Pulmonary Rehabilitation: Improvement with Movement

Rajagopal, Anita; Casaburi, Richard

doi:10.15326/jcopdf.3.1.2015.0169

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…They also perceived more environmental barriers, indicating regional disparities in the accessibility and utilization of PR. In summary, these results confirmed that limited environmental resources such as an inadequate medical insurance system [ 60 , 61 ], inconvenient transportation [ 20 , 61 ], lack of knowledge regarding the benefits of PR [ 24 , 62 ], as well as variations in the availability and quality of PR services [ 24 , 62 ], were major obstacles for the promotion of PR.…”

Section: Discussionmentioning

confidence: 64%

“…Additionally, over 90% of patients in our study cited the cost of PR services and the ratio of medical insurance reimbursement as major concerns for their intention to participate in PR programs, which indicated that financial status and out-of-pocket costs of PR were the significant factors influencing patients’ perceptions, acceptances and participation in PR [ 22 , 24 , 60 ]. Meanwhile, as observed in our study, the PR skills of medical staff, knowledge promotion or public education of PR in the community, transportation concerns, and degree of support from family and friends, were significantly associated with patients’ intention to accept PR.…”

Section: Discussionmentioning

confidence: 99%

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A Kano model-based demand analysis and perceived barriers of pulmonary rehabilitation interventions for patients with chronic obstructive pulmonary disease in China

Yao,

Li,

et al. 2023

PLoS ONE

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Background Pulmonary rehabilitation (PR) has been recognized to be an effective therapy for chronic obstructive pulmonary disease (COPD). However, in China, the application of PR interventions is still less promoted. Therefore, this cross-sectional study aimed to understand COPD patients’ intention to receive PR, capture the potential personal, social and environmental barriers preventing their willingness of receiving PR, and eventually identify demanding PR services with the highest priority from patients’ point of view. Methods In total 237 COPD patients were recruited from 8 health care facilities in Zhejiang, China. A self-designed questionnaire was applied to investigate patients’ intention to participate in PR and potentially associated factors, including personal dimension such as personal awareness, demographic factors, COPD status and health-related literacy/behaviors, as well as social policies and perceived environmental barriers. The demand questionnaire of PR interventions based on the Kano model was further adopted. Results Among the 237 COPD patients, 75.1% of COPD patients were willing to participate in PR interventions, while only 62.9% of the investigated patients had heard of PR interventions. Over 90% of patients believed that the cost of PR services and the ratio of medical insurance reimbursement were potential obstacles hindering them from accepting PR services. The multiple linear regression analysis indicated that the PR skills of medical staff, knowledge promotion and public education levels of PR in the community, patients’ transportation concerns and degree of support from family and friends were significantly associated with willingness of participation in PR interventions. By using the Kano model, the top 9 most-requisite PR services (i.e., one-dimensional qualities) were identified from patients’ point of view, which are mainly diet guidance, education interventions, psychological interventions and lower limb exercise interventions. Subgroup analysis also revealed that patients’ demographics, such as breathlessness level, age, education and income levels, could influence their choice of priorities for PR services, especially services related to exercise interventions, respiratory muscle training, oxygen therapy and expectoration. Conclusions This study suggested that PR-related knowledge education among patients and their family, as well as providing basic package of PR services with the most-requisite PR items to COPD patients, were considerable approaches to promote PR attendance in the future.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

A Kano model-based demand analysis and perceived barriers of pulmonary rehabilitation interventions for patients with chronic obstructive pulmonary disease in China

Yao,

Li,

et al. 2023

PLoS ONE

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Adherence to Pulmonary Rehabilitation in COPD

Oates

Niranjan

Ott

et al. 2019

Journal of Cardiopulmonary Rehabilitation and Prevention

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Purpose: Adherence to pulmonary rehabilitation (PR) is low. This qualitative study used the PRECEDE model to identify predisposing (intrapersonal), reinforcing (interpersonal), and enabling (structural) factors acting as barriers or facilitators of adherence to PR, and elicit recommendations for solutions from patients with chronic obstructive pulmonary disease (COPD). Methods: Focus groups with COPD patients who had attended PR in the past year were conducted. Sessions were recorded, transcribed verbatim, and coded independently by 2 coders, who then jointly decided on the final coding scheme. Data were summarized across groups, and analysis was used a thematic approach with constant comparative method to generate categories. Results: Five focus groups with 24 participants each were conducted. Participants (mean age 62 yr) were 54% male, and 67% black. More than half had annual income less than $20 000, 17% were current smokers, and 54% had low adherence (less than 35% of prescribed PR sessions). The most prominent barriers included physical ailments and lack of motivation (intrapersonal), no support system (interpersonal), transportation difficulties, and financial burden (structural). The most prominent facilitators included health improvement, personal determination (intrapersonal), support from peers, family, and friends (interpersonal), and program features such as friendly staff and educational component of sessions (structural). Proposed solutions included incentives to maintain motivation, tobacco cessation support (intrapersonal), educating the entire family (interpersonal), transportation assistance, flexible program scheduling, and financial assistance (structural). Conclusion: Health limitations, social support, transportation and financial difficulties, and program features impact ability of patients to attend PR. Interventions addressing these interpersonal, intrapersonal, and structural barriers are needed to facilitate adherence to PR.

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The impact of community-based pulmonary rehabilitation on the health and lives of migrant workers with pneumoconiosis in China: a qualitative study exploring patient experience

Nagamatsu

2023

Journal of Global Health Reports

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Background Globally, China has the highest prevalence and incidence of pneumoconiosis, which mainly occurs among migrant workers employed in dusty work environments. Pulmonary rehabilitation (PR) is recommended as the most effective therapeutic strategy in managing chronic obstructive pulmonary disease, and recent quantitative studies have validated PR’s effect on the health outcomes of patients with pneumoconiosis. However, qualitative evidence regarding PR’s impact on pneumoconiosis patients’ health and lives is lacking in the literature. Therefore, this study aimed to address this knowledge gap by exploring the experience of pneumoconiosis patients in community-based PR (CBPR). Methods A qualitative study based on the phenomenological perspective was conducted. The convenience　sampling method was used to recruit pneumoconiosis patients attending a CBPR program supported by a patient advocacy non-governmental organisation. Web-based semi-structured interviews were conducted using a self-made interview guide. Thematic analysis was performed to analyse the interview data. This study was conducted after gaining ethical approval and informed consent from all participants. Results Fifteen migrant workers with pneumoconiosis patients aged 49 to 71 years old (median: 54 years old) participated in this study. Four themes were identified from the interview data: triggering of a difficult life, reconstruction of life, sense of empowerment, and gaps in PR. Pneumoconiosis severely impaired participants’ well-being, and it triggered heavy financial strain and care burden in their families. The CBPR program allowed them to restore their physical and psychosocial health, and they achieved reconstructing their lives by leading a PR-centred life. Participating in the CBPR program, pneumoconiosis patients recognised multiple supports and were empowered with enhanced disease-coping abilities and strengthened hope to survive. Overall, participants reflected on their positive experience in the CBPR program, despite their unmet needs and existing barriers in PR. Conclusions The CBPR program integrating multiple supports empowered the vulnerable migrant workers with pneumoconiosis and facilitated their health transition and life reconstruction experience. To optimise their PR experience and improve their QoL, health service addressing their unmet needs and barriers in PR is needed. PR for pneumoconiosis patients with different sociodemographic characteristics and family-oriented management of pneumoconiosis should be explored in future research.

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Pulmonary Rehabilitation: Improvement with Movement

Cited by 3 publications

References 15 publications

A Kano model-based demand analysis and perceived barriers of pulmonary rehabilitation interventions for patients with chronic obstructive pulmonary disease in China

A Kano model-based demand analysis and perceived barriers of pulmonary rehabilitation interventions for patients with chronic obstructive pulmonary disease in China

Adherence to Pulmonary Rehabilitation in COPD

The impact of community-based pulmonary rehabilitation on the health and lives of migrant workers with pneumoconiosis in China: a qualitative study exploring patient experience

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