Bulley Catherine, Donaghy Marie, Howden Stella, Salisbury Lisa, Whiteford Suzanne, Mackay Elaine
Queen Margaret University, Edinburgh, UK.
Physiother Res Int. 2009 Sep;14(3):181-92. doi: 10.1002/pri.435.
Pulmonary rehabilitation has been found to be an effective strategy for managing chronic obstructive pulmonary disease (COPD). However, attendance at such programmes is not optimal, therefore, this study aimed to develop an in-depth understanding of views regarding attendance at pulmonary rehabilitation and experiences which may have shaped these views.
An inductive qualitative study was carried out within the framework of Interpretative Phenomenological Analysis. Five female and four male individuals with COPD who had been referred for pulmonary rehabilitation participated in semi-structured interviews. Interviews were conducted prior to participation in pulmonary rehabilitation.
Three main themes were identified that related to views about attending pulmonary rehabilitation. The first is entitled 'Desired benefits of attending pulmonary rehabilitation', which described realistic hopes about impact on daily life. The second theme was called 'Evaluating the threat of exercise', and it encompassed both positive and negative evaluations; some interviewees described fear and avoidance of exercise, while others were determined to overcome symptoms. These attitudes extended to views about pulmonary rehabilitation. The third theme was called 'Attributing value to pulmonary rehabilitation'. Contrasting opinions about the value of attending pulmonary rehabilitation appeared to be influenced by the nature of prior interactions with health personnel and systems as well as information about the programme provided at referral. The referrer's attitude towards pulmonary rehabilitation appeared to be particularly influential.
In summary, when considering rehabilitation attendance, potential participants are able to identify possible benefits, but previous experiences of symptoms and attitudes towards their condition can influence views both positively and negatively. Information and enthusiasm conveyed by the referring clinician, as well as previous interactions with health professionals can have powerful impact on views about attending. Referral practices should be informative and enthusiastic to increase the likelihood of uptake.
肺康复已被证明是管理慢性阻塞性肺疾病(COPD)的有效策略。然而,此类项目的参与率并不理想,因此,本研究旨在深入了解关于参与肺康复的观点以及可能塑造这些观点的经历。
在解释现象学分析的框架内进行了一项归纳性定性研究。五名女性和四名男性慢性阻塞性肺疾病患者被转介接受肺康复,他们参与了半结构化访谈。访谈在参与肺康复之前进行。
确定了与参与肺康复的观点相关的三个主要主题。第一个主题是“参与肺康复的预期益处”,描述了对日常生活影响的现实期望。第二个主题是“评估运动的威胁”,它包含了积极和消极的评价;一些受访者描述了对运动的恐惧和回避,而另一些人则决心克服症状。这些态度延伸到了对肺康复的看法。第三个主题是“赋予肺康复价值”。关于参与肺康复价值的不同意见似乎受到与卫生人员和系统先前互动的性质以及转介时提供的项目信息的影响。转介者对肺康复的态度似乎特别有影响力。
总之,在考虑康复参与情况时,潜在参与者能够识别可能的益处,但先前的症状经历和对自身状况的态度会对观点产生积极和消极的影响。转诊临床医生传达的信息和热情,以及先前与卫生专业人员的互动,会对参与观点产生强大影响。转诊做法应该提供信息并充满热情,以增加参与的可能性。