Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Medical Research Institute of New Zealand, Wellington, New Zealand.
Int J Chron Obstruct Pulmon Dis. 2020 Sep 11;15:2127-2133. doi: 10.2147/COPD.S267268. eCollection 2020.
Pulmonary rehabilitation (PR) is an important, evidence-based treatment that improves outcomes for people with COPD. Individualized exercise programmes aim to improve exercise capacity; self-management education and psychological support are also provided. Translating increased exercise capacity into sustained behavioural change of increased physical activity is difficult. Other unresolved problems with PR programmes include improving uptake, completion, response and sustaining long-term benefit. We offer a different perspective drawn from clinical experience of PR, quantitative and qualitative studies of singing groups for people with COPD, and stroke rehabilitation research that gives psychological factors a more central role in determining outcomes after PR. We discuss Take Charge; a simple but effective psychological intervention promoting self-management--that could be used as part of a PR programme or in situations where PR was declined or unavailable. This may be particularly relevant now when traditional face-to-face group programmes have been disrupted by COVID-19 precautions.
肺康复（PR）是一种重要的、基于证据的治疗方法，可改善 COPD 患者的预后。个体化运动方案旨在提高运动能力；还提供自我管理教育和心理支持。将运动能力的提高转化为持续的身体活动增加的行为改变是困难的。PR 方案的其他未解决的问题包括提高参与率、完成率、反应率和维持长期益处。我们提供了一种不同的视角，该视角来自 PR 的临床经验、针对 COPD 患者的歌唱团体的定量和定性研究，以及中风康复研究，这些研究使心理因素在 PR 后结果的确定中发挥更核心的作用。我们讨论了“掌控”，这是一种简单但有效的促进自我管理的心理干预措施，可以作为 PR 方案的一部分，或者在 PR 被拒绝或不可用时使用。当 COVID-19 预防措施扰乱了传统的面对面团体方案时，这可能尤其相关。
