Exploring patient perspectives of barriers and facilitators to participating in hospital-based pulmonary rehabilitation in patients diagnosed with non-small-cell lung cancer treated with curative intent.

Background: Pulmonary rehabilitation (PR) is increasingly offered to patients who have undergone lung resection for non-small-cell lung carcinoma (NSCLC) as it can improve exercise tolerance and quality of life. However, designing and implementing such a complex multidisciplinary programme has its challenges.

Objective: This study aims to explore perspectives of patients offered PR services post-lung resection for NSCLC to gain an understanding of the potential barriers and facilitators behind implementing and designing PR programmes.

Methods: The PR programmes were offered in an outpatient rehabilitation gym at University Hospital Limerick, Ireland. Patients attending routine follow-up appointments post-lung cancer resection during the period of the study were identified and based on inclusion criteria were invited to participate in semi-structured interviews (focus groups). Interviews with patients who participated in the PR programme (n = 8) and those who declined (n = 4) were transcribed and major themes identified using normalisation process theory (NPT analysis) before interpretation of the themes in context.

Results: Across 4 focus groups that were conducted, the important barriers identified were the presence of comorbidities, location, perceived lack of benefit, and a fear of causing harm. Relevant facilitators included the prospect of acquiring new knowledge, optional access to psychological support, peer interaction/social support, individualised, tailored programmes, and a holistic approach to recovery as well as goal setting and accomplishment.

Conclusions: Patient participation in PR has been shown to be influenced by both external and intrapersonal variables. The barriers and facilitators experienced by the patients in this study contribute to the existing knowledge of the patient experience of pulmonary rehabilitation and can help to inform clinical practice and future research.