Hendry Maggie, Williams Nefyn H, Markland David, Wilkinson Clare, Maddison Peter
Department of General Practice, Centre for Health Sciences Research/North Wales Clinical School, Cardiff University, Wrecsam, UK.
Fam Pract. 2006 Oct;23(5):558-67. doi: 10.1093/fampra/cml022. Epub 2006 May 26.
Osteoarthritis (OA) of the knee is common and disabling. Exercise is effective in reducing pain and disability, but long-term adherence to exercise regimens is disappointing, and motivation to exercise in those with OA knee is poorly understood.
To examine the views of primary care patients with OA knee towards exercise, explore factors that determine the acceptability and motivation to exercise, and to identify barriers that limit its use.
Semi-structured interviews were conducted with 22 primary care patients with OA knee, six of whom also participated in a focus group for triangulation. Transcripts were coded into categories and themes to develop a conceptual framework and typology of exercise behaviour.
Exercise behaviour depended upon physical capacity to exercise; exercise beliefs and other factors such as enjoyment, social support, priority setting and context. Four types of patients were identified: 'long-term sedentary' who had never exercised; 'long-term active' who continued to exercise; 'exercise retired' who used to exercise, but had stopped because of their symptoms, and because they believed that exercise was damaging their joints; and 'exercise converted' who recently started to exercise, and preferred a gym because of the supervision and social support they received there.
Several physical, cognitive and contextual factors, and a typology of exercise behaviour were identified that could be addressed in primary care consultations. The importance of gyms and GP referral schemes for people who are exercising for the first time, and the high level of patient satisfaction associated with these were highlighted.
膝关节骨关节炎（OA）很常见且会导致残疾。运动对于减轻疼痛和残疾有效，但长期坚持运动方案的情况却不尽人意，而且对于膝骨关节炎患者运动的动机了解甚少。
研究初级保健中膝骨关节炎患者对运动的看法，探究决定运动可接受性和动机的因素，并识别限制运动使用的障碍。
对22名初级保健中的膝骨关节炎患者进行了半结构化访谈，其中6人还参加了一个焦点小组以进行三角验证。访谈记录被编码为类别和主题，以建立运动行为的概念框架和类型学。
运动行为取决于运动的身体能力、运动信念以及其他因素，如乐趣、社会支持、优先级设定和环境。识别出四种类型的患者：“长期久坐不动者”，从未运动过；“长期运动者”，继续运动；“运动退役者”，过去运动，但因症状以及认为运动会损害关节而停止运动；“运动转变者”，最近开始运动，且因在健身房获得监督和社会支持而更喜欢健身房。
确定了几个身体、认知和环境因素以及一种运动行为类型学，可在初级保健咨询中加以解决。强调了健身房和全科医生转诊计划对于首次运动者的重要性，以及与之相关的高度患者满意度。
