Caregivers’ experiences of contributing to patients’ self‐care in Chronic Obstructive Pulmonary Disease: A thematic synthesis of qualitative studies

AIM: To identify, analyze and synthesize qualitative studies on caregivers’ experiences of contributions to the self‐care of patients with Chronic Obstructive Pulmonary Disease (COPD). BACKGROUND: COPD patients perform daily self‐care behaviours to manage the disease. With aging and disease progression, patients need to rely on the contributions of informal caregivers, usually family members, for disease management. Caregivers’ normal or habitual contributions to patients’ self‐care have not yet been completely investigated. DESIGN: Thematic synthesis of qualitative studies. DATA SOURCES: CINAHL, EMBASE, PubMed, PsycINFO, Web of Science, Scopus, Emcare and OpenGrey databases were searched from inception to September 2020. The search was restricted to English‐language papers. REVIEW METHODS: Studies were critically appraised using the Critical Appraisal Skills Programme checklist. The initial line‐by‐line codes were aggregated into descriptive themes from which analytical themes were derived. RESULTS: Fifteen papers from nine countries, published 2009–2020, were included. Six analytical themes encompassing 22 descriptive themes were identified and grouped in two overarching themes describing caregivers’ experiences of contributions to patients’ self‐care during the stable and exacerbation phases of COPD. In the stable phases, caregivers contribute through maintaining disease stability, promoting healthy behaviours, fostering normal life and helping perform daily activities. During exacerbations, caregivers contribute through assessing, monitoring and managing symptoms in collaboration with patients or autonomously. They contribute by performing actions, motivating patients, organizing care, sensing variations in symptoms, acquiring knowledge and educating patients, making decisions, communicating and collaborating with healthcare providers and patients and advocating for patients. CONCLUSION: This thematic synthesis enlarges knowledge of caregivers’ contributions to patients’ self‐care in COPD, detailing the ways by which caregivers provide care to patients. IMPACT: Contributing daily to the self‐care of a family member with COPD is a complex experience. Nurses need to acknowledge the importance of caregivers’ contributions to patient disease management and develop effective educational interventions to support them.