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Bloch-Nielsen JR1, Brocki BC2, Jensen FL3, Mikkelsen H4, Ravn P1, Rolving N1
1Silkeborg Regional Hospital, Physical and Occupational Therapy, Diagnostic Centre, Silkeborg, Denmark, 2Aalborg University Hospital, Dep. of Occupational Therapy and Physical Therapy, Aalborg, Denmark, 3Herning Regional Hospital, Dep. of Occupational and Physical Therapy, Herning, Denmark, 4Silkeborg Regional Hospital, Dep. of Cardiology, Diagnostic Centre, Silkeborg, Denmark
Background: At present, there are no guidelines for rehabilitation following an acute pulmonary embolism (APE) although studies have shown that patients suffer long-term negative consequences like mental distress, dyspnea, fatigue, and reduced exercise capacity and physical activity. Reduced exercise capacity and physical activity leads to reduced quality of life, an increased risk of a new cardiovascular event and all-cause mortality. An ongoing RCT investigates the effect of rehabilitation consisting of a nurse consultation, physical tests, and for the intervention group an 8-week home-based exercise program including three telephone consultations between patients and a physiotherapist. The present study is a qualitative study embedded in the RCT evaluating the intervention.
Purpose: To explore how health professionals and patients perceive and experience rehabilitation after APE.
Methods: 16 semi-structured individual interviews were carried out with patients 7-12 months following an APE. Two focus group interviews were carried out with eight physiotherapists, three nurses, and the responsible cardiologist following the intervention period. All informants have provided informed consent. Both groups were interviewed using an interview guide encompassing topics related to all elements of the RCT. Interviews were recorded and transcribed and analysed thematically.
Results: Nurses and patients perceived patients to be in need of putting the APE event into a broader context and validate and translate the information received during hospitalization. Patients and health professionals found the walking tests to motivate patients to become more physically active, and the patients experienced that the test provided confidence in being physically active again. Some patients experienced the home-based exercise program to be easy to fit into everyday life, others expressed a need for more supervision to stay motivated or as an opportunity for meeting peers. The telephone consultations were experienced by physiotherapists as a good tool to guide patients doing the exercises and to give room for questions and discussion of worries. Overall, patients and health professionals experienced the consultations with nurses and physiotherapists to provide comfort and a feeling of security.
Conclusion(s): Patients and health professionals experienced the rehabilitation to reassure patients, helping them to manage everyday life after the APE event. Furthermore, being exposed to a physical test and home-based exercise program provided confidence in resuming physical activity. The patients, however, requested more individualized forms of rehabilitation.
Implications: The above findings indicate the need of an interdisciplinary setup where physiotherapists play an important role, in particular within the physical and the mental rehabilitation to support resumption of physical activity. Physical tests in rehabilitation are not only a tool to measure physical capacity but also have a role to play for patients´ motivation and confidence in their own physical capability.
Keywords: Pulmonary embolism, Rehabilitation, Experiences
Funding acknowledgements: The study was supported by the Danish foundation Trygfonden
Purpose: To explore how health professionals and patients perceive and experience rehabilitation after APE.
Methods: 16 semi-structured individual interviews were carried out with patients 7-12 months following an APE. Two focus group interviews were carried out with eight physiotherapists, three nurses, and the responsible cardiologist following the intervention period. All informants have provided informed consent. Both groups were interviewed using an interview guide encompassing topics related to all elements of the RCT. Interviews were recorded and transcribed and analysed thematically.
Results: Nurses and patients perceived patients to be in need of putting the APE event into a broader context and validate and translate the information received during hospitalization. Patients and health professionals found the walking tests to motivate patients to become more physically active, and the patients experienced that the test provided confidence in being physically active again. Some patients experienced the home-based exercise program to be easy to fit into everyday life, others expressed a need for more supervision to stay motivated or as an opportunity for meeting peers. The telephone consultations were experienced by physiotherapists as a good tool to guide patients doing the exercises and to give room for questions and discussion of worries. Overall, patients and health professionals experienced the consultations with nurses and physiotherapists to provide comfort and a feeling of security.
Conclusion(s): Patients and health professionals experienced the rehabilitation to reassure patients, helping them to manage everyday life after the APE event. Furthermore, being exposed to a physical test and home-based exercise program provided confidence in resuming physical activity. The patients, however, requested more individualized forms of rehabilitation.
Implications: The above findings indicate the need of an interdisciplinary setup where physiotherapists play an important role, in particular within the physical and the mental rehabilitation to support resumption of physical activity. Physical tests in rehabilitation are not only a tool to measure physical capacity but also have a role to play for patients´ motivation and confidence in their own physical capability.
Keywords: Pulmonary embolism, Rehabilitation, Experiences
Funding acknowledgements: The study was supported by the Danish foundation Trygfonden
Topic: Cardiorespiratory
Ethics approval required: Yes
Institution: Central Denmark Region
Ethics committee: Ethics Committee Central Denmark Region
Ethics number: journal no. 1-10-72-243-15
All authors, affiliations and abstracts have been published as submitted.
