Assessment of Respiratory Therapists’ Knowledge and Attitudes Toward Pulmonary Rehabilitation, Patient Education, and Home Health Care in Reducing COPD Readmissions

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) is a profound global public health issue, recognized as a progressive and debilitating respiratory condition characterized by persistent airflow limitation, leading to frequent, acute exacerbations and high rates of costly hospital readmission. Non-pharmacological interventions, such as Pulmonary Rehabilitation (PR), patient education, and home health care, have emerged as essential strategies, validated by numerous systematic reviews for their efficacy in mitigating symptom burden, significantly improving patients' health-related quality of life, and reducing recurrent hospital utilization. Respiratory Therapists (RTs) are uniquely positioned to deliver these complex, multidisciplinary services. However, the consistent and effective implementation of PR is often hindered by systemic barriers, including limited awareness and a shortage of trained personnel. Therefore, this study aimed to evaluate the current knowledge and attitudes of respiratory therapists regarding the integral roles of pulmonary rehabilitation, patient education, and home health care in effectively reducing hospital readmission rates among patients with COPD

Methodology: A quantitative, cross-sectional study design was implemented. The research was conducted within the respiratory services at a Tertiary Hospital , targeting adult RTs with at least six months of clinical experience across various high-acuity and chronic care units, including intensive care, wards, and pulmonary rehabilitation. Data was gathered from participating RTs using a validated questionnaire by Wu et al. that systematically assessed 10 knowledge items and 10 attitude items related to PR and COPD management strategies.

Results: The quantitative cross-sectional study successfully surveyed 92 respiratory therapists. The demographic analysis of the surveyed RTs revealed a professional workforce, with a balanced gender split (50% male, 50% female) , a high rate of Bachelor’s degree attainment (64.13%) , and extensive experience, as over half of the respondents reported seven or more years of experience (57.61%). The findings indicated a fundamental strong professional attitude toward these services, with a majority (57.61%) agreeing that reducing COPD readmissions is a critical measure of care quality (Q18). Despite this strong intent, the study identified significant, actionable knowledge and operational deficiencies: a critical deficit was found in the ability to effectively document interventions to track patient outcomes (Q10), with over half of RTs (53.26%) expressing disagreement with their proficiency in this area. Furthermore, a notable resistance to modernizing care delivery was observed, as 42.39% actively disagreed that telehealth is a valuable tool for follow-up and education (Q14). Knowledge scores also displayed high variability across the sample regarding evidence-based PR standards, such as the main components (Q1) and recommended frequency/duration (Q3) of the program.

Conclusion: This assessment establishes that the RT workforce possesses a high level of professional commitment to implementing pulmonary rehabilitation and patient education in COPD management. However, the efficacy of these programs is severely constrained by specific, critical gaps. The most substantial barrier identified is the lack of proficiency in outcome-focused documentation, which directly impedes the ability to measure and justify the value of respiratory services. Furthermore, the resistance to telehealth adoption and the inconsistent knowledge of PR operational standards pose immediate threats to optimizing care delivery and reducing hospital readmissions. Strategically addressing these specific knowledge and technological deficiencies is paramount for empowering RTs, enhancing clinical outcomes, and ensuring the sustainability of high-quality COPD care.