Factors Influencing Compliance with Pulmonary Rehabilitation in Patients with Stable COPD: a Cross Sectional Study.

Abstract

Background: Pulmonary rehabilitation (PR) is recognized as a cost-effective non-pharmacological treatment modality to promote quality of life and delay disease progression in patients with chronic obstructive pulmonary disease (COPD). Although PR has been shown to be effective, it is underutilized in clinical practice. This study aimed to investigate the factors associated with affecting compliance with PR in stable COPD patients.

Methods: This study is a cross-sectional survey. Patients with stable COPD were included using convenience sampling method. Data were collected using questionnaires including the demographic questionnaire, PR Compliance Questionnaire, mMRC dyspnea Scale, Family Support Scale, and Chronic Disease Self-Efficacy Scale (SES6G). Univariate analysis and multiple linear regression analysis were used to analyze the data.

Results: The 100 patients with stable COPD were moderately compliant with PR (3.51 ± 0.65), with the highest compliance with medication (4.10 ± 0.86) and the lowest with exercise (3.03 ± 1.16). Univariate analysis showed statistically significant influences on PR compliance were gender (P = 0.029), educational level (P = 0.021), exercise habits (P < 0.01), willingness to PR (P < 0.01), difficulty of PR (P = 0.030), mMRC (P = 0.002), and SES6G (P = 0.002). The following equation represents the multiple linear regression model: PR compliance = 0.235 × exercise habits + 0.609 × willingness to PR + 0.325 × difficulty of PR (P < 0.0001), adjusted R² = 0.330, F=7.974, and Durbin-Watson ratio = 2.049. Patients' good exercise habits in regular life, stronger willingness to PR, and easier PR programs may contribute to improved PR compliance.

Conclusion: This study suggested that stable COPD patients were not sufficiently compliant with PR and revealed related important factors affecting the compliance. Exercise habits, willingness to PR, and PR difficulty were found to be significant influencing factors. The results of this study can provide evidence for developing a more appropriate PR program and promoting PR compliance in the future.