Indicators of a pulmonary exacerbation in adults with cystic fibrosis

• Main Author: McCourt, Fiona Louise
• Published: University of Ulster 2012
• Subjects: 362.196372
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.573078

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 R 1 and Round 2 (R2). R 1: 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): 1 0 consensus statements. CFHPs (n=38): 7 consensus statements. R3: Analysis of R 1 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.