Maria Benzo, Minji Lee, Matthew M Clark, Roberto Benzo
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引用次数: 0
Abstract
Purpose: Home-based pulmonary rehabilitation (HBPR) with health coaching (HC) in people with chronic obstructive pulmonary disease (COPD) has been reported to produce behavior change by improving accelerometry-measured physical activity level and quality of life (QoL). However, a theoretical framework supporting the observed behavior change has not been tested in people with COPD. Therefore, the purpose of this secondary analysis was to examine the mechanism by which HBPR with HC improved physical and emotional QoL, by testing a theoretical framework that may support the positive effect of the intervention. The hypothesis was that the Self-Determination Theory (SDT) supports the behavior change observed after the 12-week HBPR with HC in patients with moderate to very severe COPD. This theory posits that by supporting the individual's experience of autonomy, competence, and relatedness can foster the most volitional and high-quality forms of motivation and engagement for a behavior change.
Methods: Structural Equation Models (Path Analysis) tested the underlying assumption that competence, autonomy, and relatedness were the factors associated with improvement in the physical and emotional QoL post-intervention.
Results: The path models supported the effect HBPR with HC on physical and emotional QoL through a direct effect on competence and relatedness ( P <.01) and an indirect effect through autonomy via competence and relatedness.
Conclusions: The effect of HBPR with HC in patients with COPD is mechanistically supported by SDT. Addressing competence, relatedness, and autonomy during the pulmonary rehabilitation process may impact physical and emotional QoL, which is of utmost importance to these patients.
期刊介绍：
JCRP was the first, and remains the only, professional journal dedicated to improving multidisciplinary clinical practice and expanding research evidence specific to both cardiovascular and pulmonary rehabilitation. This includes exercise testing and prescription, behavioral medicine, and cardiopulmonary risk factor management. In 2007, JCRP expanded its scope to include primary prevention of cardiovascular and pulmonary diseases. JCRP publishes scientific and clinical peer-reviewed Original Investigations, Reviews, and Brief or Case Reports focused on the causes, prevention, and treatment of individuals with cardiovascular or pulmonary diseases in both a print and online-only format. Editorial features include Editorials, Invited Commentaries, Literature Updates, and Clinically-relevant Topical Updates. JCRP is the official Journal of the American Association of Cardiovascular and Pulmonary Rehabilitation and the Canadian Association of Cardiac Rehabilitation.
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