低收入和中等收入国家慢性阻塞性肺病患者以中心为基础的肺部康复的障碍和促进因素:一项系统综述

IF 4.3 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Yue Lei Lim, Julia Patrick Engkasan, Jayakayatri Jeevajothi Nathan, Hilary Pinnock, Ee Ming Khoo, Monsur Habib, Soo Chin Chan
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引用次数: 0

摘要

背景:慢性阻塞性肺疾病(COPD)是低收入和中等收入国家(LMICs)死亡率和发病率的主要原因。尽管肺康复(PR)对COPD患者的益处已被证实,但其转诊、吸收和完成率仍然很低。本系统综述旨在确定中低收入国家COPD患者以中心为基础的PR的障碍和促进因素。方法:检索PubMed、Web of Science、Cumulative Index to Nursing and Allied Health Literature和Scopus数据库,检索时间从数据库建立到2023年9月,并于2025年5月更新。包括COPD患者、其护理人员和卫生保健专业人员(HCPs)的研究,如果他们报告了中低收入国家中心PR的障碍或促进因素。根据健康行为的社会生态模型提取数据,并进行叙事综合。结果:5篇文章符合纳入标准,包括4项定量研究和1项定性研究,涉及1544名COPD患者、11名护理人员和84名医护人员,分别在伊朗、中国、哥伦比亚和巴西进行。最常见的公关障碍是个人经济拮据。其他经常报告的障碍包括慢性阻塞性肺病的症状严重程度、缺乏家庭和社会支持、医务人员能力不足以及后勤挑战。促进PR的因素包括更高的HCP熟练程度、更高的个人和家庭收入、更高的教育水平、更好的患者PR意识和意识规划。结论:在中低收入国家中,公共关系转诊、接受和完成的障碍和促进因素在多个层面上被确定:个人、人际、组织、社区和政策。一些因素对中低收入国家和高收入国家来说都是共同的,如住院频率、社会支持、卫生保健知识和技能、后勤挑战以及提高认识规划,但个人财务限制是中低收入国家面临的一个独特障碍。为了改善现有的公关服务或有效地执行新的公关方案,需要考虑这些因素。报名:普洛斯彼罗:CRD42024528467。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Barriers and enablers to centre-based pulmonary rehabilitation for patients with chronic obstructive pulmonary disease in low- and middle-income countries: a systematic review.

Barriers and enablers to centre-based pulmonary rehabilitation for patients with chronic obstructive pulmonary disease in low- and middle-income countries: a systematic review.

Barriers and enablers to centre-based pulmonary rehabilitation for patients with chronic obstructive pulmonary disease in low- and middle-income countries: a systematic review.

Barriers and enablers to centre-based pulmonary rehabilitation for patients with chronic obstructive pulmonary disease in low- and middle-income countries: a systematic review.

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality and morbidity in low- and middle-income countries (LMICs). Despite the proven benefits of pulmonary rehabilitation (PR) for patients with COPD, its referral, uptake, and completion rates remain low. This systematic review aimed to identify the barriers and enablers to centre-based PR among patients with COPD in LMICs.

Methods: We searched PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature, and Scopus databases from their inception to September 2023 and updated in May 2025. Studies involving patients with COPD, their caregivers, and healthcare professionals (HCPs), were included if they reported barriers or enablers to centre-based PR in LMICs. Data were extracted based on the socio-ecological model of health behaviour, and a narrative synthesis was conducted.

Results: Five articles met the inclusion criteria, comprising four quantitative and one qualitative study, involving 1544 patients with COPD, 11 caregivers, and 84 HCPs, which were conducted in Iran, China, Colombia, and Brazil. The most frequently identified barrier to PR was personal financial constraints. Other frequently reported barriers included symptom severity of COPD, lack of family and social support, inadequate competency of HCPs, and logistical challenges. Enablers to PR included higher proficiency of HCP, higher personal and family income, higher educational levels, better patient awareness of PR, and awareness programmes.

Conclusions: Barriers and enablers to PR referral, uptake, and completion in LMICs were identified at multiple levels: intrapersonal, interpersonal, organisational, community, and policy. Some factors were common to both LMICs and high-income countries, such as frequency of hospitalisation, social support, HCP knowledge and skills, logistical challenges, and awareness programmes, but personal financial constraints were a unique barrier to LMICs. To improve existing PR services or to effectively implement new PR programmes, these factors need to be considered.

Registration: PROSPERO: CRD42024528467.

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来源期刊
Journal of Global Health
Journal of Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -
CiteScore
6.10
自引率
2.80%
发文量
240
审稿时长
6 weeks
期刊介绍: Journal of Global Health is a peer-reviewed journal published by the Edinburgh University Global Health Society, a not-for-profit organization registered in the UK. We publish editorials, news, viewpoints, original research and review articles in two issues per year.
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