Benefits of Pulmonary Rehab

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Pulmonaryrehabilitation is an important part of health maintenance andclinical management of patients presenting chronic respiratorydisorders who, despite being provided with standard medical care,remain symptomatic. It is a multidimensional approach whose focus ison patients with pulmonary diseases together with their families andusually a multidisciplinary team of medical practitioners (Lan etal., 2013). According to Kyprianou and Russo (2005), there arewell-established benefits associated with pulmonary rehabilitation,especially among patients with chronic obstructive pulmonary disease(COPD). Kyprianou and Russo point out that the benefits of pulmonaryrehabilitation are not only limited to COPD patients, but emergingevidence shows that it is also beneficial to patients with otherrespiratory diseases such as cystic fibrosis and asthma as well as inpatients with impaired pulmonary function due to neuromusculardisease. In this study, I seek to investigate the various benefits ofpulmonary rehabilitation among patients with varying chronicrespiratory disorders.

Rippe (2013)points out that pulmonary rehabilitation is now recognized as astandard for the management of COPD patients. This means that theimportance of pulmonary rehabilitation cannot be overlooked. Wyka,Mathews and Rutkowski (2011) suggest that the apart from COPDpatients, pulmonary rehabilitation is also beneficial to patientswith chronic pulmonary diseases. They argue that the benefits derivedfrom pulmonary rehabilitation can be grouped into the acceptedbenefits, potential benefits as well as unlikely benefits.

Statement of the Problem

The benefits thatpatients obtain from pulmonary rehabilitation continue to be a hottopic for discussion among medical scholars and researchers.According to Wyka, Mathews and Rutkowski (2011), controversies aboundabout the actual benefits of pulmonary rehabilitation. Kyprianou andRusso (2005) point out that most of the studies done in the past havefocused on the role of pulmonary rehabilitation among COPD patientsand those patients about to undergo lung transplantation. Theysuggest that there are very limited studies that have sought toinvestigate the role of pulmonary rehabilitation in non-COPDpatients. Given the controversies and inadequate studies on thebenefits of pulmonary rehabilitation among non-COPD patients, it isimportant to determine the role and real benefits of pulmonaryrehabilitation among all patients.

TheAmerican Associationof Cardiovascular &amp Pulmonary Rehabilitation (2010) notes thatthere is a growing evidence base that supports the utilization ofpulmonary rehabilitation among patients with chronic respiratorydiseases other than COPD. It is reported that chronic respiratorydiseases are one of the leading causes of death in the U.S.A and thatthe available pulmonary rehabilitation programs are very few, thusunable to handle the heavy burden that the growing incidences ofchronic respiratory disorders are placing on the patients as well asthe society. As such, it is important for the benefits of suchprograms to the investigated and reported as it would help educateboth healthcare providers, patients and the general public about thebenefits, indications as well as the rationale for pulmonaryrehabilitation.

ResearchQuestions

The study will utilize thefollowing set of questions to help identify the benefits of pulmonaryrehabilitation:

  • What are the likely and potential benefits of pulmonary rehabilitation among both COPD and non-COPD patients?

  • Are the benefits of pulmonary rehabilitation among COPD patients similar to those derived by non-COPD patients?

  • To what extent are the medical practitioners and patients aware of the accepted and likely benefits of pulmonary rehabilitation?

ProjectBackground and Description

Pulmonaryrehabilitation, especially among COPD patients, has been widelyresearched with both the potential and accepted benefits beingpresented in different books and journal articles. It is a broadtherapeutic concept, meaning that the potential benefits to COPD andnon-COPD patients may be more than the ones which have beenidentified in past studies (Rippe, 2013). The activities involved inpulmonary rehabilitation as an intervention include comprehensivepatient assessment which is often followed by various therapiestailored to meet the specific needs of patients and includeeducation, physical exercise and behavior change (Lan et al., 2013).The main aim of pulmonary rehabilitation is to improve thepsychological as well as the physical situation of patientspresenting chronic respiratory disorders and to ensure that thepatients adhere to behaviors that are health enhancing.

The AmericanAssociation of Cardiovascular &amp Pulmonary Rehabilitation (2010)reports that there has been widening applicability of pulmonaryrehabilitation. It is argued that this increasing applicabilityfollows the growing evidence showing its benefits when used in otherdisorders apart from COPD. The benefits that patients obtain frompulmonary rehabilitation continue to be a hot topic for discussionamong medical scholars and researchers. According to Wyka, Mathewsand Rutkowski (2011), controversies abound about the actual benefitsof pulmonary rehabilitation. Most of the studies done in the pasthave focused on the role of pulmonary rehabilitation among COPDpatients and those patients about to undergo lung transplantation.Given the controversies and inadequate studies on the benefits ofpulmonary rehabilitation among non-COPD patients, it is important tofind out the role and real benefits of pulmonary rehabilitation amongthis group of patients.

ProjectOutline

The project willhave five main parts, namely the introduction, literature review,methodology, results and findings and discussion, conclusion anddiscussion sections.

This sectionpresents the main issue that the study seeks to investigate (Thebenefits of pulmonary rehabilitation). Apart from presenting theissue, the introduction will also highlight why the study isimportant and the background and context of the issue underinvestigation. The subsections under the introductory sections willinclude a statement of the research topic, statement of the researchproblem, background, the purpose of the study, objectives andresearch questions.

LiteratureReview

Under thissection, the ideas of what is already known about the benefits ofpulmonary rehabilitation will be presented. Analyzing the variousliterature sources that discuss the benefits of pulmonaryrehabilitation will help identify questions that are yet to beanswered or those that have been given little attention.

Methodology

This section will present the research design as well as instrumentsthat the current study will utilize. The section will also discuss mysampling procedure, the sample size as well as the effectiveness andvalidity of the research instruments.

Resultsand Findings

This section willreport what the overview was able to determine. The results andfindings will be presented graphically or by use of tables whenappropriate.

Conclusion,Discussion and Recommendations

The last sectionwill summarize the whole project and highlight the implications ofthe results and findings. Based on the findings, the section willalso provide the necessary recommendations with regard to thehealthcare system, healthcare providers as well as patients.

Data Collection Plan

Annotated Bibliography

Carlin B. (2009). Pulmonary Rehabilitationand Chronic Lung Disease: Opportunities for the RespiratoryTherapist. Respiratory Care, Vol. 54 (8). Inthis, the author discusses the important role played by pulmonaryrehabilitation. Additionally, this text discusses the importance ofrespiratory therapiststhrough the identification of patients that areeligible for pulmonary rehabilitation. They also identify individualsbased on their preparedness to the program. Thereafter, they provideeducation regarding the illnesses. This article is therefore relevantto this study as it ensures that individuals are well educated and ina position to understand the basic components of pulmonary diseases.

Nici, L., &amp ZuWallack, R.(2012).&nbspChronicObstructive Pulmonary Disease.Dordrecht: Springer. Nici andZuwallack discuss the benefits of pulmonary rehabilitation for COPDpatients. They argue that COPD is a major cause of mortality andmorbidity around the world. The text highlights the variousco-morbidities associated with COPD and the various treatment optionsavailable for the management and treatment of the disorder. Theauthors also present an evidence-based review of the benefits ofvarious treatment approaches including pulmonary rehabilitation.

Lan, C. Chu, W., Yang, M., Lee C., Wu, Y. &ampWu, C. (2013).&nbspBenefits ofPulmonary Rehabilitation in Patients With COPD and Normal ExerciseCapacity. Journal Respiratory Care.In this text, Lan et. al (2013)focus on multiple health-related fields, including public policy,nutrition and exercise, behavioral psychology as well as themanagement of a wide range of disorders including respiratory andpulmonary disorders. This text highlights the importance of exercisecapacity as one of the advantages that can be obtained from the useof PR programs. It is therefore relevant to this study since itprovides a relationship between patients with COPD and exercisecapacity.

Sinclair, A., Morley, J., &amp Vellas, B.(2012).&nbspPathy`sPrinciples and Practice of Geriatric Medicine.New York, NY: John Wiley &amp Sons. Thistext focuses on the medical disorders common among the agingpopulation. The text has a total of 41 chapters, covering variousissues such as treatment approaches, new infections as well as theend of life care. Through utilization of an editorial team sourcedfrom different regions of the world, the text is able to captureinternational perspectives. Pulmonary rehabilitation and its benefitsis discussed under the management of respiratory diseases. The textis suitable for use by both medical practitioners as well as studentsin the medical field.

Spencer, L., Alison, J., &amp McKeough, Z.(2009). Maintaining benefits following pulmonary rehabilitation: arandomized controlled trial.&nbspEuropeanRespiratory Journal,&nbsp35(3),571-577. http://dx.doi.org/10.1183/09031936.00073609.This article presents the findingsfrom a study whose aim was to ensure a pulmonary rehabilitationprogram would succeed in maintaining the quality of life as well asfunctional exercise capacity for COPD patients. Spencer et al. reportthat the implementation of a pulmonary rehabilitation program provedto be effective in maintaining the functional exercise and quality oflife for patients with moderate COPD. This article would be importantfor the current study as it highlights one of the many benefits ofpulmonary rehabilitation.

Survey Questions

Thefull open-ended questionnaire will be conducted face to face withpatients at pulmonary rehabilitation facilities. The document shouldbe double spaced with increased font to enable the patients read thedocument easily. The face to face interviews with the patients shouldlast for five minutes.

1. Are you a current smoker? Yes or No2.How many years have you smoked and how many packs a day did yousmoke?__3.Have you been diagnosed with COPD? Yes or No&nbsp4. Have youever had education on COPD? Yes or No5. How long have you beenenrolled in this treatment program? __6. Are youfamiliar with the potential benefits of enrolling in such a program?Yes or No.If yes, what are they?7. Since enrolling intothe program, what changes have you noticed?8. How has pulmonaryrehabilitation helped you?9. Did it make a difference in yourlife? Yes or No.If yes, how? __Ifno why? __

DataAnalysis

This study retrieveddata from thirty five participants who answered questions insemi-structured questionnaires. The participants were from differentlocations with 14 being from TriHealth Pavilion and Fitness Centre, 8from Good Samaritan Hospital and 13 from Drake Centre. Theparticipants involved in the study had been part of the pulmonaryrehabilitation for a period of time. As a result, these participantswere able to provide the relevant information that were related tothe research questions and objectives while answering thequestionnaires. The experiences, that participants had received fromthe rehabilitation centers, provided them with relevant information.

All of the thirty five participants within this study were currentlynonsmokers. However, some of the participants were able to indicatethe period that they had stopped smoking in case they were previoussmokers. One particular participant, from TriHealth Pavilion andFitness Centrer, indicated to have stopped smoking within the pasttwenty years. from the nalaysis of the feedback from TriHealthPavilion and Fitness Center, the research questions retrievedinformation regarding the number of years that the participants hadsmoked. The table below shows an analysis of individuals from thevarious locations and whether they have smoked.

Location

Smoker

Non-Smoker

TriHealth Pavilion

69.23

30.77

Good Samaritan

62.5

37.5

Drake Center

53.85

46.15

Figure1: Smokers and Non-Smokers

The study also focused on the number of years during which theparticipants actively engaged in smoking.

No Participants

Years

6

10

6

20

15

40

8

50

Figure 2: Smokers by years

The following data was also obtained with regard to the number ofpackets of cigarette consumed on a daily basis. The table below showsthe final analysis of the trend among the respondents.

No. of participants

Daily Intake (Packets)

18

1

8

2

9

3

3

Unknown

Figure 3: Daily Intake of the smokers

Further, the study proceeded to determine the number of participantsthat had been diagnosed with COPD and the results are as shown in thetable. Additionally, the number of individuals at these facilitiesthat had received education on COPD was also established.

Location

COPD

No COPD

Education

No education

TriHealth Pavilion

69.23

30.77

78.57

21.43

Good Samaritan

87.5

12.5

75

25

Drake Center

76.92

23.08

69.23

30.77

Figure 4: COPD Diagnosis and Education

All of the participants in the study reported to having been enrolledin the treatment program for a specific duration of time, with thelongest time reported being 18 and 22 years. one(2.86%) participanthad been part of the treatment program for two weeks, 3 (8.57%) ofthe participants had been part of the program for 6 months, 6(17.14%) participants within 1 year, nine (25.71%) participants fortwo years, five (14.26%) of the participants had been part of theprogram for five years, six (17.14%) participants for four years, two(5.71%) participant for 6 years, two (5.71%) participants for tenyears and, finally,1 (2.86%) participant for eighteen years and one(2.86%) of 22 years.

All of the patients’ were aware of the potential benefits that wererelated to being part of the pulmonary rehabilitation programs. Theparticipants afterwards, stated benefits associated with therehabilitation program. The graph below shows a comparison of thebenefits as per the participants at different health facilities.

Figure 5: Benefits of Pulmonary rehabilitation

The participants within the study reported to having noticed severalchanges with their bodies and health, which, became noticeable duringtheir involvement with the their involvement with the pulmonaryrehabilitation programs. Participants noticed improvements in theirhealth, physical well-being, breathing, energy, nutrition and dietaryintake. Nine (21.75%) of the participants reported to having noticedimproved health, nine (54.29%) of the participants reported to havingnoticed improved physical well-being, eleven (31.43%) of theparticipants reported to having noticed improved breathing, two(5.71%) participant reported to have noticed increased energy in thebody system, five (14.29%) of the participant reported to havenoticed improved mental health and motivation and finally three(8.57%) participant reported to having noticed improved nutrition.

All of theparticipants within the study were able to agree that the pulmonaryrehabilitation program brought difference in their lives. Eighteen(51.43%) of the participantswithin the study agreed that difference could be spotted when it cameto their respiratory well-being and health, nine (25.71%)of the participants within the study reported to have noticed adifference in their general physical health. Twenty-one(60%)participants reported a difference in their engagement in exercise asthey increased their overall exercise activities. Finally, seven(20%) participant reporteddifference in their mental health and well-being.

Rationalefor Choosing the Interview

The face-to-faceinterview was chosen for this study based on various reasons. It wasdeemed necessary to engage the patients in a personal form ofinterview, to obtain the relevant information for this study. Aface-to-face interview is one of the ways through which theresearcher and the respondents spend time together. Participants’answers were provided promptly when questioned. The nature of quickfeedback was one of the primary reasons why this form of datacollection was preferred to other designs (Lanet al., 2013).

Other advantagesof this form of data collection are that it provides accuratescreening as well as capturing both verbal and non-verbal cues. Assuch, those being interviewed have a lower possibility of providingfalse information to screening questions. Additionally, throughface-to-face interviews, additional information can be obtainedconcerning body language and the level of enthusiasm being exhibitedby individuals being interviewed. Additionally, this form of datacollection ensures that the interviewer keeps the interviewee ontrack throughout the period of the meeting. Interviews also providethe interviewer the opportunity to capture emotions and behaviors ofthe respondents. Therefore, the rationale for selecting face-to-faceinterviews was based on three major tenets namely high responserates, better observation of behaviors and increased focus on theinterviewee since they are under the control of the interviewer(Carlin, 2009).

Conclusion

The study hasbeen able to establish various benefits that can be attributed topulmonary rehabilitation. These include improved quality of life andthe identification of remedies for respiratory diseases. ThePulmonary Rehab (PR) program is also able to identify impairments.The functional consequences of the identified impairments areaddressed with the primary objective of repairing the chronicailments and returning the individual to the fullest physical,mental, and psychological independence. It was also evident thatvarious forms of illnesses such as anxiety and depression hadsufficiently responded to the PR program (Lanet al., 2013).

Through theprogram, there are considerable improvements in overall andexertional dyspnea (Spencer, Alison &ampMcKeough, 2009). Additionally, patients can considerablyengage in maximal exercise capacity. Finally, it is evident thatrespiratory rehabilitation achieves useful results in COPD patientsfollowing acute exacerbation (Nici &ampZuWallack, 2012).

Goalsof the Project

Based on theanalysis and the results obtained, it is clear that the researchanswers obtained concerning the benefits of pulmonary rehabilitationattained its objective. From the outcomes, various benefits of the PRprogram about providing remedial action for the chronic respiratorydisease have been identified.

Recommendations

Variousrecommendations can be made from this study. To begin, individualsshould be supplied with the relevant information on a constant basis.This is because the findings indicated that persons who had beeneducated on the COPD topic were more aware of the disease and can,therefore, develop the necessary remedial actions. Through theavailability of information, individuals are also able to identifythe ailments at an early stage and, therefore, seek medical attentionbefore they reach severe levels (Lan et al.,2013).

More effortshould also be placed on encouraging individuals with smoking habitsto cease before their health undergoes massive deterioration.Research indicated that the number of smokers suffering from chronicrespiratory ailments is significantly higher in comparison to that ofindividuals that do not smoke (Nici &ampZuWallack, 2012). An increase in centers providingrehabilitation facilitation would also improve the management of suchillnesses. Therefore, increases the quality of health amongindividuals. The attainment of results will also require the rightprocess in the selection of patients to be interviewed to ensure thereliability of the information obtained (Carlin, 2009).

Contributionof the Project to Future Practice

The healthcaresector requires continuous research to identify solutions to thecommon illnesses within the society (Lan etal., 2013). Therefore, despite the massive strides made inthis research, some areas would welcome additional research andanalysis of the COPD subject Additionally, it enables the analysis ofvarious forms of remedial actions that should be taken. Futureresearch can use these findings to facilitate their studies on asimilar or related topic.

References

American Association of Cardiovascular &ampPulmonary Rehabilitation. (2010).&nbspGuidelinesfor Pulmonary Rehabilitation Programs&nbsp(4thed.). New York: Human Kinetics.

Carlin B. (2009). Pulmonary Rehabilitation andChronic Lung Disease: Opportunities for the Respiratory Therapist.Respiratory Care, Vol. 54 (8).

Lan, C., Chu, W., Yang, M., Lee, C., Wu, Y., &ampWu, C. (2013). ilitation in Patients WithCOPD and Normal Exercise Capacity.&nbspRespiratoryCare,&nbsp58(9),1482-1488. http://dx.doi.org/10.4187/respcare.02051

Nici, L., &amp ZuWallack, R. (2012).&nbspChronic ObstructivePulmonary Disease. Dordrecht: Springer.

Sinclair, A., Morley, J., &amp Vellas, B.(2012).&nbspPathy`s Principles andPractice of Geriatric Medicine.New York, NY: John Wiley &amp Sons.

Spencer, L., Alison, J., &amp McKeough, Z.(2009). Maintaining benefits following pulmonary rehabilitation: arandomized controlled trial.&nbspEuropeanRespiratory Journal,&nbsp35(3),571 -577. http://dx.doi.org/10.1183/09031936.00073609.

Wyka, K., Mathews, P., &amp Clark, W.(2011).&nbspFoundations ofrespiratory care&nbsp(2nd ed.). NewYork: Cengage Learning.