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COPD is a debilitating lung condition, one of the main aims of pulmonary rehabilitation (PR) is to improve the quality of life for patients who have been diagnosed with COPD. The challenge for PR is that many patients fail to complete or engage. An intervention underpinned by social identity theory through group goal setting was developed and delivered by trained PR staff. It is believed that this encourages patients to interact and support each other and work as a team in order to achieve mutually agreed goals. However, there is an absence of research evidence to guide current practice. Methods: 84 patients enrolled in an 8-week PR programme and were recruited into pilot randomised trial to provide feasibility information on whether PR sessions based on a social identity theory intervention were acceptable to patients and would improve health-related quality of life. In depth analysis of patient’s perception of the social identity theory intervention was undertaken through focus group to explore issues such as acceptability. Interviews were transcribed verbatim. Results: Thematic analysis revealed that there was a positive social and motivational experience associated with the social identity theory intervention. The intervention promoted bonding, togetherness, friendship and support. Conclusion: The preliminary findings lend support for the development of a group-based identity intervention for creating a rehabilitation environment that was socially and motivationally inclusive. Findings suggest that group identity can help COPD patients collectively comply with exercise prescription during PR and could help promote sustainable exercise engagement.

Objectives COPD is a debilitating lung condition that affects lives in the UK. One of the main aims of pulmonary rehabilitation (PR) is to improve the quality of life for patients who have been diagnosed with COPD. The challenge for PR is that many patients do not complete or engage with the programme. Healthcare professionals delivering PR believe that patients who are working together as part of a group (intervention) may better attend and engage with PR. An intervention underpinned by social identity theory through group goal setting was developed to be delivered by trained rehabilitation staff. It is believed that this encourages patients to interact and support each other and work as a team during PR in order to achieve mutually agreed goals. However, there is an absence of research evidence to guide such desired changes to current practice. Methods 84 patients enrolled in an 8 week PR programme and were recruited into pilot randomised trial to provide feasibility information on whether PR sessions based on a social identity theory intervention were acceptable to patients and would improve health-related quality of life. In depth analysis of patient’s perception of the social identity theory intervention was undertaken through focus group interviews to explore issues such as acceptability. Interviews were transcribed verbatim. Results Inductive thematic analysis revealed that there was a positive social and motivational experience associated with the social identity theory intervention. The intervention promoted bonding, togetherness, friendship and support. In addition, the interviews indicated that patients understood the objectives of the intervention which they associated with enjoyment, pride, learning from others, greater persistence and engagement with staff. Staff were of the opinion that the intervention was easy to implement with an exception of the need to delay the starting dates for patients in order to accrue sufficient group numbers. Conclusions The preliminary findings lend support for the development of a group-based identity intervention for creating a rehabilitation environment that was socially and motivationally inclusive. Findings suggest that group identity can help COPD patients collectively comply with exercise prescription during PR and could help promote sustainable exercise engagement.

BackgroundChronic obstructive pulmonary disease (COPD) is a degenerative condition that can impair health-related quality of life (HRQoL). A number of self-management interventions, employing a variety of behavioural change techniques (BCTs), have been adopted to improve HRQoL for COPD patients. However, a lack of attention has been given to group management interventions with an emphasis on incorporating BCTs into rehabilitators' practice. This study aims to pilot and feasibly explore a social identity group management intervention, delivered by COPD rehabilitation staff to patients attending exercise pulmonary rehabilitation. Doing so will help inform the plausibility of the intervention before conducting a full trial to evaluate its effectiveness to improve HRQoL.MethodsThis is a two-centre, randomised cross-over controlled trial. Two pulmonary rehabilitation centres based in the UK will be randomly allocated to two treatment arms (standard care and intervention). Outcome measurements relating to HRQoL and social identity will be completed pre- and post-exercise rehabilitation. Focus group interviews will be conducted at the end of exercise rehabilitation to capture participants' contextualised experiences of the intervention. COPD rehabilitators will undertake semi-structured interviews at the end of the trial to garner their holistic perspectives of intervention fidelity and implementation.DiscussionThis is the first study to adopt a social identity approach to develop a rehabilitator-led, group management intervention for COPD patients attending exercise pulmonary rehabilitation. The results of this study will provide evidence for the feasibility and sample size requirements to inform a larger study, which can ascertain the intervention's effectiveness for improving HRQoL for COPD patients.Trial registrationClinicalTrials.gov NCT02288039. Date 31 October 2014.