Chronic Respiratory Disease最新文献

{"title":"Lung health in the Terai region of Nepal.","authors":"Malik Hamrouni, Sanjib K Sharma, Om P Kurmi, Prajwal Gautam, Suman Lohani, Ujwal Gautam, Sigiriya A Perone, Olivia Heller, Ian P Hall, Tricia M McKeever, Charlotte E Bolton","doi":"10.1177/14799731251415399","DOIUrl":"10.1177/14799731251415399","url":null,"abstract":"<p><p>BackgroundChronic respiratory disease burden in Nepal is high, although data from the Terai (lowlands) is limited.MethodsThrough a community outreach programme in Mechinagar, 3398 adults (mean age 49.6 years, 59% female) were recruited to complete spirometry and questionnaires to determine prevalences of airflow obstruction, breathlessness (MRC dyspnoea score ≥3) and self-reported chronic lung disease. Multivariate logistic regression examined associated demographic and lifestyle factors.ResultsPrevalences of airflow obstruction (15%) and breathlessness (13%) exceeded self-reported chronic lung disease (8%). Age (odds ratio = 1.06, 95% confidence interval = 1.05-1.07), body mass index (BMI) per 1 kg/m² (0.90, 0.88-0.93), physical inactivity (1.95, 1.07-3.84) and no formal education (1.46, 1.14-1.88) were associated with airflow obstruction. Smoking was only associated with airflow obstruction in females (1.90, 1.22-2.94) and adults ≥40 years (1.40, 1.05-1.86). Age (1.04, 1.03-1.05), airflow obstruction (2.43, 1.85-3.18), and male sex (0.63, 0.49-0.80) were associated with breathlessness. Only in females was breathlessness associated with BMI (1.08, 1.05-1.12) and mixed biomass use (2.65, 1.39-4.85). In men, labour/farming/agriculture work (3.30, 1.12-14.20) or unemployment (4.39, 1.43-19.30) was associated with breathlessness.ConclusionThere is likely underdiagnosis of chronic lung disease in the Terai. Addressing smoking, educational disparities, physical inactivity and environmental pollutant exposure are public health priorities to improve respiratory health in the region.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731251415399"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12811603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does care managers' initial professional background affect the outcomes of pulmonary rehabilitation? A retrospective cohort study of 2450 individuals with chronic respiratory diseases.","authors":"Sarah Gephine, Olivier Le Rouzic, Emeline Cailliau, Cécile Chenivesse, Jean-Marie Grosbois","doi":"10.1177/14799731251415397","DOIUrl":"10.1177/14799731251415397","url":null,"abstract":"<p><p>ObjectiveThis retrospective study in individuals with chronic respiratory diseases (CRDs) compared changes in quality of life, anxiety and depressive symptoms, and exercise capacity after a home pulmonary rehabilitation (PR) programme, based on the care manager's professional background.MethodsPR team was composed of nurses (Gr1, n = 989 patients), physiotherapists (Gr2, n = 466), one dietician and one sociomedical beautician (Gr3, n = 794) and one respiratory physician (Gr4, n = 201) who supervised one home session per week during 8 weeks. Quality of life, anxiety and depressive symptoms, dyspnea and exercise capacity were assessed at the beginning and end of PR, and at 12 months after the end of PR.Results2450 participants were included (females: 41.6%, age: 64.1 ± 13.0 years, FEV₁: 50.7 ± 25.2% of predicted, people with COPD: 51%, with ILD: 23%, with asthma: 10%). Gr 1, Gr 3 and Gr 4 improved all the assessments at short- and long-term (p < 0.01). Improvement in the Visual Simplified Respiratory Questionnaire in Gr2 was not maintained at long-term. According to the linear mixed models, changes over time were not statistically different between groups.ConclusionA personalised PR programme delivered by one care manager, led to similar short-term benefits regardless of the care manager's initial professional background.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731251415397"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12812202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of oscillatory positive expiratory pressure (OPEP) devices to augment sputum clearance in COPD: An updated systematic review and meta-analysis.","authors":"Ahmed A Alzahrani, Saeed M Alghamdi, Mansour S Majrshi, Ali M Alasmari, Surinder S Birring, Lizzie Jf Grillo, Nicholas S Hopkinson","doi":"10.1177/14799731261463730","DOIUrl":"10.1177/14799731261463730","url":null,"abstract":"<p><p>IntroductionEffective airway clearance is crucial in COPD management, and oscillatory positive expiratory pressure (OPEP) devices are a potential adjunct therapy for this. However, their clinical efficacy remains uncertain due to limited trial data.AimTo update our previous (2020) systematic review investigating the use of OPEP devices to augment sputum clearance in COPD.MethodsRandomised Clinical Trails s evaluating OPEP devices in COPD were identified from PubMed, CINAHL, Medline, Cochrane, and Embase (2020-2024). Outcomes included lung function, exercise capacity, exacerbations, and health-related quality of life (HRQoL), with pooled estimates calculated using random-effects models.ResultsTwelve trials (741 participants) were included. OPEP devices significantly reduced exacerbations (Odds Ratio: 0.39) and improved exercise capacity (+49 m at 6MWD). Small improvements were observed in FVC%, while HRQoL changes were not statistically significant. Accumulating evidence suggests benefits for sputum clearance and reduced antibiotic use. Devices were generally well accepted and safe.ConclusionOPEP devices appear to be safe and may reduce exacerbations, improve functional exercise capacity, and support sputum clearance in COPD.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261463730"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-pharmacological rehabilitation strategies for pulmonary and physical recovery in ICU survivors after COVID-19: A systematic review.","authors":"Yimy F Medina, Eliana Isabel Rodríguez Grande, Javier Leonardo Galindo, Olga Cecilia Vargas Pinilla, Franklin Soler, Gleidy Vanessa Espitia","doi":"10.1177/14799731261439941","DOIUrl":"10.1177/14799731261439941","url":null,"abstract":"<p><p>BackgroundSurvivors of severe COVID-19 requiring intensive care frequently experience persistent pulmonary and functional impairment consistent with post-critical illness sequelae. The effectiveness of non-pharmacological rehabilitation in this severity-specific subgroup remains uncertain.MethodsA systematic review was conducted in accordance with PRISMA 2020 guidelines. PubMed, Epistemonikos, LILACS, and Google Scholar were searched for randomized and observational studies evaluating non-pharmacological rehabilitation in adult ICU survivors of COVID-19. Risk of bias was assessed using RoB 2 and ROBINS-I tools. Given substantial clinical and methodological heterogeneity, quantitative meta-analysis was not performed; a structured narrative synthesis was undertaken.ResultsFourteen studies met inclusion criteria. Five incorporated comparator groups, while nine employed uncontrolled pre-post designs. Interventions ranged from early ICU mobilization to inpatient and outpatient pulmonary rehabilitation. Controlled studies reported variable between-group benefits in dyspnea and functional outcomes, whereas observational studies consistently described within-group improvement over time. However, most studies were at moderate to serious risk of bias, and heterogeneity in intervention timing, dosage, and outcome assessment limited comparability.ConclusionsNon-pharmacological rehabilitation in ICU survivors of COVID-19 is associated with improvement over time; however, the certainty of causal effectiveness remains low. ICU survivors constitute a distinct recovery population within the broader post-COVID spectrum. Adequately powered, multicenter randomized trials with standardized protocols and harmonized outcomes are required to establish long-term effectiveness.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261439941"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147615861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative assessment of ChatGPT and Gemini answers to common chronic obstructive pulmonary disease questions: An expert panel evaluation by pulmonologists.","authors":"Mutlu Onur Güçsav, Damla Serçe Unat, Onur Akçay, Ömer Selim Unat, Aysu Ayrancı, Ahmet Emin Erbaycu","doi":"10.1177/14799731261443321","DOIUrl":"10.1177/14799731261443321","url":null,"abstract":"<p><p>BackgroundAI-based chatbots are increasingly used as sources of health information. However, their reliability in delivering accurate and scientifically sound responses to patient questions remains uncertain, especially in chronic diseases such as chronic obstructive pulmonary disease (COPD). This study aims to compare the reliability of ChatGPT-4o and Gemini 2.5 Flash in providing patient-centered medical information on COPD.MethodsA total of 34 common public questions about COPD were submitted to ChatGPT-4o and Gemini 2.5 Flash. Responses were evaluated blindly by four pulmonologists across three domains: accuracy, clarity, and scientific adequacy. The mean scores and word counts were analyzed and compared via nonparametric tests.ResultsGemini 2.5 Flash outperforms ChatGPT-4o in terms of scientific adequacy (mean score: 4.69 ± 0.31 vs. 4.34 ± 0.45, <i>p</i><0.001). No significant difference was found in accuracy or clarity. The Gemini 2.5 Flash also generated significantly longer responses, particularly in the treatment and prognosis domains (<i>p</i><0.001). Both models provided generally acceptable answers, but ChatGPT-4o's responses were shorter and occasionally less complete.ConclusionsWhile both models delivered largely accurate and understandable content, Gemini 2.5 Flash tended to produce more detailed responses and received higher scientific adequacy ratings; however, this difference should be interpreted in light of the substantial imbalance in response length. These tools may support patient education however, the findings reflect a comparison between AI systems only and should be interpreted within this scope.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261443321"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13087371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in chronic ischemic heart disease mortality in patients with interstitial lung disease in the United States from 1999 to 2023.","authors":"Fan Wu, Yan Xue, Yinfeng Luan, Fengjun Zhang, Xinlai Ma, Wei Zhang","doi":"10.1177/14799731261446949","DOIUrl":"10.1177/14799731261446949","url":null,"abstract":"<p><p>BackgroundInterstitial lung disease (ILD) patients often have comorbid chronic ischemic heart disease (CIHD), which may worsen prognosis. Large-scale studies on long-term CIHD mortality trends in ILD patients are lacking. This study analyzes CIHD-related mortality trends in US adults with ILD from 1999 to 2023.MethodsCIHD-related mortality data were extracted from the CDC WONDER database for ILD patients aged ≥25 years. International Classification of Diseases, 10th Revision (ICD-10) codes J84.1, J84.8, J84.9 identified ILD, and code I25 identified CIHD. Age-adjusted mortality rates (AAMR), annual percentage change (APC), and average annual percentage change (AAPC) per 100,000 were calculated using Joinpoint regression.ResultsBetween 1999 and 2023, there were 92,779 CIHD-related deaths among U.S. decedents with interstitial lung disease (ILD, listed as an underlying or contributing cause of death in death certificates); this accounted for a substantial proportion of cardiovascular-related deaths in this decedent population. The overall AAMR showed a slight upward trend (AAPC=0.51%), but with significant nonlinearity: a decrease from 2003-2018 (APC=-1.29%), increased sharply from 2018 to 2021 (APC = 9.75%), with the increase concentrated during the COVID-19 pandemic years. The age-adjusted mortality rate rose modestly from 1.54 per 100,000 in 2018 to 1.60 in 2019 (+3.9%), then surged to 1.73 in 2020 (+8.1%) and peaked at 1.98 in 2021 (+14.5% from 2020). After 2021, mortality declined to 1.88 in 2023. Mortality was higher in men, non-Hispanic Whites, adults >85 years, and in southern and nonmetropolitan areas. Each subgroup showed a significant increase in mortality during 2020-2021, coinciding with the pandemic, while pre-pandemic trends were more gradual.ConclusionsCIHD-related mortality in ILD patients showed a fluctuating upward trend over 25 years, with a significant jump during the COVID-19 pandemic. This underscores the systemic impact of public health emergencies on cardiovascular health in vulnerable populations. Cardiovascular risk assessment and management should be integrated into routine ILD care, with tailored strategies for high-risk groups and regions.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261446949"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remote behaviour change service for inactive adults with lung disease: A non-randomised controlled study.","authors":"Jones Aw, Robinson H, Saunders M, Brewster A, Ridyard C, Smith M, Peel J, Shopland J, Wilson C, Dean A, Hinchliffe M, Siriwardena An, Law G","doi":"10.1177/14799731261453571","DOIUrl":"10.1177/14799731261453571","url":null,"abstract":"<p><p>ObjectivesTo determine whether a remote behaviour change service (Active Steps), delivered by a UK charity, can increase physical activity over a 12-month period in adults with lung disease.MethodsActive Steps (n=166) consisted of 1:1 telephone health coaching for 12 months alongside printed (e.g. activity diary and chart, information and goal setting booklet) and digital behaviour change strategies (e.g. exercise videos, motivational newsletters, pedometer). A concurrent control group was recruited (n=80) for comparison. Self-reported physical activity (Short Active Lives Survey) and self-reported health (EQ-VAS) were collected at baseline, 3, 6, and 12 months. Logistic regression models (adjusted for confounders) were used to analyse the odds of becoming physically active or average changes in physical activity time and EQ-VAS.Results<i>Primary outcome</i>: The number of participants defined as physically active at 12 months was greater with Active Steps (46%) compared to controls (23%) which was statistically significant in an unadjusted (odds ratio (OR) [95% confidence intervals (CI)]:2.8 [1.3-6.1], p=0.011) but not adjusted model (OR: 2.2 [0.9-5.4], p=0.097). <i>Secondary outcomes</i>: Compared to controls, Active Steps increased the number of participants physically active at 3 and 6 months, increased the weekly minutes of moderate-vigorous physical activity and improved self-reported health (EQ-VAS) across all timepoints.DiscussionOur findings suggest that charity-led remote behaviour change support is effective in the short-to-medium-term in adults with lung disease, but high participant attrition necessitates caution in interpreting sustained effect estimates at 12 months. Further long-term evaluations are needed to address adherence and sustainability of such services.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261453571"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148142838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of a standardized mindfulness-based stress reduction (MBSR) program in COPD patients undergoing pulmonary rehabilitation: A pilot study.","authors":"Saïda Bensliman, Vitalie Faoro, Christian Mélot, Vincent Ninane, David Zarka","doi":"10.1177/14799731261420825","DOIUrl":"10.1177/14799731261420825","url":null,"abstract":"<p><p>BackgroundMindfulness-Based Stress Reduction (MBSR) has demonstrated benefits in chronic conditions such as cancer, chronic pain, cardiovascular disease, and type 2 diabetes. However, evidence in chronic obstructive pulmonary disease (COPD) remains limited, particularly regarding the feasibility of implementing a full standardized program within pulmonary rehabilitation.MethodsThis prospective pilot study evaluated the feasibility of delivering a standardized 8-weeks MBSR program to people with COPD enrolled in pulmonary rehabilitation. Feasibility outcomes included recruitment, program completion, attendance at group sessions, home practice, and reasons for withdrawal. Adherence was conceptualized as behavioral engagement, assessed through predefined measures (session attendance and weekly self-reported home practice), and interpreted post hoc using thresholds commonly applied in previous MBSR feasibility studies (attendance ≥6/8 sessions; home practice ≥3 days/week). Reasons for discontinuation were collected by phone or email follow-up. Descriptive statistics were used.ResultsEighteen people with COPD (56% women, mean age 68 (±7.4) years; mean FEV₁ 48 (±16%) predicted) were enrolled. 14 participants (78%) completed the program, and 86% attended at least eight of nine sessions. Participants reported an average of 4.4 (±2.3) days of home practice per week, indicating regular engagement despite inter-individual variability. Reasons for withdrawal included musculoskeletal pain (<i>n</i> = 2) and limited availability (<i>n</i> = 2).ConclusionsThe standardized, in-person 8-weeks MBSR program was feasible in people with COPD undergoing pulmonary rehabilitation, as reflected by their regular attendance at hospital sessions and reported engagement in home practice. This structured context likely supported adherence and program fidelity, but its generalizability to individuals with reduced mobility or clinical instability remains uncertain. Future research should evaluate the feasibility of extending this approach to broader COPD populations and its potential psychological and clinical benefits.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261420825"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13469767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic performance of FEV₁/FEV₆ in detecting airway obstruction and chronic obstructive pulmonary disease: A systematic review and meta-analysis.","authors":"Dongru Du, Sike He, Jiangyue Qin, Hao Wang, Lijuan Gao, Mei Chen, Xiaohua Li, Zhenni Chen, Fengming Luo, Yongchun Shen","doi":"10.1177/14799731261431251","DOIUrl":"10.1177/14799731261431251","url":null,"abstract":"<p><p>BackgroundAlthough the postbronchodilator FEV₁/FVC is the gold standard for diagnosing COPD, it is not easily obtainable due to various reasons. This study aims to investigate whether FEV₁/FEV₆ may serve as an easily accessible surrogate for FEV₁/FVC in detecting airway obstruction and COPD.MethodsEligible articles were screened from PubMed, Web of Science and Scopus. The Quality Assessment of Diagnostic Accuracy Studies-2 was applied for quality assessment. The pooled sensitivity, specificity, and area under the curve (AUC) of the summary receiver operating curve were calculated to evaluate the diagnostic performance of FEV₁/FEV₆ in detecting airway obstruction and COPD and to determine the optimal cutoff value. Sensitivity analyses, subgroup analyses and meta-regression were performed to explore the source of heterogeneity.ResultsWith 28 eligible articles and 65,744 subjects, the FEV₁/FEV₆ ratio showed good diagnostic performance in detecting both airway obstruction (sensitivity: 0.87, specificity: 0.94, AUC 0.95) and COPD (sensitivity: 0.83, specificity: 0.88, AUC 0.91). Further analyses of the optimal cutoff value suggested that an FEV₁/FEV₆<0.72 was the best criterion for detecting airway obstruction (sensitivity: 0.84, specificity: 0.97, AUC 0.96), whereas an FEV₁/FEV₆<0.74 was the best criterion for detecting COPD (sensitivity: 0.87, specificity: 0.89, AUC 0.93). The results of subgroup analyses and meta-regression suggested that study design and geographical location may affect the heterogeneity of both sensitivity and specificity in detecting airway obstruction and COPD.ConclusionThe FEV₁/FEV₆ may serve as an easily accessible alternative in detecting airway obstruction and COPD. However, application of FEV₁/FEV₆ may also be constrained by availability and affordability of devices. Further studies are required to determine the best-suited population for FEV₁/FEV₆ application.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261431251"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitators and barriers to exercise adherence in patients with COPD: A qualitative study guided by the fear-avoidance model.","authors":"Ji-Hong Wu, Ji-Mei Wu, Bin Liu, Lan-Lan Wei","doi":"10.1177/14799731261480690","DOIUrl":"10.1177/14799731261480690","url":null,"abstract":"<p><p>BackgroundExercise adherence is central to pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD), yet sustained adherence remains difficult. Fear of exertional symptoms, particularly dyspnoea, may promote exercise avoidance. This study explored perceived facilitators and barriers to exercise adherence using the fear-avoidance model.MethodsFace-to-face semi-structured interviews were conducted with 18 patients with COPD recruited from respiratory inpatient wards. Data were analysed using qualitative content analysis, with the fear-avoidance model used as a sensitising framework.ResultsTwo interrelated themes and five subthemes were developed. Threat appraisal transformed exertional symptoms into cues for fear-related avoidance when exercise was viewed as unsafe, symptoms were interpreted as deterioration, and inactivity was used as self-protection. Manageable experiences and social responses rebuilt safety and control through graded success, practical resources, and family and professional responses. Family influence was bidirectional: reassurance supported engagement, whereas alarmed symptom interpretations reinforced avoidance.ConclusionsExercise adherence appeared to be shaped not only by symptoms, but also by how symptoms were interpreted in relation to previous experiences and social context. Interventions should combine symptom reappraisal, individually graded exercise, and structured family and professional support.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261480690"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}