title: Effects of the Pulmonary Hypertension Manual (PulHMan) on Awareness of Exercise in Patients with Pulmonary Hypertension.
abstract: BACKGROUND
  Patient education is an important part of holistic care for patients with chronic diseases. With the success of the Heart Manual, it was felt there is a strong need to develop such a manual for those with pulmonary hypertension (PH) - the Pulmonary Hypertension Manual (PulHMan). This was developed through a qualitative methodology in order to ensure the needs of the patients were being met. The impact of the PulHMan on awareness about exercise-related benefits and PH are not known. Therefore the aim of this study was to assess the effects of the PulHMan on improving awareness among individuals with PH.
  
  
  METHODS
  A repeat cross sectional study was carried out on 30 patients with PH to assess the effects of using the PulHMan on awareness of exercise-related benefits in PH. Awareness was assessed from a self-developed and validated questionnaire that included components of PH and exercise related components.
  
  
  RESULTS
  Thirty patients with PH (mean right ventricular systolic pressure and six minute walk distance of 89.2±4.1mm Hg and 322.8±102m respectively) were included in the study. At baseline, it was seen that there was a low awareness regarding the benefits of exercise for PH. However, they were aware of the general health benefits of walking. After three months, it was seen that the PulHMan improved awareness on the benefits of exercising. Despite a low number willing to exercise (2/30) and participate in a home-based program (2/30), after using the PulHMan for three months, there was an improvement in those willing to exercise and participate in a home-based program (22/30 and 25/30 respectively).
  
  
  CONCLUSIONS
  The PulHMan was seen to improve awareness regarding the exercise-related benefits among patients with PH. More studies are needed to determine if this change in awareness translates into a behavioural change for those with PH.
authors.affiliation: Department of Physiotherapy, School of Allied Health Sciences, Manipal University, Manipal - 576104, Karnataka, India. Electronic address: abrahambabu@gmail.com.
authors.forename: Abraham Samuel
authors.initials: AS
authors.lastname: Babu
authors.affiliation: Department of Cardiology, Kasturba Medical College, Manipal University, Manipal - 576104, Karnataka, India.
authors.forename: Padmakumar
authors.initials: P
authors.lastname: Ramachandran
authors.affiliation: Department of Physiotherapy, School of Allied Health Sciences, Manipal University, Manipal - 576104, Karnataka, India.
authors.forename: Arun G
authors.initials: AG
authors.lastname: Maiya
mesh_terms: D000328:Adult; D015444:Exercise; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology*; D008297:Male; D008370:Manuals as Topic; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*
keywords: Exercise; Patient education; Physical activity; Pulmonary arterial hypertension