Fernández-Sánchez María C, Ruiz-López Francisco J, Ros-Lucas José A, Andújar-Espinosa Rubén, Del Coso Juan, García-Pastor Teresa
Pneumology Unit, Internal Medicine Service, Rafael Mendez Hospital, Lorca, Spain.
Pneumonology Service, Arrixaca University Hospital, Murcia, Spain.
Chronic Obstr Pulm Dis. 2024 May 29;11(3):270-281. doi: 10.15326/jcopdf.2023.0456.
Daily physical activity is part of the self-management of patients with chronic obstructive pulmonary disease (COPD), and didactic information sessions may be insufficient for the provision of these skills. Prior activation can determine sensitivity to these sessions. We evaluated whether the activation in patients with COPD, as measured by the Patient Activation Measure (PAM)-13 questionnaire, determined their responses to an educational group session on physical activity (PA), which were measured with actigraphy by the number of steps/day.
We conducted an uncontrolled clinical trial in an outpatient clinic with 75 patients with nonexacerbating COPD (forced expiratory volume in 1 second 30%-80%) who were selected consecutively. Patients were provided with an actigraph that they used for 15 days and completed the PAM-13 questionnaire. On the eighth day, they attended a group educational session where they were given PA information. We compared the changes in activity after the session by pooled PAM levels and the correlation between the change in the number of steps/day and the PAM-13 questionnaire.
A total of 26 patients had activation levels of 1-2, while 49 patients had levels of 3-4. After the session, patients in Levels 1-2 decreased their number of steps (-596±42), while those in Levels 3-4 increased them (680±253, <0.01). The level of activation was positively correlated with change in the number of steps/day (<0.05).
COPD patients with greater activation showed greater improvements in daily PA after a group educational session.
日常身体活动是慢性阻塞性肺疾病（COPD）患者自我管理的一部分，单纯的教学信息课程可能不足以提供这些技能。预先激活可以决定对这些课程的敏感度。我们评估了通过患者激活量表（PAM）-13问卷测量的COPD患者的激活程度是否决定了他们对关于身体活动（PA）的教育小组课程的反应，该反应通过活动记录仪记录的每日步数来衡量。
我们在一家门诊诊所对75例非急性加重期COPD患者（一秒用力呼气容积为30%-80%）进行了一项非对照临床试验，这些患者是连续入选的。为患者提供了一个活动记录仪，他们使用15天，并完成PAM-13问卷。在第8天，他们参加了一次小组教育课程，在那里他们获得了PA信息。我们通过合并的PAM水平比较了课程后活动的变化，以及每日步数变化与PAM-13问卷之间的相关性。
共有26例患者的激活水平为1-2级，而49例患者的激活水平为3-4级。课程结束后，1-2级的患者步数减少（-596±42），而3-4级的患者步数增加（680±253，P<0.01）。激活水平与每日步数变化呈正相关（P<0.05）。
激活程度较高的COPD患者在小组教育课程后，日常PA改善更大。
