Pulmonary Rehabilitation Research Group, Department of Respiratory Medicine and Thoracic Surgery, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, England.
Pulmonary Rehabilitation Research Group, Department of Respiratory Medicine and Thoracic Surgery, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, England.
Chest. 2011 Dec;140(6):1534-1539. doi: 10.1378/chest.10-2649. Epub 2011 Jul 7.
Self-efficacy explores the emotional functioning and coping skills of an individual and is thought to be a strong predictor of health behaviors, which is particularly important for pulmonary rehabilitation (PR). However, to our knowledge, there is no measure of self-efficacy developed to explore behavior change in the context of PR.
We investigated the reproducibility and sensitivity of Pulmonary Rehabilitation Adapted Index of Self-Efficacy (PRAISE): a tool adapted from the General Self-Efficacy Scale (GSES) to measure the dimension of self-efficacy at the time of a course of PR. Twenty-nine clinically stable patients with COPD completed PRAISE on their initial assessment to PR. The tool was then completed 7 days later. An additional 225 patients completed PRAISE prior to, and on completion of a 7-week course of PR. In addition, exercise capacity was measured by the incremental shuttle walk test (ISWT), with the Medical Research Council (MRC) dyspnea scale, Chronic Respiratory Questionnaire-Self Reported (CRQ-SR), and Hospital Anxiety and Depression Scale (HADS) also being collected. This process was repeated postrehabilitation. Data were then analyzed to investigate the possibility that PRAISE could be an indicator of PR response.
In the reproducibility study, the mean change in score was 0.72 (95% CI, -2.27-0.82), examined with intraclass correlation coefficients, r = 0.99; indicating PRAISE test-retest reproducibility. The mean change of score in the sensitivity study pre- to post-PR was 3.59 (95% CI, 2.24-4.73; P = .015). Change in the ISWT was 83.44 m (95% CI, 54.0-112.8; P < .0001). There were several statistically significant differences between variables, particularly with the mastery and emotion elements of the CRQ-SR at baseline, but this was lost post-PR. This observation was also found with HADS. No significant differences were found between MRC dypsnea scale grades with the change in PRAISE score. PRAISE could not predict a successful outcome of PR.
The PRAISE tool is a reliable and sensitive measure of self-efficacy for patients with COPD attending PR.
自我效能感探讨了个体的情绪功能和应对技能，被认为是健康行为的强有力预测因素，这对肺康复（PR）尤为重要。然而，据我们所知，目前尚无针对 PR 背景下行为改变的自我效能感测量工具。
我们研究了肺康复适应自我效能感指数（PRAISE）的可重复性和敏感性：该工具是从一般自我效能感量表（GSES）改编而来，用于测量 PR 期间自我效能感的维度。29 名临床稳定的 COPD 患者在 PR 初始评估时完成了 PRAISE。7 天后，再次完成该工具。另外 225 名患者在 7 周 PR 课程之前和完成后完成了 PRAISE。此外，还通过递增穿梭步行测试（ISWT）测量了运动能力，同时还收集了医学研究委员会（MRC）呼吸困难量表、慢性呼吸系统问卷自我报告（CRQ-SR）和医院焦虑和抑郁量表（HADS）。康复后重复这些过程。然后分析数据，以探讨 PRAISE 是否可以作为 PR 反应的指标。
在可重复性研究中，平均得分为 0.72（95%置信区间，-2.27-0.82），通过组内相关系数 r = 0.99 进行检查，表明 PRAISE 测试重测的可靠性。PR 前后敏感研究中得分的平均变化为 3.59（95%置信区间，2.24-4.73；P =.015）。ISWT 增加了 83.44 米（95%置信区间，54.0-112.8；P <.0001）。基线时，变量之间存在几个统计学上的显著差异，特别是 CRQ-SR 的掌握和情绪元素，但 PR 后就没有了。这一观察结果也在 HADS 中发现。MRC 呼吸困难量表等级与 PRAISE 评分变化之间无显著差异。PRAISE 不能预测 PR 的成功结果。
PRAISE 工具是评估 COPD 患者参加 PR 时自我效能感的可靠和敏感工具。
