1 Department of Public Health and Primary Care, School of Population Health and Environmental Sciences, King's College London, London, UK.
2 Norwegian Institute of Public Health, Oslo, Norway.
Chron Respir Dis. 2019 Jan-Dec;16:1479973119869329. doi: 10.1177/1479973119869329.
Lay health workers (LHWs) can improve access to services and adherence to treatment, as well as promoting self-care and prevention. Their effect in promoting uptake and adherence in pulmonary rehabilitation (PR) for chronic obstructive pulmonary disease (COPD) has not been tested. PR is the most effective treatment for the symptoms and disability of COPD, but this effectiveness is undermined by poor rates of completion. Trained LHWs with COPD, who also have first-hand experience of PR, are well placed to help overcome the documented barriers to its completion. The relationship between LHWs and patients may be one of the keys to their effectiveness but it has been little explored. Semi-structured qualitative interviews were used with the aim of examining the LHW-patient partnership in a feasibility study of trained PR-experienced LHWs used to support COPD patients referred to PR. Twelve volunteers with COPD who completed LHW training supported 66 patients referred for PR. All 12 of these LHWs gave end-of-study interviews, 21 COPD patients supported by LHWs were also interviewed. Patients reported that the LHWs were keen to share their experiences of PR, and that this had a positive impact. The enthusiasm of the LHWs for PR was striking. The common bond between LHWs and patients of having COPD together with the LHWs positive, first-hand experience of PR were dominant and recurring themes in their relationship.
初级卫生保健工作者（LHW）可以改善服务的可及性和治疗的依从性，促进自我保健和预防。他们在促进慢性阻塞性肺疾病（COPD）患者接受和坚持肺康复（PR）方面的效果尚未得到检验。PR 是治疗 COPD 症状和残疾的最有效方法，但由于完成率低，其效果受到了影响。接受过 COPD 培训的初级卫生保健工作者，同时也有 PR 的第一手经验，他们很适合帮助克服完成 PR 的记录障碍。LHW 和患者之间的关系可能是他们有效性的关键之一，但这方面的研究很少。本研究采用半结构化定性访谈，目的是在一项关于经过培训的具有 PR 经验的初级卫生保健工作者支持 COPD 患者接受 PR 的可行性研究中，检查 LHW-患者伙伴关系。12 名完成 LHW 培训的 COPD 志愿者支持了 66 名接受 PR 的患者。这 12 名 LHW 全部在研究结束时接受了访谈，21 名由 LHW 支持的 COPD 患者也接受了访谈。患者报告说，LHW 很愿意分享他们的 PR 经验，这对他们产生了积极的影响。LHW 对 PR 的热情令人瞩目。LHW 和 COPD 患者之间的共同纽带，以及 LHW 对 PR 的积极、第一手经验，是他们关系中的主导和反复出现的主题。
