Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada.
McGill Research Centre for Physical Activity and Health, Faculty of Education, McGill University, Montreal, Quebec, Canada.
COPD. 2020 Oct;17(5):543-556. doi: 10.1080/15412555.2020.1798373. Epub 2020 Aug 18.
This study described the participation in daily and social activities and the perceived barriers and facilitators to participation of individuals with chronic obstructive pulmonary disease (COPD). Individuals, recruited from outpatient clinics, responded to a survey on their participation in, and barriers and facilitators towards, 26 daily and social activities, divided into 3 categories: (1) physical activity and movement (PAM); (2) self-care; and (3) social engagement. For each activity, chi-square analyses were used to examine participation differences by individuals': quartiles of airflow obstruction [percent predicted forced expiratory volume in 1 second (FEV1%predicted)] and breathlessness burden and exacerbation risk. Of the 200 participants (47% women; mean ± standard deviation age = 68 ± 9 years), most wanted to increase their participation in PAM activities (range 21-75%) and significant differences were found in 5/10 PAM activities for individuals' breathlessness burden and exacerbation risk (e.g., more individuals than expected in group A (modified Medical Research Council breathlessness score <2 and 0-1 exacerbations in past 12 months) as much as they wanted (χ=20.43, Cramer's =.23)). Regardless of the degree of airflow obstruction or breathlessness burden and exacerbation risk, the most common barrier to participation was breathlessness (<.001, η=.86) and the most common facilitator was engaging as part of their routine (<.001, η=.75). Individuals with COPD want to increase their participation in daily and social activities but are limited by breathlessness. Strategies to alleviate breathlessness should be identified/prioritized and incorporated into individuals' daily routines to meet their self-reported participation objectives in daily and social activities.
本研究描述了慢性阻塞性肺疾病（COPD）患者参与日常和社交活动的情况，以及他们对参与这些活动的障碍和促进因素的感知。研究人员从门诊患者中招募了参与者，让他们对 26 项日常和社交活动的参与情况以及障碍和促进因素进行了调查，这些活动分为 3 类：（1）身体活动和运动（PAM）；（2）自我护理；（3）社交参与。对于每项活动，研究人员都使用卡方分析来检查个体的以下方面的参与差异：（1）气流阻塞的四分位数[预计 1 秒用力呼气量占预计值的百分比（FEV1%predicted）]；（2）呼吸困难负担和加重风险。在 200 名参与者中（47%为女性；平均年龄±标准差为 68±9 岁），大多数参与者希望增加他们在 PAM 活动中的参与度（范围为 21%-75%），并且在 10 项 PAM 活动中的 5 项中，个体的呼吸困难负担和加重风险存在显著差异（例如，与预期相比，A 组（改良的医学研究委员会呼吸困难评分<2，过去 12 个月中 0-1 次加重）中的个体希望（χ=20.43，Cramer's =.23））。无论气流阻塞程度、呼吸困难负担和加重风险如何，参与活动的最大障碍是呼吸困难（<.001，η=.86），最大的促进因素是将活动纳入日常活动（<.001，η=.75）。COPD 患者希望增加他们在日常和社交活动中的参与度，但受到呼吸困难的限制。应确定/优先考虑缓解呼吸困难的策略，并将其纳入个体的日常生活中，以满足他们对日常和社交活动参与的自我报告目标。
