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Liao Y, Yu J, Zhan Y, Liu Y, Zhou Y, Wang H, Liu X, Wang W, Ma Y, Lan F. Motivating factors for physical activity participation among individuals with chronic obstructive pulmonary disease: A qualitative study applying the motivation, opportunity, and ability model. PLoS One 2024; 19:e0303858. [PMID: 38781270 PMCID: PMC11115224 DOI: 10.1371/journal.pone.0303858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 05/02/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE The study aims to explore the driving forces behind physical activity engagement among patients with chronic obstructive pulmonary disease, focusing on motivation, opportunity, and capability. DESIGN A phenomenological qualitative study applied the motivation, opportunity, and capability model, conducted in two respiratory units of a Chinese university hospital. METHODS Participants, selected by age, gender, and illness duration, included inpatients during the interview sessions and those recently discharged within six months. One-on-one semi-structured interviews were recorded, transcribed, and analyzed by the Colaizzi seven-step method. RESULTS Seventeen participants diagnosed with chronic obstructive pulmonary disease for over one year aged between 66 (range: 42-96) participated. Three major themes were identified: Inspiring participation motivation-transitioning from recognizing significance to habit formation; Offering participation opportunities-reiterating demand for personalized strategies and ideal environmental settings; Enhancing participation capability-addressing strategies for overcoming fears, setting goals, ensuring safety, and adjusting activity levels. CONCLUSIONS This research underscores the vital role of inspiring participation motivation, offering opportunities, and enhancing the capability for participation in effective engagement. Advocating increased attention from healthcare departments, fostering interdisciplinary collaboration, improving activity guidance and counseling effectiveness, and considering individual preferences can significantly benefit those patients with chronic obstructive pulmonary disease who hesitate or are unable to participate in physical activities, thereby increasing the dose of non-leisure time physical activity.
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Affiliation(s)
- Yuanyu Liao
- Nursing Department, Tongji Medical College Affiliated Union Hospital, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Jiaohua Yu
- Nursing Department, Tongji Medical College Affiliated Union Hospital, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yuxin Zhan
- Department of Neurosurgery, Tongji Medical College Affiliated Union Hospital, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yunfang Liu
- Department of Thoracic Surgery, Tongji Medical College Affiliated Union Hospital, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yaoling Zhou
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
- School of Nursing, Huanggang Polytechnic College, Huanggang, Hubei Province, China
| | - Huan Wang
- Department of Thoracic Surgery, Tongji Medical College Affiliated Union Hospital, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xinghong Liu
- Department of Cardiovascular Surgery, Tongji Medical College Affiliated Union Hospital, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Weiwei Wang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yu Ma
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Fenfen Lan
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
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Nyberg A, Sondell A, Lundell S, Marklund S, Tistad M, Wadell K. Experiences of Using an Electronic Health Tool Among Health Care Professionals Involved in Chronic Obstructive Pulmonary Disease Management: Qualitative Analysis. JMIR Hum Factors 2023; 10:e43269. [PMID: 36995743 PMCID: PMC10131608 DOI: 10.2196/43269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/13/2022] [Accepted: 02/26/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is one of the most common and deadliest chronic diseases of the 21st century. eHealth tools are seen as a promising way of supporting health care professionals in providing evidence-based COPD care, for example, by reinforcing information and interventions provided to the patients and providing easier access and support to the health care professional themselves. Still, knowledge is scarce on the experience of using eHealth tools from the perspective of the health care professional involved in COPD management. OBJECTIVE The study explored the experiences of using an eHealth tool among health care professionals that worked with patients with COPD in their daily clinical practice. METHODS This exploratory qualitative study is part of a process evaluation in a parallel group, controlled, pragmatic pilot trial. Semistructured interviews were performed with 10 health care professionals 3 and 12 months after getting access to an eHealth tool, the COPD Web. The COPD Web, developed using cocreation, is an interactive web-based platform that aims to help health care professionals provide health-promoting strategies. Data from the interviews were analyzed using qualitative content analysis with an inductive approach. RESULTS The main results reflected health care professionals' experiences in 3 categories: receiving competence support and adjusting practice, improving quality of care, and efforts required for implementation. These categories highlighted that using an eHealth tool such as the COPD Web was experienced to provide knowledge support for health care professionals that led to adaptation and facilitation of working procedures and person-centered care. Taken together, these changes were perceived to improve the quality of care through enhanced patient contact and encouragement of interprofessional collaboration. In addition, health care professionals expressed that patients using the COPD Web were better equipped to tackle their disease and adhered better to provided treatment, increasing their self-management ability. However, structural and external barriers bar the successful implementation of an eHealth tool in daily praxis. CONCLUSIONS This study is among the first to explore experiences of using an eHealth tool among health care professionals involved in COPD management. Our novel findings highlight that using an eHealth tool such as the COPD Web may improve the quality of care for patients with COPD (eg, by providing knowledge support for health care professionals and adapting and facilitating working procedures). Our results also indicate that an eHealth tool fosters collaborative interactions between patients and health care professionals, which explains why eHealth is a valuable means of encouraging well-informed and autonomous patients. However, structural and external barriers requiring time, support, and education must be addressed to ensure that an eHealth tool can be successfully implemented in daily praxis. TRIAL REGISTRATION ClinicalTrials.gov NCT02696187; https://clinicaltrials.gov/ct2/show/NCT02696187.
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Affiliation(s)
- André Nyberg
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
| | - Anna Sondell
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
| | - Sara Lundell
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
| | - Sarah Marklund
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
| | - Malin Tistad
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Karin Wadell
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
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Reilly C, Sails J, Stavropoulos-Kalinoglou A, Birch RJ, McKenna J, Clifton IJ, Peckham D, Birch KM, Price OJ. Physical activity promotion interventions in chronic airways disease: a systematic review and meta-analysis. Eur Respir Rev 2023; 32:32/167/220109. [PMID: 36697208 PMCID: PMC9879326 DOI: 10.1183/16000617.0109-2022] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 11/02/2022] [Indexed: 01/27/2023] Open
Abstract
Physical inactivity is common in people with chronic airways disease (pwCAD) and associated with worse clinical outcomes and impaired quality of life. We conducted a systematic review and meta-analysis to characterise and evaluate the effectiveness of interventions promoting step-based physical activity (PA) in pwCAD. We searched for studies that included a form of PA promotion and step-count outcome measure. A random-effects model was used to determine the overall effect size using post-intervention values. 38 studies (n=32 COPD; n=5 asthma; n=1 bronchiectasis; study population: n=3777) were included. Overall, implementing a form of PA promotion resulted in a significant increase in step-count: median (IQR) 705 (183-1210) when compared with usual standard care: -64 (-597-229), standardised mean difference (SMD) 0.24 (95% CI: 0.12-0.36), p<0.01. To explore the impact of specific interventions, studies were stratified into subgroups: PA promotion+wearable activity monitor-based interventions (n=17) (SMD 0.37, p<0.01); PA promotion+step-count as an outcome measure (n=9) (SMD 0.18, p=0.09); technology-based interventions (n=12) (SMD 0.16, p=0.01). Interventions promoting PA, particularly those that incorporate wearable activity monitors, result in a significant and clinically meaningful improvement in daily step-count in pwCAD.
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Affiliation(s)
- Caroline Reilly
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Joe Sails
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | | | - Rebecca J. Birch
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK
| | - Jim McKenna
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Ian J. Clifton
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK,Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Daniel Peckham
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK,Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Karen M. Birch
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, UK
| | - Oliver J. Price
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK,Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK,School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, UK,Corresponding author: Oliver J. Price ()
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Orme MW, Jayamaha AR, Santin L, Singh SJ, Pitta F. A Call for Action on Chronic Respiratory Diseases within Physical Activity Policies, Guidelines and Action Plans: Let's Move! INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16986. [PMID: 36554866 PMCID: PMC9779594 DOI: 10.3390/ijerph192416986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/09/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
Global policy documents for the promotion of physical activity (PA) play an important role in the measurement, evaluation, and monitoring of population PA levels. The World Health Organisation (WHO) guidelines include, for the first time, recommendations for specific populations, including individuals living with a range of non-communicable diseases. Of note, is the absence of any chronic respiratory diseases (CRDs) within the recommendations. Globally, CRDs are highly prevalent, are attributable to significant individual and societal burdens, and are characterised by low PA. As a community, there is a need to come together to understand how to increase CRD representation within global PA policy documents, including where the evidence gaps are and how we can align with PA research in other contexts. In this commentary, the potential for synergy between evidence into the relationships between PA in CRDs globally and the relevance to current policies, guidelines and action plans on population levels of PA are discussed. Furthermore, actions and considerations for future research, including the need to harmonize and promote PA assessment (particularly in low- and middle-income countries) and encompass the synergistic influences of PA, sedentary behaviour and sleep on health outcomes in CRD populations are presented.
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Affiliation(s)
- Mark W. Orme
- Department of Respiratory Sciences, University of Leicester, Leicester LE1 7RH, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory, University Hospitals of Leicester NHS Trust, Leicester LE3 9QP, UK
| | - Akila R. Jayamaha
- Department of Respiratory Sciences, University of Leicester, Leicester LE1 7RH, UK
- Department of Research and Development, Faculty of Nursing, KAATSU International University, Battaramulla 10120, Sri Lanka
| | - Lais Santin
- Laboratory of Research in Respiratory Physiotherapy, Health Sciences Center, Universidade Estadual de Londrina, Londrina 86057-970, Brazil
| | - Sally J. Singh
- Department of Respiratory Sciences, University of Leicester, Leicester LE1 7RH, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory, University Hospitals of Leicester NHS Trust, Leicester LE3 9QP, UK
| | - Fabio Pitta
- Laboratory of Research in Respiratory Physiotherapy, Health Sciences Center, Universidade Estadual de Londrina, Londrina 86057-970, Brazil
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Xiang X, Huang L, Fang Y, Cai S, Zhang M. Physical activity and chronic obstructive pulmonary disease: a scoping review. BMC Pulm Med 2022; 22:301. [PMID: 35932050 PMCID: PMC9354440 DOI: 10.1186/s12890-022-02099-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 07/31/2022] [Indexed: 11/25/2022] Open
Abstract
Background Reduced physical activity (PA) was the strongest predictor of all-cause mortality in patients with chronic obstructive pulmonary disease (COPD). This scoping review aimed to map the evidence on the current landscape of physical activity, barriers and facilitators, and assessment tools across COPD patients. Methods Arksey and O’Malley’s scoping review methodology framework guided the conduct of this review. An electronic search was conducted on five English databases (PubMed, Cochrane Library, PsycINFO, CINAHL and Web of Science) and three Chinese databases (CNKI, CQVIP and WAN-FANG) in January 2022. Two authors independently screened the literature, extracted the studies characteristics. Results The initial search yielded 4389 results, of which 1954 were duplicates. Of the remaining 135 articles, 42 studies met the inclusion criteria. Among the reviewed articles, there were 14 (33.3%) cross-sectional study, 9 (21.4%) cohort study, 4 (9.5%) longitudinal study, 3 qualitative study, 12 (28.7%) randomized control trials. The main barriers identified were older age, women, lung function, comorbidities, COPD symptoms (fear of breathlessness and injury, severe fatigue, anxiety and depression), GOLD stage, frequency of exacerbation, oxygen use, lack of motivation and environment-related (e.g., season and weather). Twelve studies have evaluated the effects of physical exercise (e.g., walking training, pulmonary rehabilitation (PR), pedometer, self-efficacy enhancing intervention and behavioral modification intervention) on PA and showed significant positive effects on the prognosis of patients. However, in real life it is difficult to maintain PA in people with COPD. Conclusions Changing PA behavior in patients with COPD requires multidisciplinary collaboration. Future studies need to identify the best instruments to measure physical activity in clinical practice. Future studies should focus on the effects of different types, time and intensity of PA in people with COPD and conduct randomized, adequately-powered, controlled trials to evaluate the long-term effectiveness of behavioral change interventions in PA. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-02099-4.
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Affiliation(s)
- Xinyue Xiang
- Department of Nursing, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Lihua Huang
- Department of Nursing, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
| | - Yong Fang
- Department of Nursing, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Shasha Cai
- Department of Nursing, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Mingyue Zhang
- Department of Nursing, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
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Mihaltan F, Rajnoveanu RM, Arghir OC, Alecu S, Postolache PA. High 24-Hour Respiratory Symptoms and Low Physical Activity in the Stable COPD Romanian Cohort of SPACE Study. Int J Chron Obstruct Pulmon Dis 2021; 16:2533-2544. [PMID: 34522093 PMCID: PMC8433128 DOI: 10.2147/copd.s321197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 08/23/2021] [Indexed: 11/23/2022] Open
Abstract
Objective This study assessed the characteristics and the relationship between symptoms in any part of the 24-hour (24-h) day, physical activity level (PAL), and other clinical and functional outcomes in stable COPD patients. Patients and Methods Out of the 2162 patients enrolled in the SPACE study (The Symptoms and Physical Activity in COPD patients in Europe, clinicaltrials.gov NCT03031769), 406 (18.8%) were recruited from Romania. Here, we present the Romanian cohort results. Eligible patients were adults with age at least 40 years, confirmed diagnosis of stable COPD, current or former smokers with a smoking history of minimum 10 pack-years. The 24-h respiratory symptoms were assessed using Early Morning Symptoms of COPD Instrument (EMSCI), Evaluating Respiratory Symptoms in COPD (E-RS™: COPD) and Nighttime Symptoms of COPD Instrument (NiSCI). During clinical interview, patients self-evaluated PAL through Exercise as Vital Sign (EVS) and Yale Physical Activity Survey (YPAS). Physicians assessed PAL through their clinical judgment. Results For each combination of 2 between the early morning (EM), daytime (DT) and night-time (NT) symptoms of the 24-h day, there was a significant association (p < 0.001 for each). All symptoms significantly correlated with exacerbation history (p < 0.001 for EM and NT, p=0.002 for DT), and number of severe exacerbations (p < 0.001 for DT, p=0.001 for EM and p=0.026 for NT, respectively). The 24-h symptoms correlated negatively and significantly with PAL (p < 0.001), irrespective of the assessment used. Self-reported PAL negatively correlated with dyspnea, symptom burden, severity of disease and number of exacerbations (p < 0.001). Patients spent an average (standard deviation) of 25.8 (21.0) hours/week performing physical activity. Physicians overestimated their patients' daily PAL. Conclusion A negative and significant correlation between the 24-h day symptoms and PAL was identified in stable COPD patients. Physicians need to routinely assess PAL using adequate tools and start educating inactive COPD patients to optimize their disease outcomes.
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Affiliation(s)
- Florin Mihaltan
- Pneumology Department, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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