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Pieces of the Pulmonary Rehabilitation Puzzle: Referral, Acceptance and Uptake to Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease /

Record Type:	Electronic resources : Monograph/item
Title/Author:	Pieces of the Pulmonary Rehabilitation Puzzle: Referral, Acceptance and Uptake to Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease // Siobhan Camille Milner.
Author:	Milner, Siobhan Camille,
Description:	1 electronic resource (148 pages)
Notes:	Source: Masters Abstracts International, Volume: 82-09.
Contained By:	Masters Abstracts International82-09.
Subject:	Exercise. -
Online resource:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=28248995
ISBN:	9798582592198

Pieces of the Pulmonary Rehabilitation Puzzle: Referral, Acceptance and Uptake to Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease /
Milner, Siobhan Camille,

Pieces of the Pulmonary Rehabilitation Puzzle: Referral, Acceptance and Uptake to Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease /Siobhan Camille Milner. - 1 electronic resource (148 pages)

Source: Masters Abstracts International, Volume: 82-09.

Chronic obstructive pulmonary disease (COPD) is a life-limiting, progressive lung disease characterized by airflow limitation. In 2016, chronic respiratory diseases were the third highest cause of non-communicable disease mortality, with COPD leading to the most respiratory disease deaths. Individuals with COPD experience symptoms such as a chronic chesty cough, wheezing, breathlessness, phlegm, reduced exercise capacity, limb muscle dysfunction and psychological side-effects such as anxiety or depression. All of these symptoms lead to an impaired quality of life. Pulmonary rehabilitation (PR) is regarded as the cornerstone of non-pharmacological treatment for COPD, and is a comprehensive program centred on exercise intervention, but also consists of education and social and psychological support. However, there are many barriers in the PR pathway that can negatively affect access, referrals, acceptance, uptake, completion and adherence to PR.Within the context of this complicated PR situation, the objectives of this thesis were to: 1) answer specific research questions relating to referral, acceptance and uptake to PR in order to improve understanding of the respective barriers for healthcare professionals (HCPs) and patients with stable and unstable COPD; 2) provide recommendations for improving rates of referral to PR and; 3) provide recommendations for the future development of interventions to improve acceptance and uptake to PR post acute-exacerbation of COPD (AECOPD).This thesis consists of two studies presented as separate manuscripts. The first manuscript consists of a systematic scoping review identifying the rate of referral of patients with COPD to PR by HCPs, and the barriers and enablers to referral perceived by HCPs. Referral rates were found to range from 0%-85%, and the most common barriers to PR referral were low knowledge of what PR is, its benefits and the referral process.The second manuscript is a study assessing the acceptability, feasibility, and safety of delivering a PR taster session to patients hospitalized with an AECOPD. It also evaluates the changes in patient knowledge of, and readiness to commence PR. The PR taster session was not prospectively acceptable to a large portion of patients, and only feasible with modifications to the original protocol. However, of those patients who accepted to partake in the intervention, positive median change was recorded in knowledge of PR as measured by the modified Understanding COPD (UCOPD) questionnaire, and an improvement was seen readiness to commence PR as measured by the Readiness to Change Exercise Questionnaire.The findings of both manuscripts highlight that despite the evidence for PR, barriers still exist at the patient and HCP levels. However, as both manuscript focus on a particular subset of individuals involved in the PR pathway (potential referring HCPs and patients with AECOPD), both manuscripts are able to make specific recommendations for future interventions to improve HCP referral to PR, and acceptance and uptake of PR post-AECOPD, respectively.

English

ISBN: 9798582592198Subjects--Topical Terms:

532868
Exercise.
Subjects--Index Terms:

Pulmonary rehabilitation

Pieces of the Pulmonary Rehabilitation Puzzle: Referral, Acceptance and Uptake to Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease /
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245 1 0 $a Pieces of the Pulmonary Rehabilitation Puzzle: Referral, Acceptance and Uptake to Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease / $c Siobhan Camille Milner.
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500 $a Advisors: Ferreira, Tania Janaudis.
502 $b M.Sc. $c McGill University (Canada) $d 2018.
520 $a Chronic obstructive pulmonary disease (COPD) is a life-limiting, progressive lung disease characterized by airflow limitation. In 2016, chronic respiratory diseases were the third highest cause of non-communicable disease mortality, with COPD leading to the most respiratory disease deaths. Individuals with COPD experience symptoms such as a chronic chesty cough, wheezing, breathlessness, phlegm, reduced exercise capacity, limb muscle dysfunction and psychological side-effects such as anxiety or depression. All of these symptoms lead to an impaired quality of life. Pulmonary rehabilitation (PR) is regarded as the cornerstone of non-pharmacological treatment for COPD, and is a comprehensive program centred on exercise intervention, but also consists of education and social and psychological support. However, there are many barriers in the PR pathway that can negatively affect access, referrals, acceptance, uptake, completion and adherence to PR.Within the context of this complicated PR situation, the objectives of this thesis were to: 1) answer specific research questions relating to referral, acceptance and uptake to PR in order to improve understanding of the respective barriers for healthcare professionals (HCPs) and patients with stable and unstable COPD; 2) provide recommendations for improving rates of referral to PR and; 3) provide recommendations for the future development of interventions to improve acceptance and uptake to PR post acute-exacerbation of COPD (AECOPD).This thesis consists of two studies presented as separate manuscripts. The first manuscript consists of a systematic scoping review identifying the rate of referral of patients with COPD to PR by HCPs, and the barriers and enablers to referral perceived by HCPs. Referral rates were found to range from 0%-85%, and the most common barriers to PR referral were low knowledge of what PR is, its benefits and the referral process.The second manuscript is a study assessing the acceptability, feasibility, and safety of delivering a PR taster session to patients hospitalized with an AECOPD. It also evaluates the changes in patient knowledge of, and readiness to commence PR. The PR taster session was not prospectively acceptable to a large portion of patients, and only feasible with modifications to the original protocol. However, of those patients who accepted to partake in the intervention, positive median change was recorded in knowledge of PR as measured by the modified Understanding COPD (UCOPD) questionnaire, and an improvement was seen readiness to commence PR as measured by the Readiness to Change Exercise Questionnaire.The findings of both manuscripts highlight that despite the evidence for PR, barriers still exist at the patient and HCP levels. However, as both manuscript focus on a particular subset of individuals involved in the PR pathway (potential referring HCPs and patients with AECOPD), both manuscripts are able to make specific recommendations for future interventions to improve HCP referral to PR, and acceptance and uptake of PR post-AECOPD, respectively.
520 $a La maladie pulmonaire obstructive chronique (MPOC) est une maladie evolutive qui limite la vie et qui se caracterise par une limitation du debit d'air. En 2016, les maladies respiratoires chroniques etaient la troisieme cause de mortalite due aux maladies non transmissibles. Les personnes atteintes de MPOC presentent des symptomes tels qu'une toux chronique, un essoufflement, une capacite d'exercice reduite, la dysfonction musculaire peripherique et des effets secondaires psychologiques tels que l'anxiete ou la depression. Tous ces symptomes entrainent une deterioration de la qualite de vie. La readaptation pulmonaire (RP) est consideree comme la pierre angulaire du traitement non pharmacologique de la MPOC. Il s'agit d'un programme complet axe sur l'intervention par l'exercice, mais aussi sur l'education et le soutien social et psychologique. Toutefois, il existe de nombreux obstacles dans le cheminement des RP qui peuvent avoir une incidence negative sur l'acces, l'aiguillage, l'acceptation, l'adoption, l'achevement et l'adhesion aux RP.Dans le contexte de cette situation complexe de RP, les objectifs de cette these etaient de : 1) repondre a des questions de recherche specifiques concernant l'aiguillage, l'acceptation et l'adoption des RP chez les patient.e.s atteint.e.s de MPOC afin d'ameliorer la comprehension des obstacles respectifs pour les professionnel.le.s de la sante et les patient.e.s atteint.e.s de MPOC stable et instable ; 2) fournir des recommandations pour ameliorer les taux d'aiguillage vers les RP et 3) fournir des recommandations pour le developpement futur d'interventions visant a ameliorer l'acceptation et l'adoption des RP.Cette these consiste en deux etudes presentees sous forme de manuscrits distincts concus pour repondre a des questions de recherche specifiques liees a l'aiguillage, a l'acceptation et a l'adoption de la RP chez les patient.e.s atteint.e.s de MPOC. Le premier manuscrit consiste en une revue systematique de la portee identifiant le taux d'aiguillage des patient.e.s atteint.e.s de MPOC vers les RP par les professionnel.le.s de la sante, ainsi que les obstacles et les catalyseurs de l'aiguillage percus par les professionnel.le.s de la sante. Les taux d'aiguillage varient de 0 % a 85 %, et les obstacles les plus courants a l'aiguillage vers les RP etaient une faible connaissance de ce qu'est la RP, de ses avantages et du processus d'aiguillage.Le deuxieme manuscrit est une etude evaluant l'acceptabilite, la faisabilite et la securite de la prestation d'une seance d'essai de RP a des patient.e.s hospitalise.e.s avec une exacerbation aigue de la MPOC. Il a egalement evalue l'evolution des connaissances des patient.e.s et de leur etat de preparation pour le debut des relations publiques. La seance d'essai de RP n'etait pas prospectivement acceptable pour une grande partie des patient.e.s et n'etait faisable qu'avec des modifications au protocole original. Cependant, parmi les patient.e.s qui ont accepte de participer a l'intervention, un changement median positif a ete enregistre dans la connaissance de la RP telle que mesuree par le questionnaire modifie sur la comprehension de la MPOC (UCOPD), et une amelioration a ete constatee dans l'etat de preparation a commencer la RP telle que mesuree par le questionnaire sur l'exercice de preparation au changement.Les resultats des deux manuscrits soulignent qu'en depit des donnees probantes sur les relations publiques, il existe encore des obstacles chez les patient.e.s et les professionnel.le.s de la sante. Cependant, comme les deux manuscrits se concentrent sur un sous-ensemble particulier de personnes impliquees dans le cheminement de la RP (des professionnels de la sante et des patient.e.s atteint.e.s d'une exacerbation aigue), les deux manuscrits sont capables de faire des recommandations specifiques pour des interventions futures afin d'ameliorer la reference a la RP, et l'acceptation et l'adoption de la RP, respectivement.
546 $a English
590 $a School code: 0781
650 4 $a Exercise. $3 532868
650 4 $a Physical fitness. $3 522279
650 4 $a Medicine. $3 641104
650 4 $a Early intervention. $3 3642029
650 4 $a Medical referrals. $3 3819831
650 4 $a Internal medicine. $3 829124
650 4 $a Rehabilitation. $3 529790
650 4 $a Confidence. $3 682645
650 4 $a Monetary incentives. $3 3685880
650 4 $a Chronic obstructive pulmonary disease. $3 3558078
650 4 $a Physical therapy. $3 588713
650 4 $a Public health education. $3 2144801
650 4 $a Early childhood education. $3 518817
650 4 $a Health care management. $3 2122906
653 $a Pulmonary rehabilitation
653 $a Referral
653 $a Acceptance
653 $a Uptake
653 $a Chronic obstructive pulmonary disease
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690 $a 0382
690 $a 0769
690 $a 0564
690 $a 0518
710 2 $a McGill University (Canada). $e degree granting institution. $3 3759190
720 1 $a Ferreira, Tania Janaudis $e degree supervisor.
773 0 $t Masters Abstracts International $g 82-09.
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791 $a M.Sc.
792 $a 2018
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