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 enrolment in pulmonary rehabilitation (PR) using a framework of health behaviour change, to ascertain which motivational processes resulted in the intention to enrol in PR. Method: 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, min-max, 35-84 y] completed the interviews. Four themes were identified: (1) communication, (2) extrinsic factors, (3) psychosocial factors, and (4) past experiences. Conclusions: Participants perceived enrolment in PR to be impacted by the information acquired from sources in addition to their health care 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 enrolment in PR programmes, health care providers should prioritize effective communication, address concerns and misconceptions, consider accessibility, and understand/address psychosocial factors such as motivation and belief systems.