Community Respiratory Centre, Khulna, Bangladesh Primary Care Respiratory Society (BPCRS), Bangladesh.
NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, University of Edinburgh, Edinburgh, UK.
J Glob Health. 2024 Feb 2;14:04036. doi: 10.7189/jogh.14.04036.
Chronic respiratory diseases (CRDs) require holistic management which considers patients' preferences, appropriate pharmacotherapy, pulmonary rehabilitation, and integrated care. We aimed to understand the perceptions of people with CRDs about their condition and pulmonary rehabilitation in Bangladesh.
We conducted semi-structured interviews with a maximum variation sample of people with CRDs who had participated in a feasibility study of pulmonary rehabilitation in 2021/2022. A multidisciplinary team transcribed the interviews verbatim and analysed them in Bengali using a grounded theory approach.
We interviewed 15 participants with chronic obstructive pulmonary disease, asthma, or post-tuberculosis. The analysis revealed three themes. The first encompassed understanding CRDs: Patients characterised their condition by the symptoms (e.g. 'Hapani' meaning 'breathlessness') rather than describing a disease entity. Some believed occupation, previous infection, or family history to be a cause. The second theme included perceptions of pulmonary rehabilitation: Exercise was counterintuitive, as it exacerbated the breathlessness symptom that defined their disease. Views varied, though many acknowledged the benefits after a few sessions. Even with home-based programmes, participants described practical barriers to finding time for the sessions and adopted strategies to overcome the challenges. The third theme focused on implementation: Participants highlighted the need for raising awareness of CRDs and the potential of pulmonary rehabilitation in the community, adapting to the local context, and establishing an accessible resourced service.
Understanding how patients and their communities perceive their condition and the barriers (both conceptual and logistical) to acceptance is the first step to embedding this highly effective intervention into routine health care services in Bangladesh with potential benefits for the increasing number of people living with CRDs in low- and middle-income countries.
慢性呼吸系统疾病（CRD）需要进行整体管理，综合考虑患者的偏好、适当的药物治疗、肺康复和综合护理。我们旨在了解孟加拉国 CRD 患者对自身病情和肺康复的看法。
我们对 2021/2022 年参加肺康复可行性研究的 CRD 患者进行了最大变异样本的半结构式访谈。一个多学科团队将访谈逐字转录，并使用扎根理论方法以孟加拉语进行分析。
我们采访了 15 名患有慢性阻塞性肺疾病、哮喘或肺结核的患者。分析揭示了三个主题。第一个主题包括对 CRD 的理解：患者用症状（如“哈帕尼”表示“呼吸困难”）来描述病情，而不是用疾病实体来描述。一些人认为职业、既往感染或家族史是病因。第二个主题包括对肺康复的看法：运动是违反直觉的，因为它会加重定义他们疾病的呼吸困难症状。尽管许多人在参加了几次课程后承认了其益处，但看法不一。即使是在家进行的方案，参与者也描述了寻找时间参加课程的实际障碍，并采取了策略来克服这些挑战。第三个主题侧重于实施：参与者强调需要提高社区对 CRD 和肺康复潜力的认识，适应当地情况，并建立一个可及的资源服务。
了解患者及其社区如何看待自身病情以及接受该干预措施的障碍（包括概念性和实际性障碍）是将这种非常有效的干预措施纳入孟加拉国常规医疗保健服务的第一步，这可能会为越来越多的中低收入国家的 CRD 患者带来益处。
