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Lewis A, Turner LA, Fryer S, Smith R, Dillarstone H, Patrick YW, Bevan-Smith E. The acceptability, practicality, implementation and efficacy of a physical and social activity intervention 'BreatheHappy' for people with long-term respiratory conditions: A feasibility study. Chron Respir Dis 2024; 21:14799731241238435. [PMID: 38553857 PMCID: PMC10981237 DOI: 10.1177/14799731241238435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 02/24/2024] [Accepted: 02/19/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVES This study aimed to determine the feasibility of a group-based pilot programme of low-to-moderate physical activity training, education and social activities, by investigating acceptability, practicality, implementation and efficacy testing. We offer suggestions on programme adaptions for future study. METHODS People with a range of chronic respiratory diseases were invited to participate in a pilot 12 week group activity programme. Activities included outdoor walking, tai-chi, education and a range of social activities. Acceptability was determined by participant experiences determined during interviews. Practicality was determined by programme and outcome measure completion, cost and adverse events. Implementation was determined according to whether the programme ran as planned. Efficacy was determined by statistical analyses of outcomes including hand grip strength, timed up and go test, COPD Helplessness Index, COPD Assessment Test, and measures of physical activity via accelerometry. RESULTS Thematic analysis indicated that the "BreatheHappy" programme was acceptable. Seven of nine participants completed eight out of 10 sessions and the majority completed all outcome measures. "BreatheHappy" was therefore considered practical. The programme was not implemented as planned, with only 10 sessions running rather than the 12 intended. There was a significant increase in daily step counts (MD: 1284 95% CI: 240-2329 p: 0.024 effect size: 0.988), stepping time (MD: 16 min 95% CI: 5-27 min p: 0.011 effect size: 1.36) and daily minutes completing light physical activity (MD: 23 95% CI: 6-38 p: 0.006 effect size: 1.6). However, time spent sitting for ≥30 min but ≤60 min significantly increased (MD: 26 95% CI: 0.2-52 min p: 0.049 effect size: 0.931), showing signs of efficacy and changing physical activity behaviour patterns. DISCUSSION A 10-week programme of low-moderate physical activity training, education and social activities shows signs of feasibility for future research. Suggested adaptions for future study include using physical activity measures such as daily step count or light physical activity for a primary outcome, and mental health and social health related outcome measures relatable to participant's beneficial experiences of the programme. Recruitment in future studies will try and reach both those less socially active and possibly those who have completed pulmonary rehabilitation (PR). Venues should be close to efficient transport links whilst different frequencies and durations of programme delivery should be trialled. Adequate funding should be provided for both staff running the programme and blinded research staff for outcome measurement.
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Affiliation(s)
- A Lewis
- Department of Health Sciences, Brunel University London, Uxbridge, UK
- School of Health Sciences, University of Southampton, Southampton, UK
| | - LA Turner
- School of Education and Science, University of Gloucestershire, Cheltenham, UK
| | - S Fryer
- School of Education and Science, University of Gloucestershire, Cheltenham, UK
| | - R Smith
- Department of Geography, University College London, London, UK
| | - H Dillarstone
- Institute for Global Health, University College London, London, UK
| | - YW Patrick
- Department of Health and Social Care, University of Gloucestershire, Cheltenham, UK
| | - E Bevan-Smith
- Department of Health and Social Care, University of Gloucestershire, Cheltenham, UK
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Pang H, Pan Z, Adams R, Duncan E, Chi C, Kong X, Adab P, Cheng KK, Cooper BG, Correia-de-Sousa J, Dickens AP, Enocson A, Farley A, Gale N, Jolly K, Jowett S, Maglakelidze M, Maghlakelidze T, Martins S, Sitch A, Stavrik K, Stelmach R, Turner A, Williams S, Jordan RE. Community lung health service design for COPD patients in China by the Breathe Well group. NPJ Prim Care Respir Med 2022; 32:27. [PMID: 35985992 PMCID: PMC9388970 DOI: 10.1038/s41533-022-00286-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/24/2022] [Indexed: 12/04/2022] Open
Abstract
COPD is increasingly common in China but is poorly understood by patients, medications are not used as prescribed and there is no access to recommended non-pharmacological treatment. We explored COPD patients’ and general practitioners’ (GPs) knowledge of COPD, views on its management and the acceptability of a flexible lung health service (LHS) offering health education, exercise, self-management, smoking cessation and mental health support. Using a convergent mixed methods design, data were collected from patients and GPs using focus groups (FGs) in four Chinese cities, questionnaires were also used to collect data from patients. FGs were audio-recorded and transcribed. Quantitative data were analysed descriptively, thematic framework analysis was used for the qualitative data. Two-hundred fifty-one patients completed the questionnaire; 39 patients and 30 GPs participated in ten separate FGs. Three overarching themes were identified: patients’ lack of knowledge/understanding of COPD, current management of COPD not meeting patients’ needs and LHS design, which was well received by patients and GPs. Participants wanted COPD education, TaiChi, psychological support and WeChat for social support. 39% of survey responders did not know what to do when their breathing worsened and 24% did not know how to use their inhalers. 36% of survey respondents requested guided relaxation. Overall, participants did not fully understand the implications of COPD and current treatment was sub-optimal. There was support for developing a culturally appropriate intervention meeting Chinese patients’ needs, health beliefs, and local healthcare delivery. Further research should explore the feasibility of such a service.
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Soriano JB, Hopkinson NS. Sing out for COPD! Eur Respir J 2022; 59:59/5/2102961. [PMID: 35589115 DOI: 10.1183/13993003.02961-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 12/02/2021] [Indexed: 11/05/2022]
Affiliation(s)
- Joan B Soriano
- Servicio de Neumología, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain .,Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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Philip KEJ, Owles H, McVey S, Pagnuco T, Bruce K, Brunjes H, Banya W, Mollica J, Lound A, Zumpe S, Abrahams AM, Padmanaban V, Hardy TH, Lewis A, Lalvani A, Elkin S, Hopkinson NS. An online breathing and wellbeing programme (ENO Breathe) for people with persistent symptoms following COVID-19: a parallel-group, single-blind, randomised controlled trial. THE LANCET RESPIRATORY MEDICINE 2022; 10:851-862. [PMID: 35489367 PMCID: PMC9045747 DOI: 10.1016/s2213-2600(22)00125-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/21/2022] [Accepted: 03/28/2022] [Indexed: 12/20/2022]
Abstract
Background There are few evidence-based interventions for long COVID; however, holistic approaches supporting recovery are advocated. We assessed whether an online breathing and wellbeing programme improves health related quality-of-life (HRQoL) in people with persisting breathlessness following COVID-19. Methods We conducted a parallel-group, single-blind, randomised controlled trial in patients who had been referred from one of 51 UK-based collaborating long COVID clinics. Eligible participants were aged 18 years or older; were recovering from COVID-19 with ongoing breathlessness, with or without anxiety, at least 4 weeks after symptom onset; had internet access with an appropriate device; and were deemed clinically suitable for participation by one of the collaborating COVID-19 clinics. Following clinical assessment, potential participants were given a unique online portal code. Participants were randomly assigned (1:1) to either immediate participation in the English National Opera (ENO) Breathe programme or to usual care. Randomisation was done by the research team using computer-generated block randomisation lists, with block size 10. The researcher responsible for randomisation was masked to responses. Participants in the ENO Breathe group participated in a 6-week online breathing and wellbeing programme, developed for people with long COVID experiencing breathlessness, focusing on breathing retraining using singing techniques. Those in the deferred group received usual care until they exited the trial. The primary outcome, assessed in the intention-to-treat population, was change in HRQoL, assessed using the RAND 36-item short form survey instrument mental health composite (MHC) and physical health composite (PHC) scores. Secondary outcome measures were the chronic obstructive pulmonary disease assessment test score, visual analogue scales (VAS) for breathlessness, and scores on the dyspnoea-12, the generalised anxiety disorder 7-item scale, and the short form-6D. A thematic analysis exploring participant experience was also conducted using qualitative data from focus groups, survey responses, and email correspondence. This trial is registered with ClinicalTrials.gov, NCT04830033. Findings Between April 22 and May 25, 2021, 158 participants were recruited and randomly assigned. Of these, eight (5%) individuals were excluded and 150 participants were allocated to a treatment group (74 in the ENO Breathe group and 76 in the usual care group). Compared with usual care, ENO Breathe was associated with an improvement in MHC score (regression coefficient 2·42 [95% CI 0·03 to 4·80]; p=0·047), but not PHC score (0·60 [–1·33 to 2·52]; p=0·54). VAS for breathlessness (running) favoured ENO Breathe participation (−10·48 [–17·23 to –3·73]; p=0·0026). No other statistically significant between-group differences in secondary outcomes were observed. One minor self-limiting adverse event was reported by a participant in the ENO Breathe group who felt dizzy using a computer for extended periods. Thematic analysis of ENO Breathe participant experience identified three key themes: (1) improvements in symptoms; (2) feeling that the programme was complementary to standard care; and (3) the particular suitability of singing and music to address their needs. Interpretation Our findings suggest that an online breathing and wellbeing programme can improve the mental component of HRQoL and elements of breathlessness in people with persisting symptoms after COVID-19. Mind–body and music-based approaches, including practical, enjoyable, symptom-management techniques might have a role supporting recovery. Funding Imperial College London.
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Affiliation(s)
- Keir E J Philip
- National Heart and Lung Institute, Imperial College London, London, UK; National Institute for Health Research Imperial Biomedical Research Centre, Imperial College London, London, UK.
| | - Harriet Owles
- National Heart and Lung Institute, Imperial College London, London, UK; Respiratory Medicine, Imperial College Healthcare NHS Trust, London, UK
| | - Stephanie McVey
- Learning and Participation, English National Opera, London, UK
| | - Tanja Pagnuco
- Learning and Participation, English National Opera, London, UK
| | - Katie Bruce
- Learning and Participation, English National Opera, London, UK
| | - Harry Brunjes
- Learning and Participation, English National Opera, London, UK
| | - Winston Banya
- National Heart and Lung Institute, Imperial College London, London, UK; National Institute for Health Research Imperial Biomedical Research Centre, Imperial College London, London, UK
| | - Jenny Mollica
- Learning and Participation, English National Opera, London, UK
| | - Adam Lound
- Patient Experience Research Centre, Imperial College London, London, UK
| | - Suzi Zumpe
- Learning and Participation, English National Opera, London, UK
| | - Amiad M Abrahams
- Clinical Health Psychology, Imperial College Healthcare NHS Trust, London, UK
| | - Vijay Padmanaban
- Respiratory Medicine, Imperial College Healthcare NHS Trust, London, UK
| | - Thomas H Hardy
- Learning and Participation, English National Opera, London, UK
| | - Adam Lewis
- Department of Health Sciences, Brunel University London, London, UK
| | - Ajit Lalvani
- National Heart and Lung Institute, Imperial College London, London, UK; Respiratory Medicine, Imperial College Healthcare NHS Trust, London, UK
| | - Sarah Elkin
- National Heart and Lung Institute, Imperial College London, London, UK; Respiratory Medicine, Imperial College Healthcare NHS Trust, London, UK
| | - Nicholas S Hopkinson
- National Heart and Lung Institute, Imperial College London, London, UK; National Institute for Health Research Imperial Biomedical Research Centre, Imperial College London, London, UK
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Kraemer KM, Litrownik D, Moy ML, Wayne PM, Beach D, Klings ES, Reyes Nieva H, Pinheiro A, Davis RB, Yeh GY. Exploring Tai Chi Exercise and Mind-Body Breathing in Patients with COPD in a Randomized Controlled Feasibility Trial. COPD 2021; 18:288-298. [PMID: 34106027 DOI: 10.1080/15412555.2021.1928037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
In this pilot feasibility randomized controlled trial, participants with moderate to severe COPD were randomized to a 12-week tai chi or MBB intervention. Participants were assessed at baseline, 12 weeks, and 24 weeks. Feasibility, as assessed by intervention adherence, was the primary outcome. We also estimated preliminary between-group differences in COPD symptoms and health-related quality of life, cognitive-emotional function, and functional status across three timepoints: baseline, 12, and 24 weeks. A total of 92 participants were randomized 2:1 to tai chi (n = 61) or MBB (n = 31). The overall group adherence in the first 12 weeks was 62% in tai chi and 75% in MBB. From baseline to 12 weeks, tai chi demonstrated greater improvements in depressive symptoms (Cohen's d effect size (ES) = -.53; adj mean diff = -2.31 [-5.7, 1.07]), 6-minute walk test distance (ES = .47; adj mean diff = 62.04 [2.85, 121.22]), social support (ES = .36; adj mean diff = .19 [-0.11, 0.49]) and chair stand (ES = .44; adj mean diff = .91 [-0.05, 1.86]). Only improvements in social support were maintained at 24-week follow-up. Tai chi and MBB are feasible for individuals with COPD. Preliminary effects suggest that while our mindful breathing intervention may not be sufficient to impact outcomes, tai chi may result in short-term benefits in mood, social support and functional capacity. More work is needed to better understand mindful breathing for COPD and to examine methods for maintaining improvements from tai chi over time.Supplemental data for this article is available online at https://doi.org/10.1080/15412555.2021.1928037 .
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Affiliation(s)
- Kristen M Kraemer
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Daniel Litrownik
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Marilyn L Moy
- Harvard Medical School, Boston, Massachusetts, USA.,Pulmonary and Critical Care Medicine Section, Department of Medicine, Veterans Administration Boston Healthcare System, Boston, Massachusetts, USA
| | - Peter M Wayne
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Douglas Beach
- Harvard Medical School, Boston, Massachusetts, USA.,Division of Pulmonary and Critical Care, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Elizabeth S Klings
- The Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | | | - Adlin Pinheiro
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Roger B Davis
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Gloria Y Yeh
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts, USA
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Buttery SC, Zysman M, Vikjord SAA, Hopkinson NS, Jenkins C, Vanfleteren LEGW. Contemporary perspectives in COPD: Patient burden, the role of gender and trajectories of multimorbidity. Respirology 2021; 26:419-441. [PMID: 33751727 DOI: 10.1111/resp.14032] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 02/21/2021] [Indexed: 12/13/2022]
Abstract
An individual's experience of COPD is determined by many factors in addition to the pathological features of chronic bronchitis and emphysema and the symptoms that derive directly from them. Multimorbidity is the norm rather than the exception, so most people with COPD are living with a range of other medical problems which can decrease overall quality of life. COPD is caused by the inhalation of noxious particles or gases, in particular tobacco smoke, but also by early life disadvantage impairing lung development and by occupations where inhaled exposures are common (e.g. industrial, farming and cleaning work). Wealthy people are therefore relatively protected from developing COPD and people who do develop the condition may have reduced resources to cope. COPD is also no longer a condition that predominantly affects men. The prevalence of COPD among women has equalled that of men since 2008 in many high-income countries, due to increased exposure to tobacco, and in low-income countries due to biomass fuels. COPD is one of the leading causes of death in women in the USA, and death rates attributed to COPD in women in some countries are predicted to overtake those of men in the next decade. Many factors contribute to this phenomenon, but in addition to socioeconomic and occupational factors, there is increasing evidence of a higher susceptibility of females to smoking and pollutants. Quality of life is also more significantly impaired in women. Although most medications (bronchodilators and inhaled corticosteroids) used to treat COPD demonstrate similar trends for exacerbation prevention and lung function improvement in men and women, this is an understudied area and clinical trials frequently have a preponderance of males. A better understanding of gender-based predictors of efficacy of all therapeutic interventions is crucial for comprehensive patient care. There is an urgent need to recognize the increasing burden of COPD in women and to facilitate global improvements in disease prevention and management in this specific population. Many individuals with COPD follow a trajectory of both lung function decline and also multimorbidity. Unfavourable lung function trajectories throughout life have implications for later development of other chronic diseases. An enhanced understanding of the temporal associations underlying the development of coexisting diseases is a crucial first step in unravelling potential common disease pathways. Lessons can be learned from exploring disease trajectories of other NCD as well as multimorbidity development. Further research will be essential to explain how early life risk factors commonly influence trajectories of COPD and other diseases, how different diseases develop in relation to each other in a temporal way and how this ultimately leads to different multimorbidity patterns in COPD. This review integrates new knowledge and ideas pertaining to three broad themes (i) the overall burden of disease in COPD, (ii) an unappreciated high burden in women and (iii) the contrast of COPD trajectories and different multimorbidity patterns with trajectories of other NCD. The underlying pathology of COPD is largely irreversible, but many factors noted in the review are potentially amenable to intervention. Health and social care systems need to ensure that effective treatment is accessible to all people with the condition. Preventive strategies and treatments that alter the course of disease are crucial, particularly for patients with COPD as one of many problems.
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Affiliation(s)
- Sara C Buttery
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Maéva Zysman
- Centre de Recherche cardio-thoracique de Bordeaux, Univ-Bordeaux, Pessac, France.,Service des Maladies Respiratoires, CHU Bordeaux, Pessac, France
| | - Sigrid A A Vikjord
- Department of Medicine and Rehabilitation, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.,HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Levanger, Norway
| | | | - Christine Jenkins
- Respiratory Group, The George Institute for Global Health, Sydney, NSW, Australia
| | - Lowie E G W Vanfleteren
- COPD Center, Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Philip KE, Lewis A, Jeffery E, Buttery S, Cave P, Cristiano D, Lound A, Taylor K, Man WDC, Fancourt D, Polkey MI, Hopkinson NS. Moving singing for lung health online in response to COVID-19: experience from a randomised controlled trial. BMJ Open Respir Res 2020; 7:e000737. [PMID: 33239406 PMCID: PMC7689537 DOI: 10.1136/bmjresp-2020-000737] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/29/2020] [Accepted: 10/21/2020] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Singing for lung health (SLH) is a popular arts-in-health activity for people with long-term respiratory conditions. Participants report biopsychosocial benefits, however, research on impact is limited. The 'SLH: Improving Experiences of Lung Disease trial', a randomised controlled, single (assessor) blind, trial of 12 weeks SLH versus usual care for people with chronic obstructive pulmonary disease (COPD) (n=120) was setup to help to address this. The first group (n=18, nine singing and nine controls) started face-to-face (five sessions) before changing to online delivery (seven sessions) due to COVID-19-related physical distancing measures. As such, the experience of this group is here reported as a pilot study to inform further research in this area. METHODS We conducted semistructured interviews and thematic analysis regarding barriers, facilitators and key considerations for transitioning from face-to-face to online delivery. Pilot quantitative outcomes include attendance, premeasures and postmeasures of quality of life and disease impact (Short Form 36 Health Survey, COPD Assessment Test score), breathlessness (Medical Research Council breathlessness scale, Dyspnoea-12), depression (Patient Health Questionnaire-9, PHQ-9), anxiety (Generalised Anxiety Disorder-7), balance confidence (Activity specific Balance Confidence, ABC scale) and physical activity (clinical visit PROactive physical activity in COPD tool, combining subjective rating and actigraphy). RESULTS Attendance was 69% overall, (90% of the face-to-face sessions, 53% online sessions). Analysis of semistructured interviews identified three themes regarding participation in SLH delivered face to face and online, these where (1) perceived benefits; (2) digital barriers (online) and (3) digital facilitators (online). Findings were summarised into key considerations for optimising transitioning singing groups from face-to-face to online delivery. Pilot quantitative data suggested possible improvements in depression (treatment effect -4.78 PHQ-9 points, p<0.05, MCID 5) and balance confidence (treatment effect +17.21 ABC scale points, p=0.04, MCID 14.2). DISCUSSION This study identifies key considerations regarding the adaptation of SLH from face-to-face to online delivery. Pilot data suggest online group singing for people with COPD may deliver benefits related to reducing depression and improved balance confidence.
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Affiliation(s)
- Keir Ej Philip
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | | | - Edmund Jeffery
- Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Sara Buttery
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Phoene Cave
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Daniele Cristiano
- Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Adam Lound
- Respiratory Medicine, Imperial College Healthcare NHS Trust, London, UK
| | - Karen Taylor
- Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - William D-C Man
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, UK
| | - Michael I Polkey
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Nicholas S Hopkinson
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK
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Philip KEJ, Lewis A, Williams S, Buttery SC, Polkey MI, Man W, Fancourt D, Hopkinson NS. Dance for people with chronic respiratory disease: a qualitative study. BMJ Open 2020; 10:e038719. [PMID: 33051234 PMCID: PMC7554453 DOI: 10.1136/bmjopen-2020-038719] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To explore the experiences and perceived impact on health and well-being related to participation in a dance group for people with chronic respiratory disease (CRD). DESIGN An exploratory qualitative study using thematic analysis of semistructured interviews. SETTING A community dance group in a UK health centre. PARTICIPANTS Convenience sample of long-term dance group participants. INTERVENTION Weekly community dance sessions designed for people with breathlessness, lasting 75 min, led by a trained community dance leader. RESULTS Convenience sample of eight participants, six females, aged 57-87 years (mean 75), with a median 2-year attendance at weekly dance sessions. Long-term attendance was driven by strongly held beliefs regarding the health and well-being benefits of participation. Four key themes were identified: dance as (1) a holistically beneficial activity, with physical and psychosocial health benefits including improved or maintained physical fitness and psychological well-being, and reduced need for healthcare; (2) an integral part of their life; (3) an enjoyable activity; and (4) a source of deep social cohesion. CONCLUSIONS Dance group participants perceived a broad range of health benefits of relevance to the biopsychosocial impacts of their respiratory disease. The themes identified are useful in the ongoing planning and evaluation of dance as a holistic complex intervention for people with CRD. Further research is required to assess the extent of health impacts identified, and how dance might be most effectively placed as an option in the management of CRD. TRIAL REGISTRATION NUMBER NCT04006015.
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Affiliation(s)
- Keir Elmslie James Philip
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton & Harefield NHS Foundation Trust, London, UK
| | - Adam Lewis
- Department of Health Sciences, Brunel University London, Uxbridge, UK
| | - Sian Williams
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | - Michael I Polkey
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton & Harefield NHS Foundation Trust, London, UK
| | - William Man
- Respiratory Medicine, Royal Brompton & Harefield NHS Foundation Trust, London, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London Research Department of Epidemiology and Public Health, London, UK
| | - Nicholas S Hopkinson
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton & Harefield NHS Foundation Trust, London, UK
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Stanwell-Smith R. A notable anniversary for the Nightingale effect. Perspect Public Health 2020; 140:126-127. [DOI: 10.1177/1757913920912358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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