title: A qualitative assessment of COPD patients' experiences of pulmonary rehabilitation and guidance by healthcare professionals.
abstract: BACKGROUND
  The present study aimed to assess COPD patients' experiences during an in-patient pulmonary rehabilitation program and the guidance provided by healthcare professionals. A third aim regarded examining ways to anticipate the transfer to the home environment after completion of the program.
  
  
  METHODS
  Focus groups and semi-structured interviews were used to collect data from seven COPD patients at the beginning and six other COPD patients at the end of an in-patient pulmonary rehabilitation program, supplemented by a focus group and semi-structured interviews with 14 healthcare professionals of the involved disciplines. Data were analyzed using a phenomenological approach.
  
  
  RESULTS
  Starting out, patients displayed trouble with acceptance of their disease, they had insufficient knowledge, and showed difficulties in setting specific realistic goals. Seeing fellow patients struggle with similar problems and tailored counseling by healthcare professionals helped them to overcome these barriers. During rehabilitation, patients became more confident in exercising and managing their daily life activities. Many patients evolved a desire to self-regulate their lives. Incorporating health-enhancing behaviors after returning home into their usual daily routines was anticipated to be tough.
  
  
  CONCLUSIONS
  Patients undergoing pulmonary rehabilitation experience a complex health behavior change process, in which healthcare professionals fulfill a major contributing role. Therefore, guiding patients through this health behavior change process is a vital component of healthcare professionals' work, regarding which the present study made practical implications such as applying a personalized approach by giving tailored advices, applying an autonomy-supportive counseling style, teaching self-management skills, and referring patients to local exercise facilities.
authors.affiliation: Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands. Electronic address: j.meis@maastrichtuniversity.nl.
authors.forename: Jessie J M
authors.initials: JJ
authors.lastname: Meis
authors.affiliation: Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Center+, Maastricht, The Netherlands.
authors.forename: Claudia B
authors.initials: CB
authors.lastname: Bosma
authors.affiliation: Program Development Center, CIRO+, Center of Expertise for Chronic Organ Failure, Horn, The Netherlands.
authors.forename: Martijn A
authors.initials: MA
authors.lastname: Spruit
authors.affiliation: Program Development Center, CIRO+, Center of Expertise for Chronic Organ Failure, Horn, The Netherlands.
authors.forename: Frits M E
authors.initials: FM
authors.lastname: Franssen
authors.affiliation: Program Development Center, CIRO+, Center of Expertise for Chronic Organ Failure, Horn, The Netherlands.
authors.forename: Daisy J A
authors.initials: DJ
authors.lastname: Janssen
authors.affiliation: Centre for Interdisciplinary Study of Human Performance (CIPER), Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.
authors.forename: Pedro J
authors.initials: PJ
authors.lastname: Teixeira
authors.affiliation: Program Development Center, CIRO+, Center of Expertise for Chronic Organ Failure, Horn, The Netherlands.
authors.forename: Ingrid M L
authors.initials: IM
authors.lastname: Augustin
authors.affiliation: Program Development Center, CIRO+, Center of Expertise for Chronic Organ Failure, Horn, The Netherlands; Department of Respiratory Medicine, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.
authors.forename: Emiel F M
authors.initials: EF
authors.lastname: Wouters
authors.affiliation: Department of Health Promotion, CAPHRI School for Public Health and Primary Care, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.
authors.forename: Nanne K
authors.initials: NK
authors.lastname: de Vries
authors.affiliation: Department of Respiratory Medicine, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.
authors.forename: Annemie M W J
authors.initials: AM
authors.lastname: Schols
authors.affiliation: Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.
authors.forename: Stef P J
authors.initials: SP
authors.lastname: Kremers
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation*; D036301:Qualitative Research; D012648:Self Care; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: COPD patients; Health behavior change; Healthcare professionals' counseling strategies; Pulmonary rehabilitation; Qualitative study