Perceptions about exercise and pulmonary rehabilitation in two Arabic Gulf countries (Iraq and State of Qatar); a qualitative study in patients with chronic obstructive pulmonary disease (COPD) and their health care providers

Abstract

Background: Pulmonary rehabilitation (PR) programmes are effective for COPD patients but are not yet established in the Gulf countries. Little is known about patient's and their health care providers' (HCP) perceptions about exercise and attitudes to participation to PR in Iraq and Qatar.

Aims: This study explored the similarities and differences between COPD patients' and their HCPs perceptions toward exercise, COPD management and participation to PR programmes in two Gulf countries with different socio-economic status.

Methods: We conducted semi-structured interviews in thirteen COPD patients (M:F=10: 3; Mean (SD) FEV₁% predicted:57.7 (14.1) ) and sixteen HCP recruited from chest clinics in Baghdad Hospital (Iraq) and Hamad Medical Corperation (Qatar).

Results: Four main themes emerged: 1) COPD patients' limited understanding of their disease and its management, 2) Lack of effective communication between HCPs and patients due to different factors, 3) HCPs suggestions about patients' lack of access to rehabilitation programmes and involvement in physical activity and 4) Patients' education level as a factor affecting management of the disease. Iraqi patients were more active due to participation to religious rituals and lack of private transportation compared to Qatari patients.

Conclusion: COPD patients and HCPs recognised the benefit of PR and willingness to establish it but there were differences in their perception about quality of information provided. The need for further education was identified in both countries.