Kosteli Maria-Christina, Heneghan Nicola R, Roskell Carolyn, Williams Sarah E, Adab Peymane, Dickens Andrew P, Enocson Alexandra, Fitzmaurice David A, Jolly Kate, Jordan Rachel, Greenfield Sheila, Cumming Jennifer
School of Sport, Exercise and Rehabilitation Sciences.
Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK.
Int J Chron Obstruct Pulmon Dis. 2017 Mar 28;12:1019-1031. doi: 10.2147/COPD.S119806. eCollection 2017.
Given that physical activity (PA) has a positive impact on COPD symptoms and prognosis, this study examined the factors that both encourage and limit participation in PA for individuals with COPD in a primary care setting from the perspective of social cognitive theory.
A purposive sample of 26 individuals with a range of COPD severity (age range: 50-89 years; males =15) were recruited from primary care to participate in one of four focus groups. Thematic analysis was undertaken to identify key concepts related to their self-efficacy beliefs.
Several barriers and enablers closely related to self-efficacy beliefs and symptom severity were identified. The main barriers were health related (fatigue, mobility problems, breathing issues caused by the weather), psychological (embarrassment, fear, frustration/disappointment), attitudinal (feeling in control of their condition, PA perception, older age perception), and motivational. The main enabling factors were related to motivation (autonomous or controlled), attitudes, self-regulation, and performance accomplishments.
When designing interventions for individuals with COPD, it is important to understand the patient-specific social cognitive influences on PA participation. This information can then inform individually tailored management planning.
鉴于体育活动（PA）对慢性阻塞性肺疾病（COPD）的症状和预后有积极影响，本研究从社会认知理论的角度，探讨了在初级保健环境中，影响COPD患者参与PA的促进因素和限制因素。
从初级保健机构中选取了26名COPD严重程度各异的患者（年龄范围：50 - 89岁；男性15名）作为有目的的样本，参与四个焦点小组中的一个。采用主题分析法来确定与他们自我效能信念相关的关键概念。
确定了几个与自我效能信念和症状严重程度密切相关的障碍因素和促进因素。主要障碍因素与健康相关（疲劳、行动不便、天气引起的呼吸问题）、心理方面（尴尬、恐惧、沮丧/失望）、态度方面（对自身病情的控制感、对PA的认知、对年龄较大的认知）以及动机有关。主要促进因素与动机（自主或受控制）、态度、自我调节和行为成就有关。
在为COPD患者设计干预措施时，了解患者特定的社会认知对PA参与的影响非常重要。这些信息可用于指导个性化的管理规划。
