Impact of patient characteristics and perceived barriers on referral to exercise rehabilitation among patients with pulmonary hypertension in the United States.
Impact of patient characteristics and perceived barriers on referral to exercise rehabilitation among patients with pulmonary hypertension in the United States.
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DOI：
10.1177/2045894020974926
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发表时间：
2020-10
影响因子：
2.6
通讯作者：
McLaughlin VV
中科院分区：
文献类型：
--
作者：
Cascino TM;Ashur C;Richardson CR;Jackson EA;McLaughlin VV
尽管运动康复改善了运动能力和生活质量，但肺动脉高压患者的运动康复并未得到充分利用。我们试图了解（1）患者特征和（2）患者感知的障碍和转诊运动康复之间的关联。我们对参加国际 PAH 会议的肺动脉高压或慢性血栓栓塞性肺动脉高压患者进行了横断面调查。考虑的转诊预测因素包括性别、体重指数、主观社会经济状况、保险类型、年龄、世界卫生组织功能等级以及使用心脏康复障碍量表评估的感知障碍。在 65 名参与者中，主观社会经济地位最低三分位数的参与者与最高三分位数参与者相比，转诊的几率较低（优势比 0.22，95% 置信区间：0.05–0.98，p = 0.047）。一些患者感知到的障碍与转诊几率降低有关。在李克特五点量表上，报告的障碍每增加 1 个单位，转诊的几率就会降低 85%，因为我的医生认为没有必要； 85% 的人更喜欢独自照顾自己的健康，而不是在团体中； 78%的许多有心肺问题的人没有去，但他们没事； 78% 的人因为我不了解运动疗法。缺乏感知需求子量表和总体障碍评分分别与转诊几率降低 92% 和 77% 相关。这些数据表明需要探索干预措施，以促进低社会经济地位患者的转诊并满足对治疗的感知需求。
Exercise rehabilitation is underutilized in patients with pulmonary arterial hypertension despite improving exercise capacity and quality of life. We sought to understand the association between (1) patient characteristics and (2) patient-perceived barriers and referral to exercise rehabilitation. We performed a cross-sectional survey of patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension attending an International PAH meeting. Predictors of referral considered included gender, body mass index, subjective socioeconomic status, insurance type, age, and World Health Organization functional class and perceived barriers assessed using the Cardiac Rehabilitation Barriers Scale. Among 65 participants, those in the lowest subjective socioeconomic status tertile had reduced odds of referral compared to the highest tertile participants (odds ratio 0.22, 95% confidence interval: 0.05–0.98, p = 0.047). Several patient-perceived barriers were associated with reduced odds of referral. For every 1-unit increase in a reported barrier on a five-point Likert scale, odds of referral were reduced by 85% for my doctor did not feel it was necessary; 85% for prefer to take care of my health alone, not in a group; 78% many people with heart and lung problems don’t go, and they are fine; and 78% for I didn’t know about exercise therapy. The lack of perceived need subscale and overall barriers score were associated with a 92% and 77% reduced odds of referral, respectively. These data suggest the need to explore interventions to promote referral among low socioeconomic status patients and address perceived need for the therapy.
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影响因子：
2.6
作者：
Al-Naamani N;Paulus JK;Roberts KE;Pauciulo MW;Lutz K;Nichols WC;Kawut SM
通讯作者：
Kawut SM
影响因子：
--
作者：
Grace, Sherry L.;Russell, Kelly L.;Stewart, Donna E.
通讯作者：
Stewart, Donna E.
影响因子：
158.5
作者：
Barst, RJ;Rubin, LJ;Crow, JW
通讯作者：
Crow, JW
影响因子：
9.7
作者：
Pandey, Ambarish;Garg, Sushil;Berry, Jarett D.
通讯作者：
Berry, Jarett D.
影响因子：
4.2
作者：
Adler, NE;Epel, ES;Ickovics, JR
通讯作者：
Ickovics, JR