Promoting exercise and physical activity, and decreasing inactivity has been recommended as a key component of care for people with respiratory disease. This is mostly achieved through pulmonary rehabilitation programmes (exercise, education and self-management) and there is evidence that these are effective for people with Chronic Obstructive Pulmopnary Disease (COPD) [Bolton et al 2013].
This PhD project will help to identify key approaches to optimise results from Pulmopmary Rehabilitation programmes for patients with COPD. Currently not all patients referred to pulmonary rehabilitation attend for assessment or enroll in the programme after assessment, and dropouts and non-adherence rates are high [Steiner et al 2016]. There is an urgent need to identify key ways to optimise participation in and outcomes from Pulmonary Rehabilitation.
To identify reasons for poor uptake, retention, non-adherence and decline of Pulmonary Rehabilitation programmes in Northern Ireland and identify key strategies which could optimise results from Pulmonary Rehabilitation.
*To identify reasons for poor uptake, retention, non-adherence and decline of pulmonary rehabilitation
*To evaluate pulmonary rehabilitation services including the impact on important patient outcomes e.g. exercise capacity and quality of life
*To identify key realistic strategies to promote engagement and participation in evidenced based pulmonary rehabilitation.
Methods Study 1. An in-depth analysis of existing Pulmonary Rehabilitation programmes in Northern Ireland will be conducted using a qualitative study (using Focus Group methodology). This will include providers of pulmonary rehabilitation, also those who attended but did not complete rehabilitation and where possible those who have been referred to programmes but who declined. Exploration will include accessibility, points of entry and the pathways through the pulmonary rehabilitation and follow on services. This will enable better understanding of the outcomes of pulmonary rehabilitation and it will identify areas of good practice as well as explore gaps and/or any areas for improvement or adaptation.
Analysis: thematic analysis.
Study 2. A cohort study to retrospectively evaluate patient engagement with pulmonary rehabilitation programmes, as well as patient outcomes. Patients with COPD (N=40) will be recruited from HSCTs in Northern Ireland that offer Pulmonary Rehabilitation. The investigation will include review of active referrals, uptake and patient through put. Outcome measures data (exercise capacity and quality of life) will be collected for patients before and after attending pulmonary rehabilitation. Analysis: descriptive and pre-post comparison.
This project will identify areas of strength and good practice that could be shared across sites delivering pulmonary rehabilitation, it will identify key strategies to optimise outcomes for patients with COPD. The PhD will provide an opportunity to work with a dynamic respiratory research team with strong links to clinical teams nationally and internationally.
How the proposals fit the Centre’s themes
Physical activity and exercise in COPD link to key research themes in CHaRT (1. intervention development and testing, and 2. physical activity). The project fits CHaRT aims by specifically exploring how we could ‘enable healthy living throughout the life span for people with long term conditions’ and informing how we could optimise pulmonary rehabilitation services to ‘support and empower patients to develop skills and strategies to manage their long term condition’.
This project will have high impact as it links to the delivery of standards of care for people with COPD from the Northern Ireland Service Framework for Respiratory health and well being (2018). Given the size of the population with COPD throughout the UK and Globally it has the potential to make significant impact given its broad reach across all settings in health care.
PhD project must be achievable
This project is achievable as the team have established links with clinical sites delivering pulmonary rehabilitation programmes and who have indicated that they are keen to support this research. The team have experience obtaining research governance and ethics approvals at the sites for previous clinical research in pulmonary rehabilitation. The population with COPD (1.2million in the UK) is available and the study sample sizes are feasible based on recent research in COPD and pulmonary rehabilitation by this team.
Please note, the successful candidate will be required to obtain AccessNI clearance prior to registration due to the nature of the project.
If the University receives a large number of applicants for the project, the following desirable criteria may be applied to shortlist applicants for interview.
The University offers the following awards to support PhD study and applications are invited from UK, EU and overseas for the following levels of support:
Full award (full-time PhD fees + DfE level of maintenance grant + RTSG for 3 years).
This scholarship will cover full-time PhD tuition fees and provide the recipient with £15,000 maintenance grant per annum for three years (subject to satisfactory academic performance). This scholarship also comes with £900 per annum for three years as a research training support grant (RTSG) allocation to help support the PhD researcher.
Part award (full-time PhD fees + 50% DfE level of maintenance grant + RTSG for 3 years).
This scholarship will cover full-time PhD tuition fees and provide the recipient with £7,500 maintenance grant per annum for three years (subject to satisfactory academic performance). This scholarship also comes with £900 per annum for three years as a research training support grant (RTSG) allocation to help support the PhD researcher.
Fees only award (PhD fees + RTSG for 3 years).
This scholarship will cover full-time PhD tuition fees for three years (subject to satisfactory academic performance). This scholarship also comes with £900 per annum for three years as a research training support grant (RTSG) allocation to help support the PhD researcher.
The scholarship will cover tuition fees at the Home rate and a maintenance allowance of £ 15,009 per annum for three years. EU applicants will only be eligible for the fee’s component of the studentship (no maintenance award is provided). For Non-EU nationals the candidate must be "settled" in the UK. This scholarship also comes with £900 per annum for three years as a research training support grant (RTSG) allocation to help support the PhD researcher.
Due consideration should be given to financing your studies; for further information on cost of living etc. please refer to: www.ulster.ac.uk/doctoralcollege/postgraduate-research/fees-and-funding/financing-your-studies
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Friday 7 February 2020
19th/20th March 2020
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