Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Department of Nursing, Haining People's Hospital, Haining, Zhejiang Province, China.
Sci Rep. 2023 Dec 21;13(1):22929. doi: 10.1038/s41598-023-50099-z.
The aim of this study was to evaluate whether a theory-based behavior change intervention could promote changes in physical activity (PA) and sedentary behavior (SB) among patients with chronic obstructive pulmonary disease (COPD), as well as its effects on symptoms of dyspnea, lung function, exercise capacity, self-efficacy, and health-related quality of life (HRQoL). A quasi-experimental design and convenience sampling were adopted. A total of 92 patients with stable COPD were recruited from outpatient and inpatient centers of two hospitals in Zhejiang Province, China. Both the experimental and control groups received standard medical care provided in the hospital. The experimental group performed a PA program based on the behavior change wheel theory. Outcomes were measured at baseline (T0) and after 4 weeks (T1), 8 weeks (T2), and 12 weeks of the intervention (T3). The primary outcome was PA measured by the International Physical Activity Questionnaire (IPAQ). Secondary outcomes included SB measured by the IPAQ, dyspnea measured by the modified Medical Research Council (mMRC) questionnaire, exercise capacity assessed by 6-min walk distance (6MWD), self-efficacy measured by the Exercise Self-Regulatory Efficacy Scale (EX-SRES), and HRQoL measured by the COPD Assessment Test (CAT). In addition, we measured lung function using a spirometer at baseline and 12 weeks. Of the 89 patients included in this study, 64 were male (71.91%), with a mean age of 67.03 ± 6.15 years. At 12 weeks, the improvements in PA, SB, mMRC, 6MWD, EX-SRES and CAT were all statistically significant (P < 0.05) in the experimental group compared to the control group. Repeated measures analysis of variance showed that there were group effects and time effects on total PA, SB, mMRC, 6MWD, EX-SRES, and CAT in both groups (P < 0.001). However, there was no significant difference in pulmonary function between the two groups before and after intervention (P < 0.05). The PA program based on theory significantly increased PA levels, reduced sedentary time, enhanced exercise capacity and self-efficacy as well as HRQoL in patients with stable COPD. Due to the limited intervention time in this study, the pulmonary function of COPD patients may not be reversed in a short time, and the long-term effect of this program on the pulmonary function of patients needs to be further explored.Trial registration: Clinical Trials.gov (ChiCTR2200060590). Registered 05/06/2022.
本研究旨在评估基于理论的行为改变干预措施是否可以促进慢性阻塞性肺疾病(COPD)患者的体力活动(PA)和久坐行为(SB)的改变,以及其对呼吸困难症状、肺功能、运动能力、自我效能感和健康相关生活质量(HRQoL)的影响。采用准实验设计和便利抽样法。从中国浙江省两家医院的门诊和住院中心共招募了 92 名稳定期 COPD 患者。实验组和对照组均接受医院提供的标准医疗护理。实验组根据行为改变轮理论进行 PA 方案。在干预前(T0)和 4 周(T1)、8 周(T2)和 12 周(T3)时测量结局。主要结局是通过国际体力活动问卷(IPAQ)测量的 PA。次要结局包括 IPAQ 测量的 SB、改良医学研究委员会(mMRC)问卷测量的呼吸困难、6 分钟步行距离(6MWD)评估的运动能力、运动自我调节效能感量表(EX-SRES)测量的自我效能感以及 COPD 评估测试(CAT)测量的 HRQoL。此外,我们在基线和 12 周时使用肺活量计测量肺功能。本研究共纳入 89 例患者,其中 64 例为男性(71.91%),平均年龄 67.03±6.15 岁。在 12 周时,实验组在 PA、SB、mMRC、6MWD、EX-SRES 和 CAT 方面的改善均明显优于对照组(P<0.05)。重复测量方差分析显示,两组的总 PA、SB、mMRC、6MWD、EX-SRES 和 CAT 均存在组间效应和时间效应(P<0.001)。然而,两组患者干预前后的肺功能无显著差异(P<0.05)。基于理论的 PA 方案可显著提高稳定期 COPD 患者的 PA 水平,减少久坐时间,增强运动能力和自我效能感,改善 HRQoL。由于本研究干预时间有限,短期内可能无法逆转 COPD 患者的肺功能,该方案对患者肺功能的长期影响有待进一步探讨。试验注册:ClinicalTrials.gov(ChiCTR2200060590)。注册于 2022 年 5 月 6 日。