Perera Chamilya, Jayamaha Akila, Orme Mark, Amarasekara Thamara Dilhani, Yusuf Zainab, Barradell Amy, Manifield James, Barton Andy, Karunathilake Ravini, Fernando Amitha, Wimalasekera Savithri Wasundara, Singh Sally J
Department of Respiratory Science, University of Leicester, Leicester, UK
Faculty of Nursing, KAATSU International University, Colombo, Western Province, Sri Lanka.
BMJ Open Respir Res. 2025 Jul 21;12(1):e002407. doi: 10.1136/bmjresp-2024-002407.
Pulmonary rehabilitation (PR) is a low-cost, high-impact intervention for people living with chronic obstructive pulmonary disease (COPD). Despite the high prevalence of COPD, there are currently very limited facilities to provide PR in Sri Lanka. The views of people living with COPD, their caregivers and relevant healthcare professionals (HCPs) are essential to develop culturally appropriate PR, acceptable in a Sri Lankan setting.
We aimed to explore the lived experiences of key stakeholders on the development and implementation of culturally appropriate PR in Sri Lanka.
A qualitative study was conducted at the Central Chest Clinic (CCC), Sri Lanka. Focus group discussions (FGDs) and semistructured interviews (SSIs) were conducted with the three populations: people living with COPD, their caregivers and relevant HCPs. After audio recording, transcribing and translating, the data were analysed using thematic analysis.
Three FGDs comprising 11 adults with COPD (9 males, age range 39-83 years), three FGDs comprising five family caregivers (three females), three FGDs comprising 14 nurses and 12 SSIs with doctors and physiotherapists were conducted, representing diverse ethnic groups. Two overarching themes were generated: 'PR adaptations' and 'Barriers to PR implementation and adherence'. Within 'PR adaptations', four subthemes were generated: the educational component of PR, nutritional support, psychological support and the use of music during PR sessions. Under 'Barriers to PR implementation and adherence', three subthemes were generated: barriers and issues in participating, need for better medical facilities and difficulty in conducting exercises.
Culturally tailoring PR for people living with COPD in Sri Lanka should include the integration of singing, music and nutritional support, as it may enhance acceptability. Barriers, including a lack of resources to deliver PR, difficulties encountered by patients attending PR sessions and perceived difficulties in performing standardised PR exercises, need to be addressed when developing a culturally appropriate programme in Sri Lanka.
肺康复（PR）是针对慢性阻塞性肺疾病（COPD）患者的一种低成本、高效益的干预措施。尽管COPD患病率很高，但目前斯里兰卡提供肺康复的设施非常有限。COPD患者、他们的护理人员以及相关医疗保健专业人员（HCPs）的观点对于制定在斯里兰卡环境中可接受的、符合文化背景的肺康复至关重要。
我们旨在探索关键利益相关者在斯里兰卡制定和实施符合文化背景的肺康复方面的生活经历。
在斯里兰卡中央胸科诊所（CCC）进行了一项定性研究。对COPD患者、他们的护理人员和相关HCPs这三类人群进行了焦点小组讨论（FGDs）和半结构化访谈（SSIs）。在进行录音、转录和翻译后，使用主题分析法对数据进行了分析。
进行了三次焦点小组讨论，其中包括11名成年COPD患者（9名男性，年龄范围39 - 83岁），三次焦点小组讨论包括五名家庭护理人员（三名女性），三次焦点小组讨论包括14名护士，以及与医生和物理治疗师进行的12次半结构化访谈，代表了不同的种族群体。产生了两个总体主题：“肺康复的调整”和“肺康复实施及依从性的障碍”。在“肺康复的调整”中，产生了四个子主题：肺康复的教育组成部分、营养支持、心理支持以及肺康复过程中音乐的使用。在“肺康复实施及依从性的障碍”下，产生了三个子主题：参与方面的障碍和问题、对更好医疗设施的需求以及进行锻炼的困难。
在斯里兰卡为COPD患者量身定制符合文化背景的肺康复应包括融入唱歌、音乐和营养支持，因为这可能会提高可接受性。在斯里兰卡制定符合文化背景的项目时，需要解决一些障碍，包括缺乏提供肺康复的资源、患者参加肺康复课程时遇到的困难以及在进行标准化肺康复锻炼时感知到的困难。
