Self-management experiences and needs in patients with chronic obstructive pulmonary disease: a meta-synthesis of qualitative studies

Clinical Snapshot

Key Findings

• P Value: Not applicable for qualitative synthesis

• Effect Size: Not applicable for qualitative synthesis

• Primary Outcome: Four overarching themes: physical-psychological burden, self-management barriers, active coping strategies, and multidimensional support needs

• Nnt Or Sensitivity: Thematic saturation achieved across 52 findings from 251 COPD patients

• Confidence Interval: Not applicable for qualitative synthesis

Clinical Application

Highly feasible - findings inform development of culturally appropriate self-management programs Directly applicable to Australian primary care and respiratory services, aligns with RACGP COPD guidelines emphasising patient-centred care and self-management support Australian adults with COPD across all disease stages and healthcare settings

Abstract

OBJECTIVES: To systematically review qualitative studies on the self-management experiences and needs of patients with chronic obstructive pulmonary disease (COPD) and to provide evidence for developing needs-based self-management intervention strategies. DESIGN: A systematic review and meta-aggregation of qualitative studies conducted in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement. DATA SOURCES: PubMed, Cochrane Library, Web of Science, Scopus, CINAHL, Embase, CNKI, Wanfang Database, VIP Database and CBM were searched from database inception to March 2025 for qualitative studies on COPD self-management experiences and needs. ELIGIBILITY CRITERIA: Qualitative studies involving adults (≥18 years) with a confirmed diagnosis of COPD that reported patients' real feelings, experiences and needs during the self-management process in any setting (hospital, community or home). Studies were excluded if the full text could not be obtained or data were incomplete, if they were duplicate publications or if they were not published in Chinese or English. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently screened titles, abstracts and full texts, extracted data using a standardised form and assessed methodological quality using the 2016 Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research. Findings (participants' quotations and authors' interpretive statements) were synthesised using a JBI meta-aggregation approach to develop categories and overarching synthesised findings. RESULTS: 15 qualitative studies were included, comprising 251 patients with COPD. A total of 52 findings were identified, grouped into 13 categories and synthesised into 4 overarching findings: (1) physical symptom burden strongly shapes psychological well-being during COPD self-management; (2) patients face multiple and interrelated barriers to effective self-management; (3) some patients develop active coping strategies and self-management resources; and (4) patients express multidimensional and continuing support needs. CONCLUSIONS: Patients with COPD experience substantial physical and psychological distress and face multiple challenges in the self-management process. Healthcare professionals should prioritise patients' lived experiences, establish comprehensive and coordinated support systems and develop diversified, needs-based intervention strategies to address patients' multidimensional needs, thereby enhancing self-management capacity and improving quality of life. PROSPERO REGISTRATION NUMBER: CRD42024607051.

References

1. 1.Chen, Y., Zeng, H., Hongmin, R., Yang, N. N., Cheng, C. L., Liu, R., Luo, L. W., Jimei, L., & Lina, M. (2026). Self-management experiences and needs in patients with chronic obstructive pulmonary disease: a meta-synthesis of qualitative studies. BMJ Open. https://doi.org/10.1136/bmjopen-2025-105800