Browsing by Person "Whiteford, Suzanne"

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A prospective qualitative exploration of views about attending pulmonary rehabilitation
(Wiley, 2009-02-04) Bulley, Catherine; Donaghy, Marie; Howden, Stella; Salisbury, Lisa; Whiteford, Suzanne; Mackay, Elaine
Background and Purpose. Pulmonary rehabilitation has been found to be an effective strategy for managing chronic obstructive pulmonary disease (COPD). However, attendance at such programmes is not optimal, therefore, this study aimed to develop an in-depth understanding of views regarding attendance at pulmonary rehabilitation and experiences which may have shaped these views. Methods. An inductive qualitative study was carried out within the framework of Interpretative Phenomenological Analysis. Five female and four male individuals with COPD who had been referred for pulmonary rehabilitation participated in semi-structured interviews. Interviews were conducted prior to participation in pulmonary rehabilitation. Results. Three main themes were identified that related to views about attending pulmonary rehabilitation. The first is entitled Desired benefits of attending pulmonary rehabilitation, which described realistic hopes about impact on daily life. The second theme was called Evaluating the threat of exercise, and it encompassed both positive and negative evaluations; some interviewees described fear and avoidance of exercise, while others were determined to overcome symptoms. These attitudes extended to views about pulmonary rehabilitation. The third theme was called Attributing value to pulmonary rehabilitation. Contrasting opinions about the value of attending pulmonary rehabilitation appeared to be influenced by the nature of prior interactions with health personnel and systems as well as information about the programme provided at referral. The referrer's attitude towards pulmonary rehabilitation appeared to be particularly influential. Conclusion. In summary, when considering rehabilitation attendance, potential participants are able to identify possible benefits, but previous experiences of symptoms and attitudes towards their condition can influence views both positively and negatively. Information and enthusiasm conveyed by the referring clinician, as well as previous interactions with health professionals can have powerful impact on views about attending. Referral practices should be informative and enthusiastic to increase the likelihood of uptake. Copyright 2009 John Wiley & Sons, Ltd.
Encouraging attendance at pulmonary rehabilitation: a qualitative exploration
(Elsevier Science B.V. Amsterdam, 2007-06) Bulley, Catherine; Salisbury, Lisa; Whiteford, Suzanne
PURPOSE: Chronic Obstructive Pulmonary Disease (COPD) is a limitation of airflow that leads to reduced participation in life. Pulmonary rehabilitation uses individually-tailored exercise and multidisciplinary education to help people manage their symptoms optimally and be as independent as possible. However, not all individuals referred to pulmonary rehabilitation participate. This qualitative study aimed to analyse patient views regarding attendance at pulmonary rehabilitation to explore influences on their decisions. RELEVANCE: Better understanding of influences on attendance at pulmonary rehabilitation will enable health professionals to take actions that increase the likelihood of participation; this will increase the numbers of individuals with COPD who take the opportunity to learn better ways of managing their condition. PARTICIPANTS: Individuals with COPD who were referred to a pulmonary rehabilitation service were invited to participate in a single interview prior to joining the programme. It was emphasised that their decision would not impact on any future treatment. Purposive selection of men and women ensured a variety of experiences. Five women and four men aged 59 to 82 completed interviews. All were white Caucasians living in Glasgow, Scotland. METHODS: The study was carried out within the framework of Interpretative Phenomenological Analysis. Semi-structured interviews (50-90 minutes) were carried out in participants' homes. A topic guide was developed to focus on experiences of COPD and views regarding future attendance at pulmonary rehabilitation. Ethical approval was granted by the Multi-Region Ethics Committee in Scotland. ANALYSIS: Transcribed interviews were analysed using the QSR N6 computer package. Two researchers were involved in developing themes, iteratively developing a classification or typology of views and experiences, progressing to locate relationships between themes. Three overarching master themes emerged. RESULTS: Master themes are labelled to reflect views or needs described by interviewees. The first describes contrasting experiences and attitudes: 'Exercise will kill me' versus 'I can't let it beat me.' Some individuals developed fear and avoidance of exercise, translating into wariness about attending pulmonary rehabilitation. Others refused to dwell on negative experiences,were determined to overcome symptoms, and expressed willingness to attend rehabilitation. The second master theme is called: 'A waste of my time' versus 'Doctors know best.' Participants with previous negative experiences of management often described low expectations of pulmonary rehabilitation. Others expressed faith in health professionals as a result of positive experiences, and were willing to follow their recommendations. The last theme was labelled: 'I want to walk and breathe better.' This reflects individuals' desire for professional advice and support in coping better with their condition. CONCLUSIONS: Individuals frequently recognise that they could be helped to cope better with their COPD symptoms. However,some fear that the burden of attending pulmonary rehabilitation will outweigh the benefits. IMPLICATIONS: It is important that the aims and content of pulmonary rehabilitation are carefully explained on referral in order to motivate patients and allay any fears. Positive and informative communications about pulmonary rehabilitation are likely to lead to increased uptake and benefit to more patients.