Construction And Application Of Information Support Program For Patients With Low-risk Pulmonary Nodules

Purpose:In order to guide the implementation of information support for patients with low-risk pulmonary nodules,this study intends to construct an information support program through content analysis of the literature,qualitative interviews with patients and healthcare professionals,expert panel discussions,Delphi expert consultation and this study also intends to explore the initial effects of the program in patients with low-risk pulmonary nodules.Methods:1.Constructing information support program for patients with low-risk pulmonary nodules(1)we systermatically searched the literature and analyzed the 22 included papers using content analysis to extract content related to pulmonary nodule information support.(2)By purposive sampling method,we selected 16 patients and 7 health care professionals to conduct semi-structured interviews and analyzed the data using the Classic Colaizzi seven-step analysis method.By interviewing patients,we explored their information needs,information sources,and suggestions for conducting information support;by interviewing health care professionals,we explore their suggestions for conducting information support.(3)Based on the results of the literature and qualitative interviews,the expert panel discussed and formed the first draft of the program.According to the Delphi expert consultation with 17 experts,the program was revised and improved to finalize the patient information support program.2.Initial evaluation of the information support programThe program constructed in this study was applied to patients who attended the pulmonary nodule clinic from September 1,2021 to October 31,2021,and the patients’disease knowledge,psychological status,treatment adherence were assessed before and after the intervention.Results:1.We derived four aspects of content:information support providers,contents,process,and evaluation indicators.2.Three aspects were summarized through qualitative interviews with patients:information needs(information on pulmonary nodule disease,psychological adjustment techniques,life guidance,re-checking guidance),information sources(doctors,internet resources,patients),and suggestions for conducting information support(following the evidence,avoiding jargon,providing practical guidance).3.Two aspects were summarized from interviews with health care professionals:patients needed information(avoidance of drug abuse,follow-up intervals,lung nodule measurement),suggestions for information support(dedicated staff,team guarantees,evaluation).4.The first draft of the information support program including information support providers(specialist nurses affiliated with multidisciplinary pulmonary nodule clinic),contents(information on pulmonary nodule disease,psychological adjustment,life guidance,re-checking guidance),process(learning knowledge,building beliefs,guiding behaviors)and assessment indicators(disease knowledge,psychological status,adherence).5.The rate of questionnaire returned by experts in the two rounds was 85%and 100%,the harmony coefficient was 0.223 and 0.149,the authority coefficient was 0.947,and the proportion of experts who gave opinions was 70.58%and 47.05%.These results indicate that these experts’ positive degree was high,the authority and coordination was good.6.We conducted the information support with 58 patients and found that the patients’disease knowledge score higher than before(P<0.001),the anxiety,depression,psychological distress score lower than before(P<0.001),the number of patients who had over-treat behavior or tendency was decreased(P<0.05).Conclusion:1.In this study,an information support program for patients with low-risk pulmonary nodules was established,which was implemented by specialist nurses affiliated with multidisciplinary pulmonary nodule clinic,carried out according to the process of learning knowledge,building beliefs,and guiding behaviors,with interventions derived from scientific evidence.The program includes four major aspects(information on pulmonary nodule disease,psycho-emotional regulation,life guidance,and re-checking guidance),and evaluated the intervention effects in three aspects(disease knowledge,psychological status,adherence).2.We validated the information support program in low-risk pulmonary nodules patients and found that the program could effectively improve the disease perception of patients,improve patients’ negative emotions,and reduce patients’ behavior or tendency to over-test or treat.