Education in pulmonary rehabilitation: The patient's perspective

Objectives: To ascertain from patients' perspectives what should be included in the educational component of pulmonary rehabilitation and how it should be delivered, and to compare those perspectives with the views of health professionals. Design: Qualitative research method using focus groups of patients and health professionals. Setting: A regional respiratory center and outpatient clinic. Participants: Purposive samples of 32 patients with chronic obstructive pulmonary disease (COPD) (forced expiratory volume in 1 second, 18%-67% predicted) divided into 6 focus groups; 8 health professionals knowledgeable about COPD and pulmonary rehabilitation who attended a multidisciplinary focus group meeting. Interventions: Participants attended focus group meetings (2-3h) guided by a series of questions and topics; results were posted to the participants for their verification. Main Outcome Measure: The educational content of a pulmonary rehabilitation program. Results: Deficits in patients' knowledge, understanding, and management of their disease were identified. Six key educational topics resulted: disease education, management of breathlessness, management of an exacerbation, medication, psychosocial support, and welfare and benefits systems. Patients and health professionals preferred group information sessions provided by knowledgeable people speaking layman's language, with oral presentations being supplemented by written information. Conclusions: Gaining a greater understanding of patients' educational needs permits health professionals who design pulmonary rehabilitation programs to include these requirements in a format that is acceptable to patients. The key topics, content, and format for delivery of the educational component for pulmonary rehabilitation were identified. Future research should focus on the development of an educational package and assessment of its efficacy, which would facilitate equitable patient access to education in pulmonary rehabilitation.