Chen Yun-Ju, Fan Jun-Yu, Guo Su-Er, Hwang Su-Lun, Yang Tsung-Ming
Division of Respiratory Therapy, Chiayi Chang Gung Memorial Hospital, Chang Gung Medical Foundation, Chiayi, Taiwan, Republic of China.
Graduate Institute of Nursing, College of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan, Republic of China.
Int J Chron Obstruct Pulmon Dis. 2017 Sep 11;12:2695-2702. doi: 10.2147/COPD.S142124. eCollection 2017.
Pulmonary rehabilitation (PR) is recognized as the chief non-pharmacologic management approach for patients with COPD, but is clinically under-utilized. In Taiwan, respiratory therapists (RTs) are one of the first-line health care providers who spend vast amounts of time with COPD patients in PR programs. To better enhance patients' knowledge of and participation in PR, it is necessary to understand how PR is viewed by RTs, as well as how these views influence their behavioral intentions toward promoting PR. This study applied the Theory of Planned Behavior (TPB) to investigate both the behavioral intentions and the influential factors surrounding PR in RTs.
This cross-sectional study used structured self-administered questionnaires at a national symposium for RTs to collect data on their knowledge, attitudes, subjective norms, perceived behavioral controls, and behavioral intentions with regard to promoting PR. Multiple linear regression analysis was used to identify significant factors affecting the intended promotion of PR by RTs.
The response rate after excluding respondents with incomplete data was 88.1% (n=379). A majority of the participants were college graduates, aged over 30 years, and women. The respective percentage scores derived from questionnaires gauging the knowledge, attitudes, subjective norms, self-efficacy, and behavioral intentions components of total PR scores were 63.12%, 71.33%, 68.96%, 66.46%, and 80.29%. The factors significantly affecting RTs' intentions to suggest PR participation to COPD patients or encourage it were attitudes, subjective norms, and self-efficacy. The total model explained 22.5% of the variance in behavioral intentions.
The results of the study suggest that RTs strongly intend to promote PR, but are hindered by insufficient knowledge, attitudes, and self-efficacy with regard to it. Applying TPB provided insight into which factors can be addressed, and by whom. For example, enhancing RTs' self-efficacy can be achieved through PR training via school curricula, further regular continuing education and/or courses, and practical experience.
肺康复（PR）被认为是慢性阻塞性肺疾病（COPD）患者主要的非药物治疗方法，但在临床中未得到充分利用。在台湾，呼吸治疗师（RTs）是一线医疗服务提供者之一，他们在PR项目中花费大量时间与COPD患者相处。为了更好地提高患者对PR的认知和参与度，有必要了解RTs对PR的看法，以及这些看法如何影响他们推广PR的行为意图。本研究应用计划行为理论（TPB）来调查RTs对PR的行为意图及其影响因素。
这项横断面研究在全国呼吸治疗师研讨会上使用结构化自填问卷，收集他们在推广PR方面的知识、态度、主观规范、感知行为控制和行为意图的数据。采用多元线性回归分析来确定影响RTs推广PR意愿的显著因素。
排除数据不完整的受访者后，回复率为88.1%（n = 379）。大多数参与者是大学毕业生，年龄超过30岁，且为女性。衡量PR总分的知识、态度、主观规范、自我效能和行为意图各部分问卷得分的百分比分别为63.12%、71.33%、68.96%、66.46%和80.29%。显著影响RTs向COPD患者建议或鼓励其参与PR意愿的因素是态度、主观规范和自我效能。整个模型解释了行为意图中22.5%的变异。
研究结果表明，RTs强烈希望推广PR，但在这方面受到知识、态度和自我效能不足的阻碍。应用TPB能够深入了解哪些因素以及由谁来解决这些问题。例如，可通过学校课程的PR培训、进一步的定期继续教育和/或课程以及实践经验来提高RTs的自我效能。
