Keen Carol, Fowler-Davis Sally, McLean Sionnadh, Manson Jane
1 Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield, UK.
2 Sheffield Hallam University, Sheffield, UK.
Pulm Circ. 2018 Jul-Sep;8(3):2045894018783738. doi: 10.1177/2045894018783738.
Pulmonary hypertension (PH) is a life-limiting disease affecting circulation to the lungs. The primary symptom of PH is breathlessness, yet research has shown that patients with PH can exercise safely and can benefit from exercise to improve exercise capacity and maintain quality of life. This study aimed to investigate the nature of physiotherapy delivered to patients with PH in the UK. This was a two-phase sequential, exploratory, mixed-methods study. Interviews were conducted with seven lead physiotherapists at specialist pulmonary hypertension centers and three patients. Survey data came from 63 physiotherapists caring for patients with PH in specialist and non-specialist settings. The findings from the two phases were triangulated and analyzed. Findings showed that physiotherapists and patients see the benefit and potential of physical activity for patients with PH to maintain functional wellbeing. However, current physiotherapy provision focuses on acute inpatient care and planning for discharge and is not therefore aligned with research evidence and clinical guidelines. In the absence of inpatient rehabilitation facilities, physiotherapists will occasionally access existing community services, e.g. pulmonary rehabilitation; however, specialist knowledge of this rare condition can be lacking in local services. There is aspiration among physiotherapists and patients for a new approach which supports patients from diagnosis with PH to end of life. This includes promoting and delivering rehabilitation and exercise interventions to achieve better health outcomes, in line with patient needs. Treatment would be commissioned and delivered within existing national health systems with physiotherapists developing strategies for health improvement.
肺动脉高压（PH）是一种影响肺部血液循环的、危及生命的疾病。PH的主要症状是呼吸急促，但研究表明，PH患者能够安全地进行锻炼，并且可以从锻炼中受益，以提高运动能力和维持生活质量。本研究旨在调查英国为PH患者提供的物理治疗的性质。这是一项分两个阶段的、顺序性的、探索性的混合方法研究。对7名专科肺动脉高压中心的首席物理治疗师和3名患者进行了访谈。调查数据来自63名在专科和非专科环境中护理PH患者的物理治疗师。对两个阶段的研究结果进行了三角互证和分析。结果显示，物理治疗师和患者都认识到体育活动对PH患者维持功能健康的益处和潜力。然而，目前的物理治疗服务主要集中在急性住院护理和出院计划方面，因此与研究证据和临床指南不一致。在缺乏住院康复设施的情况下，物理治疗师偶尔会利用现有的社区服务，如肺部康复；然而，当地服务可能缺乏对这种罕见疾病的专业知识。物理治疗师和患者都希望有一种新的方法，能够为从被诊断为PH到生命终结的患者提供支持。这包括推广和提供康复及运动干预措施，以根据患者需求实现更好的健康结果。治疗将在现有的国家卫生系统内委托并提供，由物理治疗师制定改善健康的策略。
