Well Being and Rehabilitation in Chronically Ill Patients: Structured Patient Education and Physical Exercise

Structured Patient Education in Combination With Physical Exercise as Part of the Integrated Care to Chronically Ill Patients With Chronic Obstructive Pulmonary Disease, Heart Failure and Stroke. A Randomized Controlled Intervention Trial.

This study addresses self management and maintenance of health through evaluation of a program of patient education in combination with physical training and with a structured follow-up.

It is hypothesized that such a program will:

1. improve quality of life, physical functioning, coping in everyday-life
2. reduce hospitalization and (re-)admissions for patients with chronic disease, reduce consumption of home care services and can increase consumption of general practice and physiotherapy services in primary health care.
3. improve patient satisfaction and health care providers satisfaction

Patients with chronically, long-lasting illness, have complex needs for treatment and care, which none of the service providers can fulfill on their own. Both patients and their relatives are in danger of experiencing severe lack of quality. Integrated care path programs are increasingly put into use. There is insufficient research-based documentation of the effect of such care paths.

The available documentation of different integrated care paths emphasizes early mobilization and discharge, rehabilitation in familiar surroundings, more effective communication and exchange of competence between the different service providers and educational self-management for patients as main elements in order to expect effect.

There are no studies that evaluate the effect of quality of life, functional skills and personal coping if group-based educational self management is combined with physical exercise and patients with different chronically illnesses participate in the same group.

Inclusion Criteria:

• 45 years of age or more
• Living at home
• Capable of active participation in a group setting
• Walking distance within 550 meter in 6 minutes
• Chronic obstructive pulmonary disease (COPD) I-III
• Chronic heart disease I-III
• Stroke(0-2 on Modified Rankin Scale)

Exclusion Criteria:

• Speaking and language problems or other substantial communication problems
• Unstable medical or social situation
• Participation in another science study