Health inequity: Possibilities of initiating pulmonary telerehabilitation programs for adults with chronic obstructive pulmonary disorders in conflict and low-resourced
Suad J. Ghaben, Arimi Fitri Mat Ludin, Badr Elkholi, Reem Kullab, Majd Al-Hour, Devinder Kaur Ajit Singh
Abstract
The “triple problems of COPD”—underdiagnosis, underrecognition, and underdevelopment of pulmonary rehabilitation programs—are global. Pulmonary telerehabilitation (PTR) may solve these problems.
Introduction
Chronic Obstructive Pulmonary Disorder (COPD) is the third and sixth leading cause of death [1] and disability [2] worldwide, affecting 4% of the population, with higher prevalence and mortality in Lower- and Middle-Income Countries (LMICs) [2,3]. The impact of conflicts on health communities leads to a high incidence of injuries and a lack of disease prevention and health promotion for noncommunicable diseases such as COPD.
Materials and methods
This mixed-methods study integrated quantitative and qualitative research and pragmatism [44,45], to generate a comprehensive understanding of the phenomena [46,47] related to the unavailability of outpatient PR programs in conflict low-resourced areas, and the possibility of launching alternative PTR programs.
Results
The study results were derived from document analysis, questionnaires, and IDI. These results were triangulated in the Convergent parallel MMR triangulation model.
Discussion
This study highlighted the environmental and professional challenges, opportunities, and characteristics of initiating PTR in a conflict and low-resource area. It also outlined the national, institutional, and professional factors that influence the initiation of PTR.
Conclusion
This study addressed the challenges and opportunities of launching PTR in areas of conflict and low resources, like the occupied territory. The primary issues preventing service needs and TR’s establishment were national, institutional, and professional issues, such as the nonpriority in MoH practice and the fragmented COPD patient management.
Citation: Ghaben SJ, Mat Ludin AF, Elkholi B, Kullab R, Al-Hour M, Singh DKA (2025) Health inequity: Possibilities of initiating pulmonary telerehabilitation programs for adults with chronic obstructive pulmonary disorders in conflict and low-resourced areas; A mixed-method phenomenological study. PLoS One 20(5): e0324624. https://doi.org/10.1371/journal.pone.0324624
Editor: Diphale Joyce Mothabeng, University of Pretoria, SOUTH AFRICA
Received: August 17, 2024; Accepted: April 28, 2025; Published: May 29, 2025
Copyright: © 2025 Ghaben et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All relevant data are within the paper and its Supporting Information files.
Funding: The author(s) received no specific funding for this work.
Competing interests: The authors have declared that no competing interests exist.
