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Original article| Volume 88, ISSUE 12, P1704-1709, December 2007

Education in Pulmonary Rehabilitation: The Patient’s Perspective

      Abstract

      Wilson JS, O’Neill B, Reilly J, MacMahon J, Bradley JM. Education in pulmonary rehabilitation: the patient’s perspective.

      Objectives

      To ascertain from patients’ perspectives what should be included in the educational component of pulmonary rehabilitation and how it should be delivered, and to compare those perspectives with the views of health professionals.

      Design

      Qualitative research method using focus groups of patients and health professionals.

      Setting

      A regional respiratory center and outpatient clinic.

      Participants

      Purposive samples of 32 patients with chronic obstructive pulmonary disease (COPD) (forced expiratory volume in 1 second, 18%–67% predicted) divided into 6 focus groups; 8 health professionals knowledgeable about COPD and pulmonary rehabilitation who attended a multidisciplinary focus group meeting.

      Interventions

      Participants attended focus group meetings (2–3h) guided by a series of questions and topics; results were posted to the participants for their verification.

      Main Outcome Measure

      The educational content of a pulmonary rehabilitation program.

      Results

      Deficits in patients’ knowledge, understanding, and management of their disease were identified. Six key educational topics resulted: disease education, management of breathlessness, management of an exacerbation, medication, psychosocial support, and welfare and benefits systems. Patients and health professionals preferred group information sessions provided by knowledgeable people speaking layman’s language, with oral presentations being supplemented by written information.

      Conclusions

      Gaining a greater understanding of patients’ educational needs permits health professionals who design pulmonary rehabilitation programs to include these requirements in a format that is acceptable to patients. The key topics, content, and format for delivery of the educational component for pulmonary rehabilitation were identified. Future research should focus on the development of an educational package and assessment of its efficacy, which would facilitate equitable patient access to education in pulmonary rehabilitation.

      Key Words

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      References

        • American Thoracic Society European Respiratory Society
        Statement on pulmonary rehabilitation.
        Am J Resp Crit Care Med. 2006; 173: 1390-1413
        • British Thoracic Society Statement Pulmonary Rehabilitation
        Thorax. 2001; 56: 827-834
        • American Association of Cardiovascular and Pulmonary Rehabilitation
        Guidelines for pulmonary rehabilitation programs.
        2nd ed. Human Kinetics, Champaign1998
        • National Collaborating Centre for Chronic Conditions
        Chronic obstructive pulmonary disease.
        Thorax. 2004; 59: 1-132
      1. Saving lives: our healthier nation, government white paper. HMSO, London1999
        • Department of Health
        NHS plan.
        HMSO, London2000
        • Department of Health
        The expert patient: a new approach to chronic disease management for the 21st century.
        DOH, London2001
        • Barr R.G.
        • Celli B.R.
        • Martinez F.J.
        • et al.
        Physician and patient perceptions in COPD: The COPD Resource Network Needs Assessment Survey.
        Am J Med. 2005; 118: 1415-1529
        • Department of Health
        A healthier future: a strategic framework for respiratory conditions.
        DOH, London2005
        • Strauss A.
        • Corbin J.
        Basics of qualitative research: grounded theory procedures and techniques.
        Sage, London1990
        • Toshima M.T.
        • Kaplan R.M.
        • Ries A.L.
        Experimental evaluation of pulmonary rehabilitation in chronic obstructive pulmonary disease: short-term effects of exercise endurance and health status.
        Health Psychol. 1990; 9: 237-252
        • Ries A.L.
        • Kaplan R.M.
        • Limberg T.M.
        • Prewitt L.M.
        Effects of pulmonary rehabilitation on physiologic and psychosocial outcomes in patients with chronic obstructive pulmonary disease.
        Ann Intern Med. 1995; 122: 823-832
        • American Thoracic Society
        Dyspnea assessment and management: a consensus statement.
        Am J Respir Crit Care Med. 1998; 159: 321-340
        • Gallefoss F.
        The effects of patient education in COPD in a 1-year follow-up randomised, controlled trial.
        Patient Educ Couns. 2004; 52: 259-266
        • Wempe J.B.
        • Wijkstra P.J.
        The influence of rehabilitation on behaviour modification in COPD.
        Patient Educ Couns. 2004; 52: 237-241
        • Curtis J.R.
        • Engelberg R.A.
        • Wenrich M.D.
        • Au D.H.
        Communication about palliative care for patients with chronic obstructive pulmonary disease.
        J Palliat Care. 2005; 21: 157-164
        • McGeoch G.R.
        • Willsman K.J.
        • Dowson C.A.
        • et al.
        Self-management plans in the primary care of patients with chronic obstructive pulmonary disease.
        Respirology. 2006; 11: 611-618
        • Ninot G.
        • Fortes M.
        • Poulain M.
        • et al.
        Gender differences in coping strategies among patients enrolled in an inpatient rehabilitation program.
        Heart Lung. 2006; 35: 130-136
        • Bourbeau J.
        • Julien M.
        • Maltais F.
        • et al.
        Reduction of hospital utilization in patients with chronic obstructive pulmonary disease.
        Arch Intern Med. 2003; 163: 585-591
        • American College of Physicians
        Living well with COPD: chronic bronchitis and emphysema.
        ACP, Northbrook2004