BREATHLEssness in INDIA (BREATHE-INDIA): realist review to develop explanatory programme theory about breathlessness self-management in India DOI Creative Commons
Joseph Clark, Naveen Salins,

Mithili Sherigar

и другие.

npj Primary Care Respiratory Medicine, Год журнала: 2025, Номер 35(1)

Опубликована: Март 13, 2025

Abstract Breathlessness is highly prevalent in low and middle-income countries (LMICs). Low-cost, non-drug, breathlessness self-management interventions are effective high-income countries. However, health beliefs influence acceptability have not been explored LMIC settings. Review with stakeholder engagement to co-develop explanatory programme theories for whom, if, how might work community settings India. Iterative systematic searches identified peer-reviewed articles, policy media, expert-identified sources. Data were extracted terms of contribution theory (high, medium, low), developed groups (doctors, nurses allied professionals, people lived experiences, lay workers) an International Steering Group (RAMESES guidelines (PROSPERO42022375768)). One hundred four data sources 11 workshops produced 8 initial 3 consolidated theories. (1) Context: common due illness, environment, lifestyle. Cultural shape misunderstandings about breathlessness; hereditary, part aging, linked asthma. It stigmatised poorly understood as a treatable issue. People often use rest, incense, or tea, while avoiding physical activity fear worsening breathlessness. Trusted voices, such healthcare workers members, can help address misconceptions clear, simple messages. (2) intervention applicability: nonpharmacological across different contexts when they unhelpful behaviours. Introducing concepts like “too much rest leads deconditioning” aligns cultural norms promoting beneficial behavioural changes, gradual activity. Acknowledging medical issue key improving patient family well-being. (3) Implementation: community-based trusted but need simple, low-cost resources/skills integrated into existing training. Education should focus on managing acute episodes daily breathlessness, reducing fear, encouraging change. Evidence-based tools vital gain support from policymakers expand implementation. management India must integrate symptom alongside public disease treatment strategies. Self-management be implemented setting. our novel methods indicate that understanding the context implementation essential so addressed at point delivery.

Язык: Английский

Delivering remote pulmonary rehabilitation in Bangladesh: a mixed-method feasibility study DOI Creative Commons
GM Monsur Habib, Md. Nazim Uzzaman, Roberto Rabinovich

и другие.

Journal of Global Health, Год журнала: 2025, Номер 15

Опубликована: Фев. 13, 2025

Abstract Background Pulmonary rehabilitation (PR) is an effective and essential component of care for the increasing number individuals with chronic respiratory diseases (CRDs). Despite benefits, it remains underutilised poorly accessible in low- middle-income countries (LMICs). We aimed to determine feasibility delivering PR Bangladesh at home because pandemic travel restrictions. Methods Aligned Medical Research Council framework development evaluation complex interventions, we recruited CRDs from Community Respiratory Centre, Khulna, a mixed-methods study. assessed their functional exercise capacity quality life before after eight-week course PR, conducted semi-structured interviews providers professional stakeholders by using topic guide aligned normalisation process theory (NPT) interpreting findings within its constructs. Results 51 out 61 referred patients range CRDs, whom 44 (86%) completed ≥70% course. Functional capacity, measured endurance shuttle walk test, improved 78% patients, 48% exceeding minimum clinically important difference (MCID). Health-related life, Chronic Obstructive Disease Assessment Test, more than MCID 83% patients. Through interviews, found that encountered challenges remote video supervision due unstable internet connections, forcing them resort telephone calls. The strength support NPT constructs varied; many participants understood appreciated role could make sense innovation (NPT-1), most were assessing potential service decide if was worthwhile (NPT-4). Participants not yet ready endorse or actively (NPT-2) operationalise (NPT-3) roll-out PR. Conclusions A programme, supported monitoring, feasible Bangladesh, but local evidence will be needed promote implementation.

Язык: Английский

Процитировано

0
BREATHLEssness in INDIA (BREATHE-INDIA): realist review to develop explanatory programme theory about breathlessness self-management in India DOI Creative Commons
Joseph Clark, Naveen Salins,

Mithili Sherigar

и другие.

npj Primary Care Respiratory Medicine, Год журнала: 2025, Номер 35(1)

Опубликована: Март 13, 2025

Abstract Breathlessness is highly prevalent in low and middle-income countries (LMICs). Low-cost, non-drug, breathlessness self-management interventions are effective high-income countries. However, health beliefs influence acceptability have not been explored LMIC settings. Review with stakeholder engagement to co-develop explanatory programme theories for whom, if, how might work community settings India. Iterative systematic searches identified peer-reviewed articles, policy media, expert-identified sources. Data were extracted terms of contribution theory (high, medium, low), developed groups (doctors, nurses allied professionals, people lived experiences, lay workers) an International Steering Group (RAMESES guidelines (PROSPERO42022375768)). One hundred four data sources 11 workshops produced 8 initial 3 consolidated theories. (1) Context: common due illness, environment, lifestyle. Cultural shape misunderstandings about breathlessness; hereditary, part aging, linked asthma. It stigmatised poorly understood as a treatable issue. People often use rest, incense, or tea, while avoiding physical activity fear worsening breathlessness. Trusted voices, such healthcare workers members, can help address misconceptions clear, simple messages. (2) intervention applicability: nonpharmacological across different contexts when they unhelpful behaviours. Introducing concepts like “too much rest leads deconditioning” aligns cultural norms promoting beneficial behavioural changes, gradual activity. Acknowledging medical issue key improving patient family well-being. (3) Implementation: community-based trusted but need simple, low-cost resources/skills integrated into existing training. Education should focus on managing acute episodes daily breathlessness, reducing fear, encouraging change. Evidence-based tools vital gain support from policymakers expand implementation. management India must integrate symptom alongside public disease treatment strategies. Self-management be implemented setting. our novel methods indicate that understanding the context implementation essential so addressed at point delivery.

Язык: Английский

Процитировано

0