Department of Respiratory Medicine, The Sutherland Hospital, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia.
South Eastern Sydney Clinical School, The University of New South Wales, Sydney, New South Wales, Australia.
Intern Med J. 2024 Feb;54(2):274-282. doi: 10.1111/imj.16167. Epub 2023 Aug 7.
Pulmonary rehabilitation (PR) improves dyspnoea, fatigue and healthcare-related quality of life (QoL) in patients with chronic lung disease (CLD). Non-English-speaking background (NESB) patients face language and cultural barriers that hinder their access to PR programmes, contributing to health disparities. Our trial aimed to demonstrate the effectiveness and feasibility of a Chinese language-specific PR programme on lung function, functional exercise capacity and QoL measures.
A prospective cohort study was conducted over a 2-year period. Participants were enrolled in an 8-week PR programme with biweekly sessions conducted by Chinese-speaking physiotherapists. Baseline and post-rehabilitation testing included pulmonary function testing, 6-min walk test (6MWT), St. George Respiratory Questionnaire (SGQR) and Short Form Health Survey (SF-36).
We enrolled 76 patients (58% male) with a median age of 77 years (interquartile range (IQR) 68-81) and achieved a completion rate of 86.8% (n = 66). CLD included chronic obstructive pulmonary disease (42%), asthma (15%) and interstitial lung disease (3%). Baseline median forced expiratory volume in 1 s (FEV1) was 1.63 L (IQR 1.17-2.05), and the median 6MWT was 282 m (IQR 232-332). Post-intervention median 6MWT increased to 332 m (IQR 290-390), and the median FEV1 was 1.99 L (IQR 1.3-2.1). Both QoL measures (SGQR and SF-36) showed significant improvement after intervention (P < 0.05).
Our study demonstrates that a language-specific PR programme is feasible, improving outcomes in NESB patients with CLD. The improvement in 6MWT and QoL measures was comparable to English-based programmes. Ensuring equal access to healthcare programmes, regardless of cultural background or language barriers, is crucial in promoting health equity.
肺康复（PR）可改善慢性肺部疾病（CLD）患者的呼吸困难、疲劳和与健康相关的生活质量（QoL）。非英语语言背景（NESB）患者面临语言和文化障碍，这阻碍了他们获得 PR 计划的机会，导致了健康差距。我们的试验旨在证明特定于中文的 PR 计划对肺功能、功能性运动能力和 QoL 测量的有效性和可行性。
进行了一项为期两年的前瞻性队列研究。参与者参加了一个为期 8 周的 PR 计划，每周两次，由讲中文的物理治疗师进行。基线和康复后测试包括肺功能测试、6 分钟步行测试（6MWT）、圣乔治呼吸问卷（SGQR）和简明健康调查量表（SF-36）。
我们招募了 76 名患者（58%为男性），中位年龄为 77 岁（四分位距（IQR）68-81），完成率为 86.8%（n=66）。CLD 包括慢性阻塞性肺疾病（42%）、哮喘（15%）和间质性肺疾病（3%）。基线中位数 1 秒用力呼气量（FEV1）为 1.63L（IQR 1.17-2.05），中位数 6MWT 为 282m（IQR 232-332）。干预后中位 6MWT 增加到 332m（IQR 290-390），中位 FEV1 为 1.99L（IQR 1.3-2.1）。两种 QoL 测量（SGQR 和 SF-36）在干预后均显著改善（P<0.05）。
我们的研究表明，特定于语言的 PR 计划是可行的，可改善 CLD 非英语语言背景患者的结局。6MWT 和 QoL 测量的改善与基于英语的计划相当。确保无论文化背景或语言障碍如何，都能平等获得医疗保健计划，对于促进健康公平至关重要。
