Exploring transitions in care from pulmonary rehabilitation to home for persons with chronic obstructive pulmonary disease

A descriptive qualitative study

Bibliographic Data

ID19509066
AuthorsJonathan Miranda (Department of Physical Therapy University of Toronto Toronto ON Canada), Danielle Underwood (Department of Physical Therapy University of Toronto Toronto ON Canada), Miranda Kuepfer‐Thomas (Department of Physical Therapy University of Toronto Toronto ON Canada), Miranda Kuepfer-Thomas (University of Toronto), Drew Coulson (Department of Physical Therapy University of Toronto Toronto ON Canada), Andy Chansoo Park (Department of Physical Therapy University of Toronto Toronto ON Canada), Stacey J Butler (0000-0002-6259-8859, Department of Physical Therapy University of Toronto Toronto ON Canada), Roger Goldstein (0000-0002-4236-043X, Department of Physical Therapy University of Toronto Toronto ON Canada), Dina Brooks (0000-0001-6080-5052, Department of Physical Therapy University of Toronto Toronto ON Canada), Amanda C Everall (0000-0002-8270-6925, Leslie Dan Faculty of Pharmacy University of Toronto Toronto ON Canada), Sara J T Guilcher (0000-0002-9552-9139, Department of Respiratory Medicine West Park Healthcare Centre York ON Canada, corresponding author)
Year2020
Volume23
Issue2
Pages414-422
Publication date2020-04-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Expectations (JOURNAL)
Journal identifiersISSN: 1369-6513 • E-ISSN: 1369-7625
PublisherWiley (PUBLISHER • GB)
DOI10.1111/hex.13012
PMID31893574
OpenAlexW2998181640
LanguageEN
Citations received1
References cited26

BACKGROUND: Individuals with chronic obstructive pulmonary disease (COPD) often experience high health-care utilization following pulmonary rehabilitation, suggesting suboptimal transitions to home. OBJECTIVE: To understand the experiences of persons with COPD and health-care professionals regarding transitions from pulmonary rehabilitation to home, including factors impacting these transitions. DESIGN: A descriptive qualitative study. SETTING AND PARTICIPANTS: Health-care professionals working at, and persons with COPD who attended, an inpatient or outpatient pulmonary rehabilitation programme at one large, urban health-care centre. The centre is located in Ontario, Canada. MAIN VARIABLE STUDIED: Experiences of participants with care transitions between pulmonary rehabilitation and home. Semi-structured interviews were audio-recorded, transcribed verbatim, and thematically analysed. RESULTS: Ten patients and eight health-care professionals participated. Four main themes were identified around the overall experiences with pulmonary rehabilitation and transitions to home: (a) pulmonary rehabilitation as a safe environment; (b) pulmonary rehabilitation as a highly structured environment; (c) contrasting perceptions of the role of pulmonary rehabilitation; and (d) dependency on pulmonary rehabilitation programmes. Persons with COPD and health-care professionals identified three key factors that influenced this transition: (a) patients' social support, (b) application of self-management strategies prior to discharge, and (c) patients' physical and mental health. CONCLUSION: Participants agreed that some patients with COPD experienced suboptimal transitions from pulmonary rehabilitation to home that were characterized by suboptimal self-management. Further research is needed to develop and evaluate interventions to improve transitions. Such interventions should include strategies to elicit long-term behaviour change to assist patients when they return into the community

COPD · Family medicine · Health care · Physical therapy · Psychiatry · Psychological intervention · Pulmonary disease · Pulmonary rehabilitation · Qualitative research · Self-management · Chronic Obstructive Pulmonary Disease (COPD) Research · Frailty in Older Adults · Medicine · Nursing · Respiratory Support and Mechanisms · Rehabilitation

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