Participation and drop-out in pulmonary rehabilitation: a qualitative analysis of the patient's perspective

被引:90
作者
Fischer, M. J.
Scharloo, M.
Abbink, J. J.
Thijs-Van Nies, A.
Rudolphus, A.
Snoei, L.
Weinman, J. A.
Kaptein, A. A.
机构
[1] Leiden Univ, Med Ctr, NL-2300 RB Leiden, Netherlands
[2] Rijnlands Rehabil Ctr, Leiden, Netherlands
[3] Schoondonck Rehabil Ctr, Breda, Netherlands
[4] St Franciscus Gasthuis, Dept Resp Med, Rotterdam, Netherlands
[5] Inst Psychiat, Hlth Psychol Sect, London, England
关键词
D O I
10.1177/0269215506070783
中图分类号
R49 [康复医学];
学科分类号
100215 [康复医学与理疗学];
摘要
Objective: To examine patients' pretreatment beliefs and goals regarding pulmonary rehabilitation. Design: Qualitative study using semi-structured interviews. Setting: Interviews conducted at participants' homes. Subjects: Twelve patients with chronic obstructive pulmonary disease who had been referred to a rehabilitation clinic. Main measures: Patients' beliefs about pulmonary rehabilitation, self-set treatment goals and anticipated reasons for drop-out. Results: Patients' beliefs about pulmonary rehabilitation comprised positive aspects (participation as an opportunity for improvement, a safe and multidisciplinary setting, presence of motivating and supporting patients) and negative aspects of exercising in a rehabilitation centre (e.g. disruption of normal routine, being tired after training, transportation difficulties, limited privacy and confrontation with severely ill patients). Four types of treatment goals were formulated: increase in functional performance, weight regulation, reduction of dyspnoea, and improvement of psychosocial wellbeing. Four clusters of anticipated reasons for drop-out were identified: the intensity of the programme, barriers to attending (e.g. transportation problems, sudden illness and other duties/responsibilities), lack of improvement and social factors. Four different attitudes towards pulmonary rehabilitation could be distinguished: optimistic, 'wait and see', sceptic and pessimistic, Follow-up data revealed that whereas a pessimistic attitude (high disability, low self-confidence, many concerns) was related to decline, the 'sceptic' patients had dropped out during the course. Conclusions: Uptake and drop-out may be related to patients' perceived disabilities, expected benefits and concerns with regard to rehabilitation, practical barriers and confidence in their own capabilities.
引用
收藏
页码:212 / 221
页数:10
相关论文
共 42 条
[1]
PREDICTORS OF CARDIAC REHABILITATION PARTICIPATION IN OLDER CORONARY PATIENTS [J].
ADES, PA ;
WALDMANN, ML ;
MCCANN, WJ ;
WEAVER, SO .
ARCHIVES OF INTERNAL MEDICINE, 1992, 152 (05) :1033-1035
[2]
Goal-setting protocol in adherence to exercise by Italian adults [J].
Annesi, JJ .
PERCEPTUAL AND MOTOR SKILLS, 2002, 94 (02) :453-458
[3]
[Anonymous], 1998, Adherence to Treatment in medical conditions
[4]
Adherence to pulmonary rehabilitation: A qualitative study [J].
Arnold, E. ;
Bruton, A. ;
Ellis-Hill, C. .
RESPIRATORY MEDICINE, 2006, 100 (10) :1716-1723
[5]
Promoting participation in cardiac rehabilitation: patient choices and experiences [J].
Clark, AM ;
Barbour, RS ;
White, M ;
MacIntyre, PD .
JOURNAL OF ADVANCED NURSING, 2004, 47 (01) :5-14
[6]
Treatment adherence in rehabilitation: The role of treatment accommodation [J].
Clay, DL ;
Hopps, JA .
REHABILITATION PSYCHOLOGY, 2003, 48 (03) :215-219
[7]
Maintaining exercise capacity and quality of life following pulmonary rehabilitation [J].
Cockram, J ;
Cecins, N ;
Jenkins, S .
RESPIROLOGY, 2006, 11 (01) :98-104
[8]
Why patients do not attend cardiac rehabilitation: role of intentions and illness beliefs [J].
Cooper, A ;
Lloyd, G ;
Weinman, J ;
Jackson, G .
HEART, 1999, 82 (02) :234-236
[9]
A qualitative study investigating patients' beliefs about cardiac rehabilitation [J].
Cooper, AF ;
Jackson, G ;
Weinman, J ;
Horne, R .
CLINICAL REHABILITATION, 2005, 19 (01) :87-96
[10]
Pulmonary rehabilitation and the BODE index in COPD [J].
Cote, CG ;
Celli, BR .
EUROPEAN RESPIRATORY JOURNAL, 2005, 26 (04) :630-636