Bickton Fanuel Meckson, Mankhokwe Talumba, Chavula Beatrice, Chitedze Emily, Manda Martha, Fombe Cashon, Mitengo Martha, Mwahimba Langsfield, Isiagi Moses, van Zyl-Smit Richard N, Hanekom Susan, Heine Martin, Shannon Harriet, Rylance Jamie, Chisati Enock, Gordon Stephen B, Limbani Felix
Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
Department of Rehabilitation Sciences, School of Life Sciences and Allied Health Professions, Kamuzu University of Health Sciences, Blantyre, Malawi.
BMJ Open Respir Res. 2025 May 22;12(1):e002547. doi: 10.1136/bmjresp-2024-002547.
Pulmonary rehabilitation (PR) is an effective non-pharmacological intervention for people with chronic respiratory diseases (CRDs), but its acceptability in Malawi was unknown.
To explore patients' acceptability of PR at Queen Elizabeth Central Hospital, Blantyre, Malawi.
This was a pre-post cohort study where participants were offered a two times per week hospital-based PR programme for 6 weeks, consisting of endurance and strengthening exercises. Following programme completion, face-to-face semistructured in-depth interviews with the participants were conducted. Interview transcripts were thematically analysed using a deductive approach.
10 adults (five females and five males) out of 14 invited (~70% uptake) participated in the PR programme and subsequent in-depth interviews. Five key themes emerged: (1) debilitating symptom experience of CRD prior to PR; (2) positive impact of PR on living with CRD; (3) contextual programme design improved participants' experience with PR; (4) one size does not fit all and (5) challenges and opportunities for home-based PR. Participants reported experiencing improvements in physical, psychological and social health associated with PR programme participation. The provision of transport was considered a key facilitator for PR programme completion. Realising the gained PR benefits, participants were willing to continue exercising at their homes.
The PR programme improved the participants' perceived health status and was well-accepted. Addressing barriers related to transport facilitated immediate implementation while providing a challenge for the scaling and sustainability of PR beyond the project duration. These findings support the drive for shifting chronic care, including rehabilitation, towards primary care and community.
Prospective; 27 August 2021; ISRCTN13836793.
肺康复（PR）是一种针对慢性呼吸道疾病（CRD）患者的有效的非药物干预措施，但在马拉维其可接受性尚不清楚。
探讨马拉维布兰太尔伊丽莎白女王中央医院患者对肺康复的可接受性。
这是一项前后队列研究，为参与者提供为期6周、每周两次的基于医院的肺康复计划，包括耐力和强化训练。计划完成后，对参与者进行面对面的半结构化深入访谈。访谈记录采用演绎法进行主题分析。
14名受邀者中有10名成年人（5名女性和5名男性，参与率约70%）参加了肺康复计划及后续的深入访谈。出现了五个关键主题：（1）肺康复前慢性呼吸道疾病使人衰弱的症状体验；（2）肺康复对慢性呼吸道疾病患者生活的积极影响；（3）根据具体情况设计的计划改善了参与者的肺康复体验；（4）一刀切并不适用；（5）家庭肺康复的挑战与机遇。参与者报告称，参与肺康复计划后，身体、心理和社会健康状况有所改善。提供交通被认为是完成肺康复计划的关键促进因素。认识到肺康复带来的益处后，参与者愿意在家继续锻炼。
肺康复计划改善了参与者的健康状况感知，且被广泛接受。解决与交通相关的障碍有助于立即实施，但也为项目结束后的肺康复扩展和可持续性带来挑战。这些发现支持将包括康复在内的慢性病护理转向初级保健和社区的努力。
前瞻性；2021年8月27日；ISRCTN13836793。
