TY - JOUR
T1 - “You leave there feeling part of something”
T2 - A qualitative study of hospitalized COPD patients’ perceptions of pulmonary rehabilitation
AU - Spitzer, Kerry A.
AU - Stefan, Mihaela S.
AU - Drake, Aubri A.
AU - Pack, Quinn R.
AU - Lagu, Tara
AU - Mazor, Kathleen M.
AU - Pinto-Plata, Victor
AU - Lindenauer, Peter K.
N1 - Funding Information:
The research was supported by the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Numbers K24HL132008 and R01HL133046. The funders had no role in data collection, management, analysis; study design, conduct, or interpretation of study findings; or the preparation, review, or approval of the manuscript submitted for the publication. Dr. Pack was supported by a grant from the National Heart, Lung and Blood Institute of the National Institutes of Health of Bethesda, MD under award number 1K23HL135440.
Publisher Copyright:
© 2020 Spitzer et al. This work is published and licensed by Dove Medical Press Limited.
PY - 2020
Y1 - 2020
N2 - Rationale: Current guidelines recommend that patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease (COPD) initiate pulmonary rehabilitation (PR) shortly after discharge from the hospital. However, fewer than 2 percent of Medicare beneficiaries do so. Few studies have examined hospitalized patients’ perceptions of the barriers and facilitators to enroll in PR. The aim of this study was to develop an understanding of these factors by interviewing patients. Methods: We conducted semi-structured interviews with patients during a hospitalization for COPD exacerbation in a large teaching hospital. Directed content analysis was used to code and analyze interview transcripts. Results: Of the 15 patients we interviewed, 9 had participated in PR prior to their hospitalization, 10 were women; 4 were black, and 1 was Hispanic. Facilitators of enrollment included a desire to learn more about the disease, social support, and trust in the health-care provider recommending PR. Barriers to enrollment included lack of awareness, family obligations, lack of motivation, and transportation. For those who had previous experience with PR, but who did not complete the program, another barrier was not feeling well enough. Facilitators to adherence included the educational component of the program; feeling better through exercise; and a social connection with both participants and staff. For some patients. PR contributed to a renewed sense of hope or meaning. Most interviewees expressed interest in a peer coaching program. Conclusion: Our results highlight the importance of increasing awareness of PR and building trust between the provider and patients to facilitate initial enrollment. Future interventions to improve enrollment and adherence should address the need for education about the benefits of PR and the value of social support.
AB - Rationale: Current guidelines recommend that patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease (COPD) initiate pulmonary rehabilitation (PR) shortly after discharge from the hospital. However, fewer than 2 percent of Medicare beneficiaries do so. Few studies have examined hospitalized patients’ perceptions of the barriers and facilitators to enroll in PR. The aim of this study was to develop an understanding of these factors by interviewing patients. Methods: We conducted semi-structured interviews with patients during a hospitalization for COPD exacerbation in a large teaching hospital. Directed content analysis was used to code and analyze interview transcripts. Results: Of the 15 patients we interviewed, 9 had participated in PR prior to their hospitalization, 10 were women; 4 were black, and 1 was Hispanic. Facilitators of enrollment included a desire to learn more about the disease, social support, and trust in the health-care provider recommending PR. Barriers to enrollment included lack of awareness, family obligations, lack of motivation, and transportation. For those who had previous experience with PR, but who did not complete the program, another barrier was not feeling well enough. Facilitators to adherence included the educational component of the program; feeling better through exercise; and a social connection with both participants and staff. For some patients. PR contributed to a renewed sense of hope or meaning. Most interviewees expressed interest in a peer coaching program. Conclusion: Our results highlight the importance of increasing awareness of PR and building trust between the provider and patients to facilitate initial enrollment. Future interventions to improve enrollment and adherence should address the need for education about the benefits of PR and the value of social support.
KW - COPD
KW - Chronic obstructive pulmonary disease
KW - Hospitalization
KW - Patient perspectives
KW - Pulmonary rehabilitation
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U2 - 10.2147/COPD.S234833
DO - 10.2147/COPD.S234833
M3 - Article
C2 - 32231430
AN - SCOPUS:85082439860
VL - 15
SP - 575
EP - 583
JO - International Journal of COPD
JF - International Journal of COPD
SN - 1176-9106
ER -