Evidence map›Paper›PMID 40695532›Full record

ArticleBMJ open respiratory research2025

How to culturally adapt the pulmonary rehabilitation programme for people living with COPD in Sri Lanka: a qualitative study.

Chamilya Perera, Akila Jayamaha, Mark Orme, Thamara Dilhani Amarasekara, Zainab Yusuf, Amy Barradell, James Manifield, Andy Barton, Ravini Karunathilake, Amitha Fernando and 2 more

Abstract read
In one paragraph

Article in BMJ open respiratory research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Chamilya PereraDepartment of Respiratory Science, University of Leicester, Leicester, UK chp22@leicester.ac.uk.ORCID http://orcid.org/0000-0001-6239-033X
Akila JayamahaDepartment of Respiratory Science, University of Leicester, Leicester, UK.
Mark OrmeDepartment of Respiratory Science, University of Leicester, Leicester, UK.
Thamara Dilhani AmarasekaraNursing and Midwifery, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.ORCID http://orcid.org/0000-0003-0191-0973
Zainab YusufBMJ, London, UK.
Amy BarradellCentre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory, University Hospitals of Leicester NHS Trust, Leicester, UK.
James ManifieldDepartment of Respiratory Science, University of Leicester, Leicester, UK.
Andy BartonDepartment of Respiratory Science, University of Leicester, Leicester, UK.
Ravini KarunathilakeCentral Chest Clinic, Colombo, Sri Lanka.
Amitha FernandoCentral Chest Clinic, Colombo, Sri Lanka.
Savithri Wasundara WimalasekeraUniversity of Sri Jayewardenepura Faculty of Medical Sciences, Nugegoda, Sri Lanka.
Sally J SinghDepartment of Respiratory Science, University of Leicester, Leicester, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPulmonary rehabilitation (PR) is a low-cost, high-impact intervention for people living with chronic obstructive pulmonary disease (COPD). Despite the high prevalence of COPD, there are currently very limited facilities to provide PR in Sri Lanka. The views of people living with COPD, their caregivers and relevant healthcare professionals (HCPs) are essential to develop culturally appropriate PR, acceptable in a Sri Lankan setting.

objectivesWe aimed to explore the lived experiences of key stakeholders on the development and implementation of culturally appropriate PR in Sri Lanka. METHODOLOGY: A qualitative study was conducted at the Central Chest Clinic (CCC), Sri Lanka. Focus group discussions (FGDs) and semistructured interviews (SSIs) were conducted with the three populations: people living with COPD, their caregivers and relevant HCPs. After audio recording, transcribing and translating, the data were analysed using thematic analysis.

resultsThree FGDs comprising 11 adults with COPD (9 males, age range 39-83 years), three FGDs comprising five family caregivers (three females), three FGDs comprising 14 nurses and 12 SSIs with doctors and physiotherapists were conducted, representing diverse ethnic groups. Two overarching themes were generated: 'PR adaptations' and 'Barriers to PR implementation and adherence'. Within 'PR adaptations', four subthemes were generated: the educational component of PR, nutritional support, psychological support and the use of music during PR sessions. Under 'Barriers to PR implementation and adherence', three subthemes were generated: barriers and issues in participating, need for better medical facilities and difficulty in conducting exercises.

conclusionCulturally tailoring PR for people living with COPD in Sri Lanka should include the integration of singing, music and nutritional support, as it may enhance acceptability. Barriers, including a lack of resources to deliver PR, difficulties encountered by patients attending PR sessions and perceived difficulties in performing standardised PR exercises, need to be addressed when developing a culturally appropriate programme in Sri Lanka.

Indexed as

Culturally Competent CarePulmonary Disease, Chronic ObstructiveAdultAgedAged, 80 and overCaregiversFemaleFocus GroupsHumansMaleMiddle AgedQualitative ResearchSri LankaPulmonary Disease, Chronic ObstructivePulmonary Rehabilitation

Identifiers

PMID40695532
PMCPMC12281325

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.