Arnold Elisabeth, Bruton Anne, Ellis-Hill Caroline
Physiotherapy Department, Queen Alexandra Hospital, Portsmouth City Health Care Trust, Cosham, Portsmouth PO6 3RY, UK.
Respir Med. 2006 Oct;100(10):1716-23. doi: 10.1016/j.rmed.2006.02.007. Epub 2006 Mar 22.
To explore the experiences of chronic obstructive pulmonary disease (COPD) patients invited to join a pulmonary rehabilitation (PR) programme. PR has been shown to be an effective non-pharmacological intervention; however uptake and completion of programmes is frequently low.
Qualitative study using semi-structured interviews.
Twenty COPD patients aged 45-85 years, referred for PR over a 2-year period.
In this group of patients the influence of the referring doctor was the key factor in leading patients to take up an invitation to attend a PR programme. Patients responded positively to doctors who imparted enthusiasm for, and belief in, the benefits of the intervention. Once started, ongoing adherence to the programme was positively influenced by a sense of group support, and increased self-confidence. Lack of social support at home and overcoming the effort of living with COPD in order to attend were cited as negative influences on continued adherence.
This study has shown that the referring doctor plays a key role in the uptake of PR programmes. It suggests that a positive approach by doctors could increase the level of adherence to PR. Recognition and support in the area of social support for those living alone may also increase adherence. These simple, cost effective approaches may encourage more patients with COPD to participate in a therapeutic intervention which now has a strong evidence base.
探讨受邀参加肺康复（PR）项目的慢性阻塞性肺疾病（COPD）患者的经历。肺康复已被证明是一种有效的非药物干预措施；然而，项目的参与率和完成率通常较低。
采用半结构式访谈的定性研究。
20名年龄在45 - 85岁之间的COPD患者，在两年时间内被转诊接受肺康复治疗。
在这组患者中，转诊医生的影响是促使患者接受参加肺康复项目邀请的关键因素。患者对那些对该干预措施的益处表现出热情和信心的医生反应积极。一旦开始，群体支持感和自信心增强对持续参与该项目有积极影响。家庭缺乏社会支持以及为了参加而克服与COPD共存的困难被认为是对持续参与的负面影响。
本研究表明，转诊医生在肺康复项目的参与方面起着关键作用。这表明医生采取积极的方法可能会提高对肺康复的依从性。对独居者在社会支持方面的认可和支持也可能提高依从性。这些简单且具有成本效益的方法可能会鼓励更多COPD患者参与到目前有充分证据基础的治疗干预中。
