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Pulmonary rehabilitation referral and participation are commonly influenced by environment, knowledge, and beliefs about consequences: a systematic review using the Theoretical Domains Framework

Citation

Cox, NS and Oliveira, CC and Lahham, A and Holland, AE, Pulmonary rehabilitation referral and participation are commonly influenced by environment, knowledge, and beliefs about consequences: a systematic review using the Theoretical Domains Framework, Journal of Physiotherapy, 63, (2) pp. 84-93. ISSN 1836-9553 (2017) [Refereed Article]


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Copyright Statement

2017 Australian Physiotherapy Association. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) http://creativecommons.org/licenses/by-nc-nd/4.0/

DOI: doi:10.1016/j.jphys.2017.02.002

Abstract

Question: What are the barriers and enablers of referral, uptake, attendance and completion of pulmonary rehabilitation for people with chronic obstructive pulmonary disease (COPD)?

Design: Systematic review of qualitative or quantitative studies reporting data relating to referral, uptake, attendance and/or completion in pulmonary rehabilitation.

Participants: People aged >18years with a diagnosis of COPD and/or their healthcare professionals.

Data Extraction and analysis: Data were extracted regarding the nature of barriers and enablers of pulmonary rehabilitation referral and participation. Extracted data items were mapped to the Theoretical Domains Framework (TDF).

Results: A total of 6969 references were screened, with 48 studies included and 369 relevant items mapped to the TDF. The most frequently represented domain was 'Environment' (33/48 included studies, 37% of mapped items), which included items such as waiting time, burden of illness, travel, transport and health system resources. Other frequently represented domains were 'Knowledge' (18/48 studies, including items such as clinician knowledge of referral processes, patient understanding of rehabilitation content) and 'Beliefs about consequences' (15/48 studies, including items such as beliefs regarding role and safety of exercise, expectations of rehabilitation outcomes). Barriers to referral, uptake, attendance or completion represented 71% (n=183) of items mapped to the TDF. All domains of the TDF were represented; however, items were least frequently coded to the domains of 'Optimism' and 'Memory'. The methodological quality of included studies was fair (mean quality score 9/12, SD 2).

Conclusion: Many factors - particularly those related to environment, knowledge, attitudes and behaviours - interact to influence referral, uptake, attendance and completion of pulmonary rehabilitation. Overcoming the challenges associated with the personal and/or healthcare system environment will be imperative to improving access and uptake of pulmonary rehabilitation.

Item Details

Item Type:Refereed Article
Keywords:COPD, pulmonary rehabilitation, systematic review
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Respiratory Diseases
Objective Division:Expanding Knowledge
Objective Group:Expanding Knowledge
Objective Field:Expanding Knowledge in the Medical and Health Sciences
UTAS Author:Lahham, A (Dr Aroub Lahham)
ID Code:128935
Year Published:2017
Web of Science® Times Cited:31
Deposited By:Menzies Institute for Medical Research
Deposited On:2018-10-26
Last Modified:2018-11-26
Downloads:20 View Download Statistics

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