Barriers and enablers of physical activity engagement for patients with COPD in primary care

Abstract

BackgroundGiven that physical activity (PA) has a positive impact on COPD symptoms and prognosis, this study examined the factors that both encourage and limit participation in PA for individuals with COPD in a primary care setting from the perspective of social cognitive theory.MethodsA purposive sample of 26 individuals with a range of COPD severity (age range: 50–89 years; males =15) were recruited from primary care to participate in one of four focus groups. Thematic analysis was undertaken to identify key concepts related to their self-efficacy beliefs.ResultsSeveral barriers and enablers closely related to self-efficacy beliefs and symptom severity were identified. The main barriers were health related (fatigue, mobility problems, breathing issues caused by the weather), psychological (embarrassment, fear, frustration/disappointment), attitudinal (feeling in control of their condition, PA perception, older age perception), and motivational. The main enabling factors were related to motivation (autonomous or controlled), attitudes, self-regulation, and performance accomplishments.Clinical implicationsWhen designing interventions for individuals with COPD, it is important to understand the patient-specific social cognitive influences on PA participation. This information can then inform individually tailored management planning.

Pulmonary rehabilitation, physical activity, respiratory failure and palliative respiratory care

“…The degree of airflow limitation is only moderately related to daily physical activity (PA) levels in patients with COPD,25 stressing the importance of searching for extrapulmonary barriers and enablers that may affect PA 26. Proximity of residence to green or open spaces and neighbourhood deprivation are not determinants of PA, but dog walking and grand parenting are 27.…”

Behaviour change techniques to optimise participation in physical activity or exercise in adolescents and young adults with chronic cardiorespiratory conditions: a systematic review

“…People with chronic cardiorespiratory conditions, however, participate in less physical activity than their healthy counterparts . In addition to barriers experienced by the general population, people with a chronic cardiorespiratory condition are likely to face disease‐specific barriers to participation in physical activity, such as the time burden of treatment and unpleasant symptoms of breathlessness, leg muscle and general fatigue during physical activity . Participation in physical activity is of particular concern during ‘transitional’ years, such as adolescence and early adulthood.…”

“…5,[17][18][19][20] In addition to barriers experienced by the general population, people with a chronic cardiorespiratory condition are likely to face disease-specific barriers to participation in physical activity, such as the time burden of treatment 6 and unpleasant symptoms of breathlessness, leg muscle and general fatigue during physical activity. 7,21 Participation in physical activity is of particular concern during 'transitional' years, such as adolescence and early adulthood. During this developmental period, peer relationships, disease stigma and an increased level of autonomy become important influencing factors to treatment adherence.…”

Quels sont les profils motivationnels envers l’activité physique et la sédentarité de patients admis en réhabilitation respiratoire ?

“…Dans le même sens, environ deux tiers des études confirment le lien positif entre la motivation autodéterminée et le niveau d'AP (Teixeira, et al, 2012). Dans le domaine de la maladie respiratoire spécifiquement, plusieurs études qualitatives indiquent que la perception de l'AP dans sa dimension agréable, ou au contraire ennuyeuse ou stressante (i.e., notamment à cause des sensations d'essoufflement), est un facteur impliqué dans l'AP des patients en soin courant (Kosteli, et al, 2017 ;Mancuso, 2006), comme en post-réhabilitation (Stewart, et al, 2014). De la même manière, les perceptions de bénéfices physiques et psychologiques liés à l'AP ont été significativement associées au comportement d'AP (Danilack, et al, 2014).…”