Table 1.
Characteristics of included studies
| Author (year), country | Design | Qualitative data collection methods; setting; analytical approach | Sample size (n) | Gender (M/F) | Age (years) | COPD characteristics | Pulmonary rehabilitation setting; duration; intensity | Data collection context: duration after pulmonary rehabilitation; participation in usual care or intervention; duration/intensity of the intervention |
|---|---|---|---|---|---|---|---|---|
| Camp et al. (2000), Canada33 | Mixed methods | Semi-structured interview Participants home aEstablished guidelines for data analysis |
7 | 2/5 | Range: 82–86 | Severe to moderately severe (FEV1 % predicted mean (SD), 43 (14)), range = 23–69 Smoking (pack-years): mean (SD) 37 (21), range = 0–80 |
Hospital-based/in-patient PR 5 weeks 3 × weekly sessions |
<2 weeks Usual care |
| Desveaux (2014), Canada30 | Qualitative | Focus groups Setting: NR Thematic content analysis |
12 | 6/6 | Range: 52–85 | Severe (FEV1 % predicted mean (SD): 44 (18)) MRC: median = 3 |
Hospital-based PR Inpatient PR: 6 weeks Outpatient PR: 12 weeks |
>6 months Individuals were participating in community exercise maintenance programme 12 months/2 × 1 h sessions per week |
| Desveaux (2017), Canada34 | Qualitative | Semi-structured interviews Participants rehabilitation hospital Deductive thematic analysis |
6b | 3/3 | Range: 65–74 | Number of comorbidities range: 1–6 | Hospital-based PR | >3 months Usual care |
| Halding (2012), Norway35 | Qualitative | Semi-structured interviews Participants’ homes or at the researcher’s office Thematic analysis |
T1 = 18, T2 = 15c | 13/5 | Range: 52–81 | Mild to severe Smoking status (n): Former = 11, Current = 5 |
Hospital-based PR Outpatient PR programme 12-week; (1 day/week) |
T1 = <2 months, T2 = <12 months Usual care |
| Hoaas (2016), Norway28,27 | Mixed methods | Focus group Rehabilitation centre Thematic analysis Systematic text condensation |
10 | 5/5 | Mean: 55.2 years | Moderate to severe Oxygen users (n): 3 |
Inpatient programme 4-weeks; (5 days/week) |
T1: <18 months T2: <30 months T3: <42 monthsd Tele-rehabilitation intervention 24 months/3 × 30 min per week |
| Hogg (2012), England38 | Qualitative | Focus groups Community hospital Informed by grounded theory |
16 Group A: 9 Group B: 7e |
Group A: 4/5 Group B: 5/2 |
Mean (SD) Group A: 71 (10) Group B: 67 (11) |
Mild to severe; FEV1 % predicted mean (SD): Group A: 67 (16); Group B: 59 (17) MRC: mean (SD): Group A: 2.1 (0.5); Group B: 2.3 (0.4) |
Outpatient programme 8-weeks |
<24 months Usual care |
| Lewis and Cramp (2010), England39 | Qualitative | Focus groups Setting: NR Inductive thematic analysis |
6 | 1/5 | Mean: 69.3 years Range: 61–83 |
Moderate to very severe MRC: 2 (n = 5) 4 (n = 1) |
NR | <48 months Usual care |
| Norweg (2008), USA42 | Qualitative | Semi-structured interviews Interviews at home or rehabilitation centre Informed by grounded theory |
4 | 1/3 | Mean: 73 Range: 69–80 |
Disease length (years): 0.25–20 Oxygen users (n): 1 |
Outpatient programme 7.5 weeksf 2× week |
6–11 months Usual care |
| Rabinowitz (1998), USA43 | Qualitative | Open-ended interviews Interviews at participants homes Informed by phenomenological approach |
8 | 3/5 | Mean: 64 Range: 45–75 |
Smoking status (n): former smoker (7), current smoker (1) Oxygen users (n): Supply at home as required (8) long-term (1) |
In-patient programme 3 weeks; (3 × 1 h daily sessions) |
<18 months Usual care |
| Rodgers (2007), England40 | Qualitative | Focus groups Setting: NR Template analysis |
23 | 14/9 | Range: 63–70 years | FEV1 % predicted (range between focus groups 1–4): 40–49% MRC median: (range between focus groups 1–4): 3–4 |
Outpatient programme 6 weeks 2× week |
<4 months Usual care |
| Stewart (2014), The Netherlands37 | Qualitative | Semi-structured interviews Setting: assessment centre or patients’ home Qualitative content analysis |
22 | 14/8 | Mean (SD) 63.5 (7.8) Range: 45–78 |
Mild to very severe; FEV1 % predicted: Mean (SD): 52.5 (14.4) Disease length (years) mean (SD): 5 (3.9) MRC: mean (SD) 2.9 (1.3). |
Outpatient programme 4 months |
<8–11 months Participants were involved in an ongoing NUTRAIN trial (nutritional supplementation during 4 months of supervised exercise training) |
| Sundfør(2010), Norway36 | Qualitative | Semi-structured interviews Participants homes Systematic text condensation |
6 | 2/4 | Mean: 64.5 Range: 55–75 |
Moderate to severe Disease length (years): 0.5–20 |
Hospital programme 4 weeks 1+ session daily |
Between 4–6 months Usual care |
| Williams (2010), England41 | Qualitative | Semi-structured interviews Participants homes Inductive approach informed by grounded theory methods |
9 | 6/3 | Range: 54–84 | Moderate to very severe Disease length range (years): <5–>10 Oxygen users (n): 1 |
Outpatient 8 weeks 2× weekly |
T0: interview pre-PR T1: interview post-PR; 1–2 weeks Usual care |
| Zakrisson (2014), Sweden44 | Qualitative | Semi-structured interviews PHC and participants homes Qualitative content analysis |
20 | 13/7 | Mean (SD): 68 (4.1) Range: 62–78 |
Moderate to severe FEV1 % predicted Mean (SD): 46 (10) Smoking status (n): Current smoker (4) |
PHC 6 weeks 2 h per week |
<36 monthsg Usual care |
n number, COPD chronic obstructive pulmonary disease, PR pulmonary rehabilitation, M/F male/female, FEV1 (% predicted) percentage of forced expiration volume in one second divided by the average FEV1% in the population for any person of similar age, sex, and body composition, SD standard deviation, NR not reported, PHC primary health care, GOLD stages global initiative for chronic obstructive lung disease stages, MRC dyspnoea medical research council dyspnoea scale, T1/T2/T3 time 1/time 2/time 3
aAnalytical approach was: “established guidelines for data analysis”
bThis study involved participants with heart failure but only the COPD subgroup was reported in this table
cTwo people did not provide follow-up interviews because of death, and one could not be reached
dT3 refers to a second paper which followed up the same participants’ experiences of PA following tele-rehabilitation
eUsing records held by the pulmonary rehabilitation team, eligible participants were placed into two groups (Group A: had received input from pulmonary rehabilitation staff to assist with ongoing exercise following completion of the pulmonary rehabilitation course; Group B: had not received any input from pulmonary rehabilitation staff regarding ongoing exercise)
fEstimated duration of PR programme, based on “six, 1-h weekly sessions of occupational therapy” and “15 sessions held twice weekly” of the exercise training programme
gData collection timescale post-PR estimated from reported information: PR during: 2007–2008, interviews in Spring 2009