<i>‘I’ve never heard of pulmonary rehab’:</i> Healthcare professionals’ perceptions in regards to chronic obstructive pulmonary disease

ObjectiveTo identify healthcare professionals' perceptions of pulmonary rehabilitation as a management strategy for people with chronic obstructive pulmonary disease (COPD).DesignA qualitative interview study which adopted an interpretive phenomenological approach.MethodsTwenty-seven healthcare professionals were recruited from general practices in the North West of England and two hospital trusts, consisting of: general practitioners, practice nurses, and doctors and nurses working on general medical wards. Audio recorded semi-structured interviews investigated healthcare professionals' perceptions and knowledge of pulmonary rehabilitation; interpretive phenomenological analysis was conducted on the transcribed interviews.ResultsThree themes were identified: <i>COPD Illness Perceptions</i>, <i>Pulmonary Rehabilitation Beliefs</i>, and <i>Organisational and Referral Pathway Perceptions</i>. Commonalities and disparities were identified between primary and secondary care and amongst the different professional groups. Healthcare professionals held negative COPD illness perceptions including stigmatising beliefs in relation to the disease. These beliefs impacted their referral practice. Beliefs about pulmonary rehabilitation included views about patient suitability for the pulmonary rehabilitation programme. A lack of knowledge of pulmonary rehabilitation and the referral process was evident. Surprisingly, many working on general medical wards had not heard of pulmonary rehabilitation and none in their current role had referred to the programme. Organisational and referral pathway perceptions revealed barriers and facilitators to referral.ConclusionReferral to pulmonary rehabilitation programmes is influenced by healthcare professionals' perceptions and knowledge of pulmonary rehabilitation, referral pathways and how COPD affects patients. Together health professional perceptions could act as a predictor of referral practice and inform strategies for increasing referral rates.