Physicians’ Attitudes, Beliefs and Barriers to a Pulmonary Rehabilitation for COPD Patients in Saudi Arabia: A Cross-Sectional Study

Aldhahir, Abdulelah M.; Alqahtani, Jaber S; Alghamdi, Saeed M; Alqarni, Abdullah; Khormi, S.K.; Alwafi, Hassan; Samannodi, Mohammed; Siraj, Rayan A.; Alhotye, Munyra; Naser, Abdallah Y; Hakamy, Ali

doi:10.3390/healthcare10050904

Cited by 8 publications

(19 citation statements)

References 30 publications

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“… 16 In addition, our findings are similar to previous investigations into the barriers to setting up pulmonary rehabilitation programs in Saudi Arabia, which reported that lack of capacity in medical facilities is one of the main barriers. 20 , 29 , 30 This lack in the current clinical practice indicates the need across the country to establish and formulate comprehensive CR programs that meet current international clinical guidelines. In achieving this, it is essential to note that CR could be integrated within clinical sites by employing multidisciplinary collaboration.…”

Section: Discussionmentioning

confidence: 99%

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Physiotherapists’ Attitudes, and Barriers of Delivering Cardiopulmonary Rehabilitation for Patients with Heart Failure in Saudi Arabia: A Cross-Sectional Study

Aldhahir¹,

Alhotye²,

Alqahtani³

et al. 2022

JMDH

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Background Cardiopulmonary rehabilitation (CR) is an effective management approach for heart failure (HF) patients and is delivered by multidisciplinary teams including physiotherapists (PTs). PT attitudes about delivering CR and barriers that might affect referral have not been explored. Thus, this study is aimed to explore PT attitudes about delivering CR programs to patients with HF and identify factors and barriers that might affect referral decisions. Methods A cross-sectional online survey was disseminated to all PTs in Saudi Arabia between 19 February and 27 June, 2022. The characteristics of the respondents were described using descriptive statistics. Percentages and frequencies were used to report categorical variables. Results Overall, 553 PTs, 289 (52.30%) male and 264 (47.70%) females, completed the online survey. Of these, 360 (65.1%) strongly agreed that CR would improve patients’ physical fitness and 334 (60.4%) strongly agreed that CR would reduce breathlessness in patients with HF. The majority of PTs (321, 58%) strongly agreed that CR would improve HF patients’ palpitation and fatigue. Out of 553 PTs, 349 (63.1%) strongly agreed that CR would improve patients’ ability to perform daily activities. A hospital-supervised program was the preferred mode of delivering CR programs by 499 (90.20%) of the respondents. Apart from the exercise component, stress management was perceived by 455 (82.30%) as an essential component of CR programs. The most common patient-related factor that strongly influenced referral decisions was “fatigue related to disease” (42%). A lack of CR centers was reported by 59.90% as the most common referring barrier. Conclusion PTs perceived CR as a successful strategy for patients with HF. Although a supervised hospital-based program with stress management as an essential component aside from the exercise component was perceived as the preferred mode of delivery, CR was lacking, which caused a significant barrier to CR referral from the PTs’ perspective.

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Section: Discussionmentioning

confidence: 99%

“…We used a modified version of a survey that was previously designed, created, and validated by Aldhahir et al 20–23 The questionnaire included eight closed-ended multiple-choice questions.…”

Section: Methodsmentioning

confidence: 99%

Physiotherapists’ Attitudes, and Barriers of Delivering Cardiopulmonary Rehabilitation for Patients with Heart Failure in Saudi Arabia: A Cross-Sectional Study

Aldhahir¹,

Alhotye²,

Alqahtani³

et al. 2022

JMDH

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“…Reasons for not referring patients with COPD to PR programmes are likely to be multifactorial; lack of available PR centres is at top of the list, as shown in this study which is in accordance with recent study that included physicians and concluded that limited PR centres was the cause of low PR referral. 13 Saudi Arabia has a limited number of PR centres, and the number of people who can access these centres is extremely low. 9 This contrasts, for instance, with the situation in the UK, which has 228 PR services.…”

Section: Discussionmentioning

confidence: 99%

“…Our findings showed that the referral rate was low among all physicians, which was attributed to a lack of PR centres and trained staff. 13 Given the fact that our previous study did not survey non-physicians HCPs’ attitudes, although they were implicated as a barrier to referral, the present study aimed to explore allied healthcare professionals’ attitudes and expectations towards delivering a PR programme and identify their views on factors and barriers that might influence the referral of patients with COPD in Saudi Arabia.…”

Section: Introductionmentioning

confidence: 99%

Healthcare providers’ attitudes, beliefs and barriers to pulmonary rehabilitation for patients with chronic obstructive pulmonary disease in Saudi Arabia: a cross-sectional study

Aldhahir

Alqahtani²,

AlDraiwiesh³

et al. 2022

BMJ Open

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ObjectivesTo assess the attitude of healthcare providers (HCPs) towards the delivering of pulmonary rehabilitation (PR) to patients with chronic obstructive pulmonary disease (COPD) and identify factors and barriers that might influence referral.DesignA cross-sectional online survey consisting of nine multiple-choice questions.SettingsSaudi Arabia.Participants980 HCPs including nurses, respiratory therapists (RT) and physiotherapists.Primary outcome measuresHCPs attitudes towards and expectations of the delivery of PR to COPD patients and the identification of factors and barriers that might influence referral in Saudi Arabia.ResultsOverall, 980 HCPs, 53.1% of whom were men, completed the survey. Nurses accounted for 40.1% of the total sample size, and RTs and physiotherapists accounted for 32.1% and 16.5%, respectively. The majority of HCPs strongly agreed that PR would improve exercise capacity 589 (60.1%), health-related quality of life 571 (58.3%), and disease self-management in patients with COPD 589 (60.1%). Moreover, the in-hospital supervised PR programme was the preferred method of delivering PR, according to 374 (38.16%) HCPs. Around 85% of HCPs perceived information about COPD, followed by smoking cessation 787 (80.3%) as essential components of PR besides the exercise component. The most common patient-related factor that strongly influenced referral decisions was ‘mobility affected by breathlessness’ (64%), while the ‘availability of PR centres’ (61%), the ‘lack of trained HCPs’ (52%) and the ‘lack of authority to refer patients’ (44%) were the most common barriers to referral.ConclusionPR is perceived as an effective management strategy for patients with COPD. A supervised hospital-based programme is the preferred method of delivering PR, with information about COPD and smoking cessation considered essential components of PR besides the exercise component. A lack of PR centres, well-trained staff and the authority to refer patients were major barriers to referring patients with COPD. Further research is needed to confirm HCP perceptions of patient-related barriers.

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“…We used a modified version of a questionnaire that was previously designed, created, and validated by Aldhahir et al [ 17 , 18 , 19 , 20 ]. The questionnaire included eight closed-ended multiple-choice questions.…”

Section: Methodsmentioning

confidence: 99%

Nurses’ Perception of, and Barriers to, Delivering Cardiopulmonary Rehabilitation for Heart Failure Patients: A National Survey in Saudi Arabia

Aldhahir

2022

IJERPH

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Background: Heart failure (HF) patients require a holistic management approach to improve their clinical outcomes. Cardiopulmonary rehabilitation (CR) is a core component of HF patients’ management and is supervised by a multidisciplinary team including nurses. Nursing attitudes regarding CR delivery for patients with HF and the possible barriers and factors that potentially affect referral have not been explored. Therefore, this study seeks to evaluate nurses’ attitudes towards the delivery of CR programs and the possible barriers and factors that potentially influence the decision for a referral. Methods: An online survey with eight multiple-choice items was disseminated to all nurses between February and July 2022 in Saudi Arabia. The characteristics of the respondents were described using descriptive statistics. Percentages and frequencies were used to report categorical variables. Results: Overall, 1056 nurses completed the online survey, of which 395 (37.40%) were male. Out of 1056 nurses, 414 (39.20%) strongly agreed that CR would improve patients’ physical fitness, and 392 (37.10%) strongly agreed that CR would reduce breathlessness in patients with HF. In total, 381 nurses strongly agreed (36.10%) that CR would improve HF patients’ palpitation and fatigue. Out of 1056 nurses, 396 (37.50%) strongly agreed that CR would improve HF patients’ ability to perform daily activities, and 326 (30.90%) strongly agreed that CPR would reduce the rate of hospital readmission. The at-home program was the preferred mode of delivering CR programs among 607 (57.50%) nurses. Apart from the exercise component, symptom management was perceived by 704 (66.70%) nurses as the fundamental component of CR programs. The most common patient-related factor that strongly affected the decisions regarding referral was “mobility affected by breathlessness” (57%). A lack of CR centers (46%) was the most common barrier. Conclusion: Nurses perceived CR as an effective management strategy for HF patients. Although a home-based program, with symptom management being an essential component, in addition to the exercise component, was perceived as the preferred mode of delivery, CR centers are lacking, which represented a significant barrier to CR referral from the nurses’ perspective.

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Physicians’ Attitudes, Beliefs and Barriers to a Pulmonary Rehabilitation for COPD Patients in Saudi Arabia: A Cross-Sectional Study

Cited by 8 publications

References 30 publications

Physiotherapists’ Attitudes, and Barriers of Delivering Cardiopulmonary Rehabilitation for Patients with Heart Failure in Saudi Arabia: A Cross-Sectional Study

Physiotherapists’ Attitudes, and Barriers of Delivering Cardiopulmonary Rehabilitation for Patients with Heart Failure in Saudi Arabia: A Cross-Sectional Study

Healthcare providers’ attitudes, beliefs and barriers to pulmonary rehabilitation for patients with chronic obstructive pulmonary disease in Saudi Arabia: a cross-sectional study

Nurses’ Perception of, and Barriers to, Delivering Cardiopulmonary Rehabilitation for Heart Failure Patients: A National Survey in Saudi Arabia

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