Patients Expectations and Experiences of Rehabilitation after Lung Transplantation

Abstract

Purpose Exercise rehabilitation is commonly undertaken before & after lung transplant, but little is known about the patient experience of this treatment.This qualitative study explored patients expectations & attitudes to a supervised exercise rehabilitation program following lung transplant. Methods and Materials Patients undertook 2 semi-structured interviews, one before commencement of rehabilitation & one at the conclusion of rehabilitation. Interviews were digitally recorded & line by line iterative thematic analysis of the transcribed interviews was completed. Open coding followed by axial coding was used to develop major themes & subthemes based on grounded theory. Quotations were extracted from the transcripts to support the data for each theme. Results 18 adults(7 males)with median age of 52 took part in an outpatient exercise program (average attendance of 26 sessions). Four major themes were common to both pre & post rehabilitation:1) hopes of returning to normal life,including resuming family roles,performing everyday activities & return to leisure or sporting activities; 2) importance of rehabilitation as the mechanism for how this transformation occurred; 3)the benefits of exercising in a group & 4) the limitations of rehabilitation that were imposed by co-morbidities either existing pretransplant or occurring as a postoperative sequelae. A minor theme before rehabilitation was taking resposibility for regaining fitness,whereas the post rehabilitation minor themes were attainment of goals & a changed perspective on exercise. Conclusions Post transplant exercise rehabilitation was perceived as a highly valuable tool that assisted patients to attain their goals of returning to normal life. Group exercise was motivational, offered peer support & was advantageous to assist patients to achieve their desired physical performance level.