“我没有动力”：一项针对有冠心病和抑郁症状人群进行身体活动的障碍和促进因素的定性研究。
"I don't have the heart": a qualitative study of barriers to and facilitators of physical activity for people with coronary heart disease and depressive symptoms.
机构信息
Heart Research Centre, The Royal Melbourne Hospital, PO Box 2137, Post Office, Melbourne, VIC, 3050, Australia.
出版信息
Int J Behav Nutr Phys Act. 2012 Nov 30;9:140. doi: 10.1186/1479-5868-9-140.
BACKGROUND
Physical activity has been shown to reduce depression in people with coronary heart disease (CHD), however many people with CHD do not engage in sufficient levels of physical activity to reap its positive effects. People with depression and CHD are at particular risk of non-adherence to physical activity. Little is known about the barriers to and facilitators of physical activity for people with CHD and depressive symptoms. Using qualitative interviews, the aim of this study was to explore the barriers to and facilitators of physical activity for cardiac patients with depressive symptoms.
METHODS
Fifteen participants with CHD and depressive symptoms (assessed using the Cardiac Depression Scale) participated in in-depth semi-structured interviews. The interviews were focussed on investigating participants' experiences of physical activity since their cardiac event. Interviews were content analysed to determine major themes.
RESULTS
Participants identified a number of barriers to and facilitators of physical activity. Barriers included having negative perceptions towards health and life changes as a result of the cardiac event, having low mood and low motivation to exercise, feeling physically restricted towards or fearful of exercise, lacking knowledge regarding exercise and perceiving external barriers. Facilitators included having a reason for exercising, being able to identify the psychological benefits of exercise, having positive social support and using psychological strategies. 'Inactive' participants reported more barriers and fewer facilitators than did 'active' participants.
CONCLUSIONS
The barriers reported in this study were highly salient for a number of participants. Health professionals and researchers can use this information to assist people with CHD and depressive symptoms to identify and possibly overcome barriers to physical activity. Relevant barriers and facilitators could be taken into account to increase their effectiveness when designing interventions to encourage physical activity maintenance in this population.
背景
已有研究表明，身体活动可降低冠心病（CHD）患者的抑郁程度，然而，许多 CHD 患者的身体活动量并未达到足以产生积极效果的水平。患有抑郁症和 CHD 的人群特别容易出现身体活动不依从的情况。对于同时患有 CHD 和抑郁症状的人群，他们进行身体活动的障碍因素和促进因素知之甚少。本研究采用定性访谈的方法，旨在探讨冠心病合并抑郁症状患者进行身体活动的障碍因素和促进因素。
方法
15 名 CHD 合并抑郁症状（采用心脏病抑郁量表评估）的患者参与了深入的半结构化访谈。访谈重点关注参与者在发生心脏事件后进行身体活动的经历。对访谈内容进行了内容分析，以确定主要主题。
结果
参与者确定了一些进行身体活动的障碍因素和促进因素。障碍因素包括由于心脏事件，对健康和生活变化产生负面看法、情绪低落且缺乏锻炼的动力、对运动感到身体受限或恐惧、缺乏有关运动的知识并认为存在外部障碍。促进因素包括有锻炼的理由、能够识别运动的心理益处、拥有积极的社会支持以及使用心理策略。与“活跃”参与者相比，“不活跃”参与者报告的障碍因素更多，促进因素更少。
结论
本研究报告的障碍因素对许多参与者来说非常重要。健康专业人员和研究人员可以利用这些信息帮助患有 CHD 和抑郁症状的人群识别并可能克服身体活动的障碍。在设计旨在鼓励该人群保持身体活动的干预措施时，可以考虑相关的障碍因素和促进因素，以提高其效果。
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