Highlights
- •Initiating the position of SDP PR nurse requires adequate preparation and multidisciplinary support.
- •SDP PR nurses have transition shock, and many factors affect their adaption.
- •Independent management is essential for department of SDP PR nurses.
- •Optimization requires initial and ongoing management and policy adjustments.
Abstract
Background
The globally low access to pulmonary rehabilitation can be attributed to the shortage
of competent professionals. Setting up specific-duty-post nurses in pulmonary rehabilitation
is a novel attempt to solve it. However, their work experience in this position has
not been examined.
Objectives
To describe the working experience of special-duty-post pulmonary rehabilitation nurses
to improve the efficiency of this mode and provide guidance for management hospitals
contemplating setting up and optimizing this position.
Methods
A descriptive phenomenology qualitative approach with semi-structured in-depth interviews
was adopted.
Results
Fourteen special-duty-post pulmonary rehabilitation nurses were recruited by purposive
and snowball sampling from May to July 2021. Four main themes emerged: finding the
way in the dark, meeting qualifications and requirements, seeking independence, and
anticipating better development. The lack of relevant standards, inadequate support,
and variation in chronic respiratory diseases had made them felt like they were finding
their way in the dark. As a result of meeting new requirements and qualifications,
they experienced role transition shock. Moreover, they were seeking a clear role boundary
and independence to foster their sense of belonging. They suggested ways that future
management and policies could nurture them to invest more in pulmonary rehabilitation
development.
Conclusion
Developing detailed working standards before work begins and providing adequate support,
especially from pulmonologists was key. Compared to a clinical position, this position
requires a high level of specialty knowledge, communication skills, self-learning,
innovative ability, decision-making, and resilience. Special-duty-post pulmonary rehabilitation
nurses suggested ways that tailored management based on the identified factors could
counteract their transition shock. A clear role boundary and independence help foster
belongingness. To maximize effectiveness and overcome challenges requires identifying
obstacles to success, initiating strategies to overcome these and ongoing efforts
to promote interdisciplinary support of the role.
Keywords
Abbreviations:
SDP (Specific-duty-post), PR (Pulmonary rehabilitation), ICU (Intensive care unit)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Heart & Lung: The Journal of Cardiopulmonary and Acute CareAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Prevalence and attributable health burden of chronic respiratory diseases, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.Lancet Respir Med. 2020; 8: 585-596https://doi.org/10.1016/S2213-2600(20)30105-3
- An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation [published correction appears in Am J Respir Crit Care Med. 2014 Jun 15;189(12):1570].Am J Respir Crit Care Med. 2013; 188: e13-e64https://doi.org/10.1164/rccm.201309-1634ST
- Pulmonary rehabilitation for chronic obstructive pulmonary disease.Cochrane Database Syst Rev. 2015;
- Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease.Cochrane Database Syst Rev. 2016; 12 (Published 2016 Dec 8)CD005305https://doi.org/10.1002/14651858.CD005305.pub4
- Pulmonary Rehabilitation as a Mechanism to Reduce Hospitalizations for Acute Exacerbations of COPD: A Systematic Review and Meta-Analysis.Chest. 2016; 150: 837-859https://doi.org/10.1016/j.chest.2016.05.038
- Effectiveness of pulmonary rehabilitation in elderlypatients with COPD: A systematic review and meta-analysis of randomized controlled trials.Int J Nurs Pract. 2019; 25: e12745https://doi.org/10.1111/ijn.12745
- Textbook of pulmonary rehabilitation.(editors) Springer International Publishing, New York2018
- Australian and New Zealand Pulmonary Rehabilitation Guidelines.Respirology. 2017; 22: 800-819https://doi.org/10.1111/resp.13025
- Defining Modern Pulmonary Rehabilitation. An Official American Thoracic Society Workshop Report.Ann Am Thorac Soc. 2021; 18: e12-e29https://doi.org/10.1513/AnnalsATS.202102-146ST
- Pulmonary Rehabilitation Utilization in Older Adults With Chronic Obstructive Pulmonary Disease, 2003 to 2012.J Cardiopulm Rehabil Prev. 2016; 36: 375-382https://doi.org/10.1097/HCR.0000000000000194
- Pulmonary rehabilitation in Canada: A report from the Canadian Thoracic Society COPD Clinical Assembly.Can Respir J. 2015; 22: 147-152https://doi.org/10.1155/2015/369851
- American Thoracic Society/European Respiratory Society Task Force on Policy in Pulmonary Rehabilitation. Increasing implementation and delivery of pulmonary rehabilitation: key messages from the new ATS/ERS policy statement.Eur Respir J. 2016; 47: 1336-1341https://doi.org/10.1183/13993003.02151-2015
- Pulmonary rehabilitation referral and participation are commonly influenced by environment, knowledge, and beliefs about consequences: a systematic review using the Theoretical Domains Framework.J Physiother. 2017; 63: 84-93https://doi.org/10.1016/j.jphys.2017.02.002
- Exploring the barriers to pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: a qualitative study.BMC Health Serv Res. 2021; 21 (Published 2021 Aug 17): 828https://doi.org/10.1186/s12913-021-06814-5
- The Need for Expanding Pulmonary Rehabilitation Services.Life (Basel). 2021; 11 (Published 2021 Nov 15): 1236https://doi.org/10.3390/life11111236
- Pulmonary rehabilitation in chronic obstructive pulmonary disease.Am J Respir Crit Care Med. 2005; 172: 19-38https://doi.org/10.1164/rccm.200408-1109SO
- Differences in content and organisational aspects of pulmonary rehabilitation programmes.Eur Respir J. 2014; 43: 1326-1337https://doi.org/10.1183/09031936.00145613
- Optimizing pulmonary rehabilitation in chronic obstructive pulmonary disease–practical issues: a Canadian Thoracic Society Clinical Practice Guideline.Can Respir J. 2010; 17: 159-168https://doi.org/10.1155/2010/425975
- Improvements in exercise capacity during a 4-weeks pulmonary rehabilitation program for COPD patients do not correspond with improvements in self-reported health status or quality of life.Int J Chron Obstruct Pulmon Dis. 2007; 2: 355-359
- Predictors of success for pulmonary rehabilitation in patients awaiting lung transplantation.Transplantation. 2015; 99: 1072-1077https://doi.org/10.1097/TP.0000000000000472
- Outpatient pulmonary rehabilitation - rehabilitation models and shortcomings in outpatient aftercare.GMS Health Technol Assess. 2010; 6 (Doc11. Published 2010 Jul 29)https://doi.org/10.3205/hta000089
- Characterization of pulmonary rehabilitation programs in Canada in 2005.Can Respir J. 2007; 14: 87-92https://doi.org/10.1155/2007/951498
- Pulmonary rehabilitation exercise prescription in chronic obstructive lung disease: US survey and review of guidelines and clinical practices.J Cardiopulm Rehabil Prev. 2013; 33: 314-322https://doi.org/10.1097/HCR.0b013e318297fea4
- Differential response to pulmonary rehabilitation in COPD: multidimensional profiling.Eur Respir J. 2015; 46: 1625-1635https://doi.org/10.1183/13993003.00350-2015
- Choosing a Qualitative Research Approach.J Grad Med Educ. 2015; 7: 669-670https://doi.org/10.4300/JGME-D-15-00414.1
- Differentiating between descriptive and interpretive phenomenological research approaches.Nurse Res. 2015; 22: 22-27https://doi.org/10.7748/nr.22.6.22.e1344
Zakrisson AB. Management of patients with chronic obstructive pulmonary disease in primary health care: a study of a nurse-led multidisciplinary programme of pulmonary rehabilitation (Doctoral dissertation, Örebro universitet).
- Establishing a residency program for a chiropractic specialty in a public hospital system: Experiences from Denmark.J Chiropr Educ. 2020; 34: 164-171https://doi.org/10.7899/JCE-18-6
- The past, present and future of pulmonary rehabilitation.Respirology. 2019; 24: 830-837https://doi.org/10.1111/resp.13517
- Knowledge level about pulmonary rehabilitation: a questionnaire analysis in respiratory physicians in Shanghai.Chinese J Respir Crit Care Med. 2012; 11: 375-377
- An Official American Thoracic Society/European Respiratory Society Policy Statement: Enhancing Implementation, Use, and Delivery of Pulmonary Rehabilitation.Am J Respir Crit Care Med. 2015; 192: 1373-1386https://doi.org/10.1164/rccm.201510-1966ST
- How to adapt the pulmonary rehabilitation programme to patients with chronic respiratory disease other than COPD.Eur Respir Rev. 2013; 22: 577-586https://doi.org/10.1183/09059180.00005613
- Pulmonary rehabilitation in Australia: a national survey.Physiotherapy. 2011; 97: 284-290https://doi.org/10.1016/j.physio.2010.12.001
- Cognitive status of nurses in Shanghai on pulmonary rehabilitation.Ann Palliat Med. 2021; 10: 2184-2194https://doi.org/10.21037/apm-21-190
- The importance of boundary management.Nurs Manage. 2019; 50: 51-54https://doi.org/10.1097/01.NUMA.0000575308.00185.00
- Participation in Pulmonary Rehabilitation after Hospitalization for Chronic Obstructive Pulmonary Disease among Medicare Beneficiaries.Ann Am Thorac Soc. 2019; 16: 99-106https://doi.org/10.1513/AnnalsATS.201805-332OC
- Adherence to Pulmonary Rehabilitation in COPD: A QUALITATIVE EXPLORATION OF PATIENT PERSPECTIVES ON BARRIERS AND FACILITATORS.J Cardiopulm Rehabil Prev. 2019; 39: 344-349https://doi.org/10.1097/HCR.0000000000000436
Article info
Publication history
Published online: November 11, 2022
Accepted:
November 6,
2022
Received in revised form:
October 28,
2022
Received:
August 13,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
