title: Advance care planning education in pulmonary rehabilitation: A qualitative study exploring participant perspectives.
abstract: BACKGROUND
  Advance care planning is considered to have an important role in the management of people with chronic lung disease; however, uptake in clinical practice remains limited. Participant acceptance of the inclusion of an advance care planning information session in pulmonary rehabilitation and maintenance programmes could support a practical solution.
  
  
  OBJECTIVE
  To evaluate the introduction of a structured group advance care planning information session from the perspective of participants in pulmonary rehabilitation and maintenance programmes.
  
  
  METHODS
  Prospective qualitative study with semi-structured interview transcripts analysed using iterative thematic analysis.
  
  
  METHODS
  Participants in pulmonary rehabilitation and maintenance programmes at a tertiary metropolitan hospital and two affiliated community sites.
  
  
  RESULTS
  Sixty-seven participants with a range of chronic lung diseases were interviewed with ages ranging from 39 to 88 years, forced expiratory volume in 1 s (FEV1) ranging from 18% to 130% predicted and 6-min walk distance ranging from 105 to 619 m. Sixteen participants (24%) had previously heard of advance care planning. Major themes were that participants valued the advance care planning information and thought pulmonary rehabilitation was an appropriate setting. The group education format was well accepted and perceived to have advantages over individual sessions. Participants were happy to receive the information from a non-medical facilitator. Non-attendees had usually missed the session for reasons unrelated to content. A small number of participants felt advance care planning was not appropriate for them, but all recognised its value for other participants.
  
  
  CONCLUSIONS
  Participants in our pulmonary rehabilitation and maintenance programmes value the opportunity to participate in a structured, group-based advance care planning session. Consideration should be given to broader inclusion of advance care planning education into existing pulmonary rehabilitation and maintenance programmes for people with chronic respiratory disease.
authors: Physiotherapy Department, The Alfred, Melbourne, VIC, Australia. A.Burge@alfred.org.au
authors: Angela T
authors: AT
authors: Burge
authors: Annemarie
authors: A
authors: Lee
authors: Mandy
authors: M
authors: Nicholes
authors: Stephanie
authors: S
authors: Purcell
authors: Belinda
authors: B
authors: Miller
authors: Naomi
authors: N
authors: Norris
authors: Sarah
authors: S
authors: McArdle
authors: Sean
authors: S
authors: Sandilands
authors: Anne E
authors: AE
authors: Holland
mesh_terms: D000328:Adult; D032722:Advance Care Planning; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D017060:Patient Satisfaction; D011446:Prospective Studies; D036301:Qualitative Research
keywords: Advance care planning; exercise; lung diseases; patient education as topic; qualitative research