Step 4
Post-program evaluation
- Importance of the post-program evaluation
- The patient’s post-program evaluation
- Measurement instruments
The patient’s post-program evaluation
This evaluation consists of two parts.
Part 1
Check if the goals determined at the beginning of the program were achieved by the patient at the end of the program.
For example:
- Improved breathing
- Capable of engaging in their daily activities
- Decrease in anxiety
- Etc.
A word of caution
This verification is a very personal assessment. It doesn't give us any kind of "score", to either compare patients amongst one another or to evaluate the "measurable" benefits of the program. However, it does enable the patient to establish certain benchmark references just for themselves.
Part 2
Systematically measure the same data with all the patients using standardized and validated measurement instruments.
For example, one can measure:
- Shortness of breath (MRC scale, TDI, CRQ)
- Physical capacity (six-minute walk test, Shuttle Walk Distance Test, stress test in an exercise laboratory)
- Physical activities (questionnaires such as CHAMPS, logbook or daily notebook, accelerometer)
- Quality of life (SF-36, St. George's Hospital Respiratory Questionnaire, CRQ, Hospital Anxiety and Depression (HAD) Scale (FR) , Geriatric depression scale)
Each measurement instrument has its own particular strengths and shortcomings. Some may be self-administered, while others may require that a professional administer them.
Know the limitations...
It's important to properly understand the precise limitations of the measurement instrument (its psychometric properties; reproducibility, validity, sensitivity to change and the given minimum clinically important difference) so that one can use it properly and, especially, interpret the results in an appropriate fashion.
Compare results to verify the effectiveness of the program
This systematic evaluation enables one to determine whether the patient has responded as expected, and this, with reference to a similar group that shares the same characteristics. In addition, do the improvements achieved represent a minimum clinically important difference (MCID). This evaluation also enables one to compare results between patients and to tally the results to see if the pulmonary rehabilitation program is as effective as it should be (with reference to the data in the literature).
See the section "Measurement instruments" to learn more about the different tests that are available to evaluate patients who participate in pulmonary rehabilitation programs.