School of Rehabilitation Sciences, McMaster University, Hamilton, Canada; West Park Healthcare Centre, Toronto, Canada.
School of Rehabilitation Sciences, McMaster University, Hamilton, Canada.
Respir Med. 2024 Apr-May;225:107588. doi: 10.1016/j.rmed.2024.107588. Epub 2024 Mar 7.
Pulmonary rehabilitation (PR) plays an important role in the management of symptomatic patients with chronic respiratory diseases (CRD). While studies have investigated the feasibility and efficacy of virtual PR (VPR), it is important to understand the experiences of patients and healthcare providers (HCPs) during the rapid digital health transformation that occurred in the COVID-19 pandemic.
To explore the experiences and perspectives of patients and HCPs who participated in VPR during the pandemic.
Semi-structured interviews were conducted with CRD patients and HCPs. This study used a qualitative descriptive approach and a team-based inductive thematic analysis.
Participants included 11 HCPs (7 female; 29-55 years) and 19 CRD patients (11 male; 62-83 years; 15 COPD, 4 COPD/ILD). Three major themes and 10 subthemes were identified: i) the pandemic response: a 'trial by fire' (navigating uncertainty, emotional impact of change, shifting practice amid complexity); ii) beyond the emergency: navigating a 'new normal' (eligibility and assessment for VPR, virtual exercise, virtual education and resources, clinical supervision and patient safety); and iii) care beyond boundaries: the implications of using technology for PR (benefits and limitations of technology, psychosocial implications, VPR in the future).
The pivot to VPR was acknowledged as positive by both patients and HCPs although both groups were mindful of the implementation challenges. These findings provide insight into the experience of HCPs and patients in introducing VPR in response to the pandemic and will inform future implementation of VPR for individuals with CRD.
肺康复（PR）在管理有症状的慢性呼吸系统疾病（CRD）患者中起着重要作用。虽然已经研究了虚拟 PR（VPR）的可行性和疗效，但了解在 COVID-19 大流行期间快速数字化健康转型期间患者和医疗保健提供者（HCP）的体验非常重要。
探讨在大流行期间参与 VPR 的患者和 HCP 的经验和观点。
对 CRD 患者和 HCP 进行半结构化访谈。本研究采用定性描述方法和基于团队的归纳主题分析。
参与者包括 11 名 HCP（7 名女性；29-55 岁）和 19 名 CRD 患者（11 名男性；62-83 岁；15 名 COPD，4 名 COPD/ILD）。确定了三个主要主题和十个子主题：i）大流行应对：“试金石”（应对不确定性、变化的情绪影响、在复杂性中转变实践）；ii）超越紧急情况：驾驭“新常态”（VPR 的资格和评估、虚拟运动、虚拟教育和资源、临床监督和患者安全）；iii）超越界限的护理：使用技术进行 PR 的影响（技术的优缺点、心理社会影响、未来的 VPR）。
患者和 HCP 都认为转向 VPR 是积极的，尽管双方都注意到了实施挑战。这些发现为 HCP 和患者在引入 VPR 以应对大流行时的体验提供了深入了解，并将为未来为 CRD 患者实施 VPR 提供信息。
