Ann Am Thorac Soc. 2018 Jul;15(7):769-784. doi: 10.1513/AnnalsATS.201804-253WS.
According to the 2013 American Thoracic Society/European Respiratory Society statement on pulmonary rehabilitation (PR), education to promote effective self-management is a cornerstone of this intervention. Despite education's stature within PR, there is currently limited evidence supporting its overall efficacy, and minimal evidence guiding its optimal design and delivery. This workshop was convened to focus on the current state of education in PR for patients with chronic obstructive pulmonary disease, who are the most common people referred to PR. The workshop explored the learning needs and limitations of patients participating in PR, promising design features (from work done outside of PR) that may inform our approach to education, and professional development of PR healthcare educators. Areas identified as needing development include: 1) outcome assessment for the educational component; 2) screening patients for conditions that will impede the learning process (anxiety, depression, cognitive deficits and health literacy issues); 3) tailoring content and optimizing delivery of the educational component; and 4) training PR professionals in their roles as educators. By necessity, the workshop conclusions are painted in broad strokes. However, with ongoing interest in improving quality through individualized patient assessment, educational design innovations, and scientific scrutiny comparable to that given to exercise training, the educational component of PR may achieve effective self-management, leading to successful behavior change and enhancement in health.
根据 2013 年美国胸科学会/欧洲呼吸学会关于肺康复(PR)的声明,促进有效的自我管理的教育是该干预措施的基石。尽管教育在 PR 中的地位很高,但目前支持其整体疗效的证据有限,指导其最佳设计和实施的证据也很少。本次研讨会的目的是集中讨论慢性阻塞性肺疾病(COPD)患者 PR 中的教育现状,COPD 是最常见的 PR 转诊人群。该研讨会探讨了参与 PR 的患者的学习需求和局限性,有前途的设计特点(来自 PR 以外的工作)可能为我们的教育方法提供信息,并为 PR 医疗保健教育者提供专业发展。需要开发的领域包括:1)教育部分的结果评估;2)筛选可能阻碍学习过程的条件(焦虑、抑郁、认知缺陷和健康素养问题)的患者;3)调整教育部分的内容和优化交付;4)培训 PR 专业人员在教育者角色中的作用。由于需要,研讨会的结论是广泛的。然而,随着通过个性化患者评估、教育设计创新以及与运动训练相当的科学审查来提高质量的持续兴趣,PR 的教育部分可能实现有效的自我管理,从而导致成功的行为改变和健康状况的改善。