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Table 1 Guiding principles for TANDEM

From: Developing a complex intervention whilst considering implementation: the TANDEM (Tailored intervention for ANxiety and DEpression Management) intervention for patients with chronic obstructive pulmonary disease (COPD)

 

Illustrating quotes

Intervention guiding principles

 Depression and anxiety are key topics but could be introduced via breathlessness

I think they most often talk about symptoms like breathlessness, rather than saying that they are anxious or depressed. (HCP006 Physio)

Terminology is important such as ‘dealing with’ ‘living with’ (patient)

 The Intervention should be tailored/flexible to individuals

It’s just that patients are all different, and therefore present very differently and the intervention has to be tailored individually to what they are presenting with. (HCP003, psychologist)

 Sessions could be offered at home, or clinic but there may be limitations to the latter, accessibility is key

So I think having the capacity to start off at home is certainly a good idea. I think just something about accessible locations. (HCP002, Psychologist)

 Clear expectations and boundaries should be set at the start of the intervention

So there needs to be quite clear boundaries about what the intervention offers and does not offer.(HCP006, physio)

Implementation guiding principles

 Delivery by respiratory professionals rather than psychologists is preferable

It feels important that other members of the healthcare team are being trained up in these approaches. That can only be a good thing… (HCP003,psychologist)

 Some selection and training of facilitators will be needed

A lot of people would be attracted to this, but it’s not for everyone to deliver.(HCP005, physio)

What training would this nurse have? (Patient)

 Supervision of facilitators delivering the intervention is essential and should be ongoing

I think that’s important.[supervision] (HCP005, physiotherapist)

 The intervention must be deliverable and supported by management

There’s no point evaluating it if it’s not something that’s going to be deliverable. (HCP FG001 Doctor)

 The intervention should be able to account for patient breaks due to illness

...that’s important, and you have to acknowledge if they are not feeling well, we have to assess it and make sure that they get the right treatment. (HCP005, Physiotherapist)

Timing is important’(patient)