Indicators of a pulmonary exacerbation in adults with cystic fibrosis

Abstract

The literature review found that pulmonary exacerbations (PEXs) impact on the quality of life (QOL) of people with cystic fibrosis (CF). There is currently no standardised definition of a PEX in CF to inform patient care and QOL. Before a definition can be achieved agreement must be attained on the indicators of a PEX. This thesis aims to identify important indicators of a PEX in adults with CF (ACFs) and establish consensus among ACFs and CF health professionals (CFHPs).

The Delphi technique was used to conduct parallel web surveys over a series of rounds across 13 CF centres in the UK and Ireland. A range of sources were utilised to develop 48 statements that informed the Delphi surveys in Round 1 (R1). A 75% consensus level was applied for R1 and Round 2 (R2).

R1: Participants rated their level of agreement with each statement. ACFs (n=31): 21 consensus statements. CFHPs (n=38): 23 consensus statements. Five additional statements were generated through open questions and added to R2.

R2: Statements not reaching consensus in R1 and the 5 additional statements were presented to participants to re-rate. ACFs (n=28):10 consensus statements. CFHPs (n=38): 7 consensus statements.

R3: Analysis of R1 and R2 found 26 consensus statements common in both groups. Additional consensus statements were identified from each group (ACF: 5; CFHP: 4). 35 statements were presented to both participant groups in R3 to rate from 1–10. Results were averaged and ranked in importance.

Agreement was established within each participant group on 35 important indicators of a PEX. Each group identified a different hierarchy of indicators.

This consensus is an important step in the development of a tool to be used by CFHPs to identify when a PEX is occurring and provides a strong platform for further research into PEXs in CF.

Date of Award	Sept 2012
Original language	English
Sponsors	Health and Social Care Research Development Office
Supervisor	Stephanie Mc Keown (Supervisor) & IAN LOGAN (Supervisor)