Taking Charge: A Proposed Psychological Intervention to Improve Pulmonary Rehabilitation Outcomes for People with COPD
psychological, pulmonary rehabilitation, Self-Efficacy, self-management
Amanda McNaughton,1,2 William Levack,3 Harry McNaughton2 1Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK; 2Medical Research Institute of New Zealand, Wellington, New Zealand; 3Department of Medicine, University of Otago, Wellington, New ZealandCorrespondence: Amanda McNaughton Email amanda.mcnaughton@nhs.netAbstract: Pulmonary rehabilitation (PR) is an important, evidence-based treatment that improves outcomes for people with COPD. Individualized exercise programmes aim to improve exercise capacity; self-management education and psychological support are also provided. Translating increased exercise capacity into sustained behavioural change of increased physical activity is difficult. Other unresolved problems with PR programmes include improving uptake, completion, response and sustaining long-term benefit. We offer a different perspective drawn from clinical experience of PR, quantitative and qualitative studies of singing groups for people with COPD, and stroke rehabilitation research that gives psychological factors a more central role in determining outcomes after PR. We discuss Take Charge; a simple but effective psychological intervention promoting self-management––that could be used as part of a PR programme or in situations where PR was declined or unavailable. This may be particularly relevant now when traditional face-to-face group programmes have been disrupted by COVID-19 precautions.Keywords: pulmonary rehabilitation, self-management, self-efficacy, psychological