Abstract
<title>Abstract</title> <p>Background The incidence of pulmonary hypertension (PH) is significantly higher in high-altitude environments, where disease progression is also more rapid. Pulmonary rehabilitation (PR) is a core intervention for improving functional status in patients with chronic respiratory diseases. However, a systematic PR program specifically tailored for patients with PH in high-altitude areas is currently lacking. Objective To develop a PR program suitable for patients with PH in the Qinghai-Tibet Plateau region of China, thereby providing a scientific and feasible basis for clinical intervention. Methods A Delphi method was employed. An initial draft of the program was formulated through literature review and research team discussions. Seventeen experts were recruited to participate in two rounds of consultation. Experts rated the importance and feasibility of each item using a 5-point Likert scale and provided suggestions for modification. Consensus criteria were defined as mean score > 3.5, full-mark percentage > 20%, and coefficient of variation (CV) < 0.25. Results The effective response rates for the two rounds were 100% and 88.24%, respectively, and the expert authority coefficient was 0.835. After two rounds of consultation, the mean importance scores of items ranged from 4.13 to 5.00, the mean feasibility scores ranged from 3.87 to 4.67, and all CV were < 0.25. The Kendall’s coefficients of concordance for all items increased from the first round to the second round, with values of 0.221 for importance and 0.197 for feasibility in the second round (both P < 0.001). The final program encompasses six domains, including multidisciplinary team, rehabilitation assessment, exercise prescription, health education, psychological support, and follow-up management, and comprises 6 first-level items, 27 second-level items, and 57 third-level items. Conclusion The PR program developed in this study for patients with PH in high-altitude areas demonstrates both environmental adaptability and clinical operability, providing a key reference framework for implementing PR in high-altitude areas.</p>