Pulmonary rehabilitation referral and participation are commonly influenced by environment, knowledge, and beliefs about consequences: a systematic review using the Theoretical Domains Framework.
J Physiother
; 63(2): 84-93, 2017 04.
Article
en En
| MEDLINE
| ID: mdl-28433238
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 ANDANALYSIS:
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. TRIAL REGISTRATION PROSPERO CRD42015015976. [Cox NS, Oliveira CC, Lahham A, Holland AE (2017) 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 84-93].Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Participación del Paciente
/
Derivación y Consulta
/
Aceptación de la Atención de Salud
/
Conocimientos, Actitudes y Práctica en Salud
/
Enfermedad Pulmonar Obstructiva Crónica
Tipo de estudio:
Qualitative_research
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
J Physiother
Año:
2017
Tipo del documento:
Article
País de afiliación:
Australia