Pellegrini Christine A, Ledford Gwendolyn, Chang Rowland W, Cameron Kenzie A
a Department of Preventive Medicine , Northwestern University , Chicago , IL , USA.
b Department of Exercise Science , University of South Carolina , Columbia , SC , USA.
Disabil Rehabil. 2018 Aug;40(17):2004-2010. doi: 10.1080/09638288.2017.1323026. Epub 2017 May 5.
We sought to identify patient-reported barriers and facilitators to healthy eating and physical activity among patients before or after knee arthroplasty.
Twenty patients with knee osteoarthritis aged 40-79 years who had knee arthroplasty surgery scheduled or completed within 3 months were interviewed. Interview topics included perceived barriers and facilitators to healthy eating and activity before or after surgery. Interviews were coded and analyzed using constant comparative analysis.
Interviews were completed with 11 pre-operative (67.1 ± 7.6 years, 45.5% female, BMI 31.2 ± 6.3) and nine post-operative patients (61.7 ± 11.7 years, 44.4% female, BMI 30.2 ± 4.7 kg/m). The most commonly identified personal barriers to healthy eating identified were desire for high-fat/high-calorie foods, managing overconsumption and mood. Factors related to planning, portion control and motivation to improve health were identified as healthy eating facilitators. Identified personal barriers for activity included pain, physical limitations and lack of motivation, whereas facilitators included having motivation to improve knee symptoms/outcomes, personal commitment to activity and monitoring activity levels.
Identifying specific eating and activity barriers and facilitators, such as mood and motivation to improve outcomes, provides critical insight from the patient perspective, which will aid in developing weight management programs during rehabilitation for knee arthroplasty patients. Implications for rehabilitation This study provides insight into the identified barriers and facilitators to healthy eating and physical activity in knee arthroplasty patients, both before and after surgery. Intrapersonal barriers that may hinder engagement in physical activity and rehabilitation include pain, physical limitations and lack of motivation; factors that may help to improve activity and the rehabilitation process include being motivated to improve knee outcomes, having a personal commitment to activity and tracking activity levels. Barriers that may interfere with healthy eating behaviors and knee arthroplasty rehabilitation include the desire for high-fat/high-calorie foods, overeating and mood; whereas planning and portion control may help to facilitate healthy eating. Understanding barriers and facilitators to healthy eating and physical activity can help guide rehabilitation professionals with their discussions on weight management with patients who had or are contemplating knee arthroplasty.
我们试图确定膝关节置换术前或术后患者报告的健康饮食和体育活动的障碍及促进因素。
对20例年龄在40 - 79岁、计划在3个月内进行或已完成膝关节置换手术的膝骨关节炎患者进行访谈。访谈主题包括手术前后健康饮食和活动的感知障碍及促进因素。采用持续比较分析法对访谈内容进行编码和分析。
对11例术前患者（年龄67.1±7.6岁，女性占45.5%，BMI为31.2±6.3）和9例术后患者（年龄61.7±11.7岁，女性占44.4%，BMI为30.2±4.7kg/m²）完成了访谈。确定的健康饮食最常见个人障碍是对高脂肪/高热量食物的渴望、控制过量饮食和情绪问题。与计划、分量控制及改善健康的动机相关的因素被确定为健康饮食的促进因素。确定的活动个人障碍包括疼痛、身体限制和缺乏动力，而促进因素包括改善膝关节症状/结果的动机、对活动的个人承诺以及监测活动水平。
识别特定的饮食和活动障碍及促进因素，如情绪和改善结果的动机，从患者角度提供了关键见解，这将有助于为膝关节置换患者制定康复期间的体重管理计划。对康复的启示 本研究深入了解了膝关节置换患者手术前后健康饮食和体育活动的已识别障碍及促进因素。可能阻碍参与体育活动和康复的个人障碍包括疼痛、身体限制和缺乏动力；可能有助于改善活动和康复过程的因素包括改善膝关节结果的动机、对活动的个人承诺以及跟踪活动水平。可能干扰健康饮食行为和膝关节置换康复的障碍包括对高脂肪/高热量食物的渴望、暴饮暴食和情绪问题；而计划和分量控制可能有助于促进健康饮食。了解健康饮食和体育活动的障碍及促进因素有助于指导康复专业人员与接受或考虑进行膝关节置换的患者讨论体重管理问题。
