Improving the uptake of pulmonary rehabilitation in patients with COPD: qualitative study of experiences and attitudes.
BACKGROUND
Pulmonary rehabilitation can improve the quality of life and ability to function of patients with chronic obstructive pulmonary disease (COPD). It may also reduce hospital admission and inpatient stay with exacerbations of COPD. Some patients who are eligible for pulmonary rehabilitation may not accept an offer of it, thereby missing an opportunity to improve their health status.


OBJECTIVE
To identify a strategy for improving the uptake of pulmonary rehabilitation.


METHODS
Qualitative interviews with patients.


METHODS
Patients with COPD were recruited from a suburban general practice in north-east Derbyshire, UK.


METHODS
In-depth interviews were conducted on a purposive sample of 16 patients with COPD to assess their concerns about accepting an offer of pulmonary rehabilitation. Interviews were analysed using grounded theory.


RESULTS
Fear of breathlessness and exercise, and the effect of pulmonary rehabilitation on coexisting medical problems were the most common concerns patients had about taking part in the rehabilitation. The possibility of reducing the sensation of breathlessness and regaining the ability to do things, such as play with their grandchildren, were motivators to participating.


CONCLUSIONS
A model is proposed where patients who feel a loss of control as their disease advances may find that pulmonary rehabilitation offers them the opportunity to regain control. Acknowledging patients' fears and framing pulmonary rehabilitation as a way of 'regaining control' may improve patient uptake.
Harris
David
D
Killamarsh Medical Practice, Killamarsh, Sheffield. david.harris@nhs.net
Hayter
Mark
M
Allender
Steven
S
D000368:Aged; D004417:Dyspnea / Q000209:etiology / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods* / Q000706:statistics & numerical data; D005194:Family Practice; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000534:rehabilitation*; D011788:Quality of Life; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects