Understanding the Pulmonary Function Testing Experience: A Qualitative Study in Patient-Centered Education.

Abstract

Pulmonary function tests (PFTs) are essential for evaluating respiratory disease but are often accompanied by limited patient education. There is a lack of data describing how patients experience PFTs and what they need to feel prepared. Inadequate pre-test counseling may contribute to anxiety, poor patient understanding, and resultant suboptimal test performance. What are patients' experiences with PFTs, and how can these insights inform the content of a patient-centered educational pamphlet optimized for clinical use and ease of readability? We conducted a multiphase study at a large academic safety-net hospital. Initial pamphlet development drew on a targeted literature review, observation of PFTs, and firsthand PFT experience. We held six patient focus groups, one clinician focus group, and one respiratory therapist interview. Transcripts underwent rapid content analysis to identify themes and refine the pamphlet iteratively. Readability of the final pamphlet was assessed with the Simple Measure of Gobbledygook (SMOG) and Flesch-Kincaid grade-level tools. Four major themes emerged: (1) emotional responses (anxiety, shame), (2) physical demands, (3) expectation-experience mismatches, and (4) clinician interactions. Patients reported inadequate pre-test information about logistics and PFT maneuvers. They viewed the pamphlet favorably and suggested clearer wording, more visuals, and varied delivery formats, which informed revisions. The final pamphlet measured SMOG grade 6 and Flesch-Kincaid grade 7, aligning with American Medical Association recommendations. Our findings reveal a previously under-recognized problem: patients undergoing PFTs face substantial informational, emotional, and physical challenges that are rarely documented. A concise, user-centered pamphlet co-developed with patient and clinician input may improve understanding and reduce anxiety. Future studies should evaluate the impact of such patient educational materials on PFT result quality and post-test patient outcomes.