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Chronic Pulmonary and Chronic Cardiac Rehabilitation: Staff Perspectives and Patient Experiences

Flora-Joan van Rotterdam, Michael Hensley and Michael Hazelton

Background: Cardiac (CR) and Pulmonary Rehabilitation (PR) programs have been shown to enhance self-management, improve quality of life and decrease dependence on healthcare services. Patient Outcome Measures (POMs) such as Quality of Life (QoL) questionnaires are essential to evaluate these programs' ability to measure treatment effectiveness. However, many of the present QoL instruments either underestimate or overestimate the response to the change in health status in these programs. Aim: This study sets out to analyse discussions by patients and staff engaged in CR and sPR. These discussions occurred both pre and post program to compare and contrast what changes for these patients. Study design: This is a qualitative descriptive study. Methods: This study analyses the data collected both pre and post program, from those patients and staff participating in outpatient CR and PR programs. Focus groups and individual interviews were audio-taped and transcribed verbatim. Transcripts were analysed, tabulated and coded for common themes, then a cohesive story was formulated to explain the concepts put forward. Results: Patients and staff discussed some common themes however terminology was different between the two groups. There is also a change in patient's perspective from pre to post rehabilitation, patient's expectations change from wanting to get back to a "normal" state of health to accepting living within "certain limits". Conclusion: This qualitative study clearly shows a "Response Shift" in patient perceptions pre to post CR and PR program and that language used by patients is very different to that of health staff and often is different to present POMs used in these programs.