Construction of a patient health management patient journey map based on health action process approach theory for patients with chronic obstructive pulmonary disease.
Chen Shengxi S, Li Yinlong Y, Zhang Yan Y, Chen Xinxin X et al.
BackgroundSelf-management ability for patients with chronic obstructive pulmonary disease (COPD) in China urgently needs to be strengthened. The Health Action Process Approach (HAPA) promotes health-oriented behaviour change by tailoring interventions to each stage of the individual's disease. This approach has been applied across a wide range of fields. However, its application among patients with COPD remains relatively limited.ObjectiveTo construct a patient health management journey map based on the HAPA theory.MethodsUsing the HAPA theory as a framework, a patient health management patient journey map was developed through literature review, reference to standardised guidelines, phenomenological research and expert consultation.ResultsFrom the literature review, 12 relevant articles were included to form the preliminary framework. Semi-structured interviews with 5 respiratory medical staff identified the core stages of the patient journey. In a separate subsequent process, the 8 experts selected for consultation had an average work experience of 19.13 ± 3.27 years. Education levels included 2 with a bachelor's degree and 6 with a master's degree or above; professional titles included 3 associate senior doctors, 3 senior doctors and 2 intermediate doctors; and research specialties included 5 in respiratory medicine and 3 in internal medicine nursing. As for the consultation involvement, 3 experts participated once and 5 experts participated twice or more. The familiarity coefficient with consultation content was 0.851, the judgment basis coefficient was 0.916 and the authority coefficient of the experts was 0.889. The coordination of expert opinions was measured by Kendall's W and was 0.429 (χ2 = 42.452, P < 0.001). Finally, a proof-of-concept test with 5 patients refined the patient journey map's usability by simplifying terminology and adjusting adherence strategies.DiscussionThe patient health management journey map constructed in this study, based on the HAPA theory, is scientific, comprehensive and usable, covering key stages such as disease diagnosis, acute exacerbation management, stable period maintenance and rehabilitation support. It provides patients with comprehensive scientific guidance and promotes the establishment of healthy behaviours.