ABSTRACT
Many people with chronic obstructive pulmonary disease (COPD) undertake pulmonary rehabilitation more than once. This study examined patient experiences and health professional perspectives regarding repeating pulmonary rehabilitation. Participants were 14 patients with COPD and 15 health professionals. Patients had undertaken pulmonary rehabilitation at a tertiary hospital; health professionals were doctors, physiotherapists, and nurses. Semi-structured interviews were conducted, and data were analyzed using thematic analysis. Patients described improved fitness and better breathing after repeating pulmonary rehabilitation; however, some also reported that repeating required confronting their disease progression. Improved confidence and motivation were an important outcome of repeating. Although most participants had attended community-based exercise classes, they valued the greater intensity of exercise and closer supervision that came with repeating pulmonary rehabilitation. Health professionals reported referring patients to repeat pulmonary rehabilitation if they had worsening functional capacity, an exacerbation, or hospitalization. There was no agreement regarding the optimal time for repeating and many would only re-refer if the patient demonstrated motivation to attend. In conclusion, patients with COPD reported many symptomatic benefits from repeating pulmonary rehabilitation and gained confidence from a supervised program. There was no agreement between health professionals regarding the optimal time to repeat pulmonary rehabilitation.
Subject(s)
Attitude of Health Personnel , Hospitals, Rehabilitation , Physical Fitness , Pulmonary Disease, Chronic Obstructive , Quality of Life , Retreatment , Aged , Australia , Disease Progression , Exercise Therapy/methods , Exercise Therapy/psychology , Exercise Therapy/standards , Female , Hospitals, Rehabilitation/methods , Hospitals, Rehabilitation/standards , Humans , Male , Motivation , Physical Fitness/physiology , Physical Fitness/psychology , Pulmonary Disease, Chronic Obstructive/physiopathology , Pulmonary Disease, Chronic Obstructive/psychology , Pulmonary Disease, Chronic Obstructive/rehabilitation , Qualitative Research , Recovery of Function , Retreatment/methods , Retreatment/psychology , Retreatment/statistics & numerical data , Tertiary Healthcare , Treatment OutcomeABSTRACT
This study evaluates the validity of the last-7-day, self-administered version of the International Physical Activity Questionnaire (IPAQ) long form in HIV-infected people, using accelerometry as the objective criterion. The ActiGraph GT1M accelerometer was worn during all waking hours for 7 days, and the IPAQ was completed on day 7. A total of 30 men were recruited as participants from the Alfred Infectious Disease Clinic, Melbourne, Australia. Self-reported total number of metabolic equivalents minutes per week correlated moderately with accelerometer total activity counts (r = .41, p = .02). However, mean differences showed overreporting with the questionnaire; 546.63 min/wk (95% confidence interval: 217.1-871.2 minutes) for moderate and 295.33 min/wk (95% confidence interval: 88.08-502.6 minutes) for vigorous activity. The IPAQ correlated with accelerometry, but substantial overreporting occurred. The tool may be useful in screening physical activity but should not be used to determine precise levels.