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提高 COPD 急性加重后肺康复的接受度和使用率:出院前进行 PR“品尝”课程的可接受性、可行性和安全性。

Improving acceptance and uptake of pulmonary rehabilitation after acute exacerbation of COPD: Acceptability, feasibility, and safety of a PR "taster" session delivered before hospital discharge.

机构信息

School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.

Translational Research in Respiratory Diseases Program, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.

出版信息

Chron Respir Dis. 2019 Jan-Dec;16:1479973119872517. doi: 10.1177/1479973119872517.

Abstract

The objectives of this study were to (1) assess the acceptability, feasibility, and safety of delivering a pulmonary rehabilitation (PR) "taster" session to patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease; (2) evaluate the changes in patient knowledge and readiness to commence PR; and (3) make recommendations for future intervention iterations. Acceptability was measured by the proportion of patients that accepted to participate. Feasibility was measured by the proportion of eligible participants. Knowledge was evaluated using the modified versions of the Understanding COPD (UCOPD) and Bristol COPD Knowledge (BCKQ) questionnaires. Readiness to commence PR was measured by a modified version of the Readiness to Change Exercise Questionnaire. All measures were delivered pre- and post-intervention. Thirty-one of 34 eligible individuals were able to be approached. Prospective acceptability was low, with 24 individuals declining the intervention, 1 being discharged without making a decision, and only 6 participating. Positive median change was recorded in the modified UCOPD questionnaire (+8), but not the BCKQ (0). Three of the patients were already in the action phase pre-intervention, with all but one in that phase post-intervention. The delivery of a PR "taster" session was not prospectively acceptable to a large portion of patients and only feasible with modifications to the original protocol.

摘要

本研究的目的是

(1)评估向因慢性阻塞性肺疾病急性加重而住院的患者提供肺康复(PR)“体验”课程的可接受性、可行性和安全性;(2)评估患者知识和开始 PR 的准备情况的变化;(3)为未来的干预迭代提供建议。可接受性通过接受参与的患者比例来衡量。可行性通过符合条件的参与者比例来衡量。知识是通过使用 COPD 理解度(UCOPD)和布里斯托 COPD 知识(BCKQ)问卷的修改版本来评估的。开始 PR 的准备情况通过修改后的改变运动意愿问卷来衡量。所有措施均在干预前后进行。34 名符合条件的个人中有 31 名可以接近。前瞻性可接受性较低,24 名个体拒绝干预,1 名个体未经决定出院,只有 6 名个体参与。修改后的 UCOPD 问卷(+8)记录了阳性中位数变化,但 BCKQ(0)没有。3 名患者在干预前已经处于行动阶段,除 1 名患者外,所有患者在干预后都处于该阶段。PR“体验”课程的提供对于大部分患者来说并不是前瞻性可接受的,并且仅通过对原始方案进行修改才可行。

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