Perceived Acceptability of SPACE for COPD© as a Maintenance Option Following Pulmonary Rehabilitation Discharge: A Qualitative Interview Study with Patients and Facilitators Using Framework Analysis

Abstract

Introduction: Following completion of Pulmonary Rehabilitation (PR), the biopsychosocial benefits often decline. PR maintenance is recommended to extend the benefits; however, detail lacks on what this should entail. SPACE for COPD© is a light touch, evidenced-based self-management intervention which we tested as a maintenance strategy during the COVID-19 pandemic. We explored the acceptability of SPACE for COPD© as a maintenance option following PR for both patients and facilitators using qualitative research methods.

Methods: We conducted semi-structured interviews and focus groups with patients and intervention facilitators involved in the SPACE for COPD© maintenance study. These were audio recorded, transcribed verbatim and analysed using Framework Analysis.

Results: Seventeen patients were interviewed; 13 (76.5%) of which were programme completers: five (29.4%) received a group-based intervention, four (23.5%) received one-to-one, and eight (47.1%) received hybrid. Two focus groups were conducted with eight facilitators; six (75%) were physiotherapists, one (12.5%) was a nurse, and one (12.5%) was a health psychologist. Analysis generated six themes: (1) the changing structure of maintenance SPACE for COPD©; (2) the integral role of the facilitator; (3) engagement with the manual required time and commitment from patients; (4) staying active on maintenance SPACE for COPD© was facilitated by goal setting and exercise; (5) biopsychosocial outcomes of maintenance SPACE for COPD©; and (6) the future of maintenance SPACE for COPD©.

Conclusion: Maintenance SPACE for COPD© was acceptable and could be implemented into the PR healthcare pathway during the COVID-19 pandemic. It helped patients to adopt and integrate new exercise habits if they could adapt and personalise these to their home lives. Adaptions made during the COVID-19 pandemic created a menu of options. Building upon this personalisation is required to ensure the intervention is accessible and patient-centred.