Perceptions and Beliefs Associated with Enrolling in Pulmonary Rehabilitation in People with Chronic Respiratory Diseases: A Qualitative Study

Purpose: To explore the reasons people with chronic respiratory diseases (CRD) accept enrollment in pulmonary rehabilitation (PR) using a framework of health behaviour change, to ascertain which motivational processes resulted in the intention to enroll in PR.Methods: Semi-structured interviews informed by the Health Action Process Approach (HAPA) framework were conducted with individuals with CRD who were referred to for PR. Content analysis was performed.Results: Eleven participants [accept PR (n = 10), decline PR (n = 1); COPD (n = 5), interstitial lung disease (n = 6); female (n = 5), median age = 72 (range 35-84 years)] completed the interviews. Four themes were identified: (1) communication, (2) extrinsic factors, (3) psychosocial factors, and (4) past experiences.Conclusions: Participants perceived enrollment in PR to be impacted by the information acquired from sources in addition to their healthcare providers, logistics associated with accessing PR, perception of their current capabilities, the belief that PR was their last resource for improvement and past experiences regarding knowledge about exercise and symptoms. To increase enrollment in PR programs, healthcare providers should prioritize effective communication, address concerns and misconceptions, consider accessibility, and understand/address psychosocial factors such as motivation and belief systems. Objectif : explorer les raisons pour lesquelles les personnes atteintes d'une maladie respiratoire chronique (MRC) acceptent de participer a une readaptation pulmonaire (RP) au moyen d'un cadre de changements de comportements relatifs a la sante, afin de determiner les processus motivationnels expliquant l'intention de participer a la RP.Methodologie : les chercheurs ont procede a des entrevues semi-structurees construites d'apres l'approche du processus d'action en sante (APAS) aupres de personnes atteintes d'une MRC dirigees en RP. Ils ont effectue une analyse de contenu.Resultats : au total, 11 participants [acceptation de la RP (n = 10), refus de la RP (n = 1); MPOC (n = 5), maladie pulmonaire interstitielle (n = 6); sexe feminin (n = 5), age median = 72 ans (plage de 35 a 84 ans)] ont pris part aux entrevues. Il en est ressorti quatre themes : 1) la communication, 2) les facteurs extrinseques, 3) les facteurs psychosociaux et 4) les experiences passees.Conclusions : les participants trouvaient que la participation a la RP dependait de l'information acquise d'autres sources que leur professionnel de la sante, de la logistique associee a l'acces a la RP, de la perception de leurs capacites, de l'impression que la RP etait leur derniere ressource pour s'ameliorer et des experiences passees au sujet des connaissances de l'exercice et des symptomes. Pour accroitre la participation a des programmes de RP, les professionnels de la sante devraient prioriser une communication efficace, repondre aux inquietudes et aux meconnaissances et comprendre les facteurs psychosociaux comme les systemes de motivation et de croyance et y reagir.