Asthmatic patients' views of a comprehensive asthma rehabilitation programme: a three-year follow-up

Twenty-one asthmatic patients aged 27-59 years, with mild to moderate asthma, participated in a 10-week group rehabilitation programme covering physical training and theoretical and practical education in medication, self-management strategies and physiotherapy. This study was undertaken retrospectively to investigate (1) the patients' reasons for joining the programme, (2) their experiences of the programme, and (3) their ways of coping with disease-related problems before joining and three years after completion of the programme.

Patients were followed up every six months for three years and were interviewed after the three years. The semi-structured interviews were tape-recorded, transcribed and revised.

The life-situation of most of the patients before the 10-week programme was characterized by helplessness at exacerbations, anxiety/insecurity about medications and their side-effects, and/or concern about future health. More than half of the subjects felt physical limitations in daily life or when exercising. All wished to increase their knowledge of asthma by joining the programme, but only nine patients expected asthma improvement. The experience that they were able to carry out physical exercise to a maximal intensity and that physical training improved their asthma, with increased knowledge about medications were mentioned by all as the most valuable effects of the programme. Moreover, most patients emphasized their increased ability in self-management strategies (stress reduction and breathing technique). The increased knowledge and improved practical skills contributed to a better life-situation after the rehabilitation. After the three years virtually all the patients' lives were characterized by improved self-management, increased physical activity and a sense of security. Almost half of them expressed a wish to take responsibility for the disease.

In addition to medical therapy and education, physical training and techniques for relaxation and breathing should form part of the treatment of asthma.