Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/16762
Title: Pulmonary rehabilitation referral and participation are commonly influenced by environment, knowledge, and beliefs about consequences: a systematic review using the Theoretical Domains Framework
Authors: Cox, Narelle S;Oliveira, Cristino C;Lahham, Aroub;Holland, Anne E
Issue Date: Apr-2017
EDate: 2017-02-28
Citation: Journal of Physiotherapy 2017; 63(2): 84-93
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 AND ANALYSIS: 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].
URI: http://ahro.austin.org.au/austinjspui/handle/1/16762
DOI: 10.1016/j.jphys.2017.02.002
PubMed URL: https://www.ncbi.nlm.nih.gov/pubmed/28433238
Type: Journal Article
Subjects: Pulmonary rehabilitation
Chronic obstructive pulmonary disease (COPD)
Barriers
Facilitators
Participation
Type of Clinical Study or Trial: Reviews/Systematic Reviews
Appears in Collections:Journal articles

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