suggest a more holistic approach to long term care of people with COPD. More attention should go to listening to their fears and supporting them than handing out home rescue medications which are often left untouched.Abstract P256 Table 1 Males (n= 12) Females (n= 12) Abnormal levels of depression as scored by HADs (score >16) 10 (83%) 11 (92%) Abnormal levels of anxiety as scored by HADs (score >16) 6 (50%) 9 (75%) External locus of control (LOC) 7 (58%) 11 (92%) Abnormal ways of coping 6 (50%) 12 (100%)