Selzler Anne-Marie, Rodgers Wendy M, Berry Tanya R, Stickland Michael K
Faculty of Physical Education and Recreation, University of Alberta.
Division of Pulmonary Medicine, Department of Medicine, University of Alberta.
Rehabil Psychol. 2016 Nov;61(4):380-388. doi: 10.1037/rep0000106.
Pulmonary rehabilitation (PR) improves functional exercise capacity and health status in people with chronic obstructive pulmonary disease (COPD), although these outcomes are often not maintained following PR. Self-efficacy is a precursor to outcomes achievement, yet few studies have examined the importance of self-efficacy to outcome improvement during PR, or how it develops over time. Further, the contribution of exercise-specific self-efficacy to outcomes in PR is unknown. The aims of this study were to determine (a) whether baseline exercise self-efficacy predicts PR attendance and change in functional exercise capacity and health status over PR, and (b) if exercise self-efficacy changes with PR.
Fifty-eight out of 64 patients with COPD completed PR and assessments of exercise self-efficacy (task, coping, scheduling), the 6-minute walk test (6MWT), and St. George's Respiratory Questionnaire (SGRQ) at the beginning and end of PR. Analyses were conducted to predict attendance, and change in 6MWT and SGRQ, while controlling for baseline demographic and clinical indicators. Change in 6MWT, SGRQ, and self-efficacy with PR was also examined.
Clinically significant increases in the 6MWT and SGRQ were achieved with PR. Stronger task self-efficacy predicted better attendance, while stronger coping self-efficacy predicted greater 6MWT improvement. No variables predicted SGRQ change. Scheduling self-efficacy significantly improved with PR, whereas task and coping self-efficacy did not.
Baseline exercise self-efficacy appears to be a determinant of rehabilitation attendance and functional exercise improvement with PR. Clinicians should evaluate and target exercise self-efficacy to maximize adherence and health outcome improvement with PR. (PsycINFO Database Record
肺康复（PR）可改善慢性阻塞性肺疾病（COPD）患者的功能运动能力和健康状况，尽管这些结果在PR后往往难以维持。自我效能感是取得良好结果的前提，但很少有研究探讨自我效能感对PR期间结果改善的重要性，或其随时间的变化情况。此外，特定运动自我效能感对PR结果的贡献尚不清楚。本研究的目的是确定：（a）基线运动自我效能感是否能预测PR的参与情况以及PR期间功能运动能力和健康状况的变化；（b）运动自我效能感是否会随PR而改变。
64例COPD患者中有58例完成了PR，并在PR开始和结束时进行了运动自我效能感（任务、应对、计划）、6分钟步行试验（6MWT）和圣乔治呼吸问卷（SGRQ）的评估。在控制基线人口统计学和临床指标的同时进行分析，以预测参与情况、6MWT和SGRQ的变化。还研究了6MWT、SGRQ和自我效能感随PR的变化。
PR使6MWT和SGRQ有临床意义的增加。更强的任务自我效能感预测更好的参与情况，而更强的应对自我效能感预测6MWT有更大改善。没有变量能预测SGRQ的变化。计划自我效能感随PR显著改善，而任务和应对自我效能感没有。
基线运动自我效能感似乎是PR参与情况和功能运动改善的决定因素。临床医生应评估并针对运动自我效能感，以最大限度地提高PR的依从性和改善健康结果。（PsycINFO数据库记录）
