Response shift in COPD patients undertaking pulmonary rehabilitation

Introduction/Aim: Chronic Obstructive Pulmonary Disease(COPD) is a condition known to cause significant disability and impact a person's quality of life. For adults with COPD, pulmonary rehabilitation is a proven non-pharmacological intervention that enhances health and physical functioning and these changes are known as response shift. This qualitative study sought to better comprehend the response shift phenomenon from COPD patients' perspectives and under-stand how any cognitive change occurs in recalibrating their internal values, reconceptualising and reprioritising aspects of their life during a pulmonary rehabilitation program. Methods: A qualitative study using a descriptive approach through semi-structured face-to-face interviews was con-ducted with COPD patients to build an understanding of change in a patient's health and social values during pulmonary rehabilitation. Ethical approval for the study was granted from the Research and Ethics Committee of South Western Sydney Local Health District (LNR/14/LPOOL/566HE14/327) and the Western Sydney University's Human Research Ethics Committee (H11024).Results: 11 interviews were conducted at three time points: beginning of pulmonary rehabilitation, midway through the pulmonary rehabilitation program and end of program. Three themes were evident from transcripts and pertained to key personal drivers:- Personal commitment to self; personal commitment to others; reassessment of personal goals. Conclusion: Response shift was driven by personal needs associated with social commitments. When progression of disease confounded the progress towards personal goals, personal beliefs were challenged, and reassessment of beliefs and life goals occurred.