Exploring The Current Situation And Influencing Factors Of Physical Activity In Patients With COPD Based On Health Promotion Model

Objective:This study aimed to evaluate the physical activity levels of patients with chronic obstructive pulmonary disease(COPD),and to investigate the influencing factors of physical activity of patients with COPD based on Health Promotion Model.Methods:The cross-sectional study design was used in this study.Two hundred and twenty-three patients with COPD from 4 Third-Grade Class A Hospitals were enrolled from December 2018 to June 2019.Based on Health Promotion Model,International Physical Activity Questionnaire(IPAQ),Global Physical Activity Questionnaire(GPAQ)and Pulmonary Functional Status and Dyspnea Questionnaire-modified(PFSDQ-M)were used to assess the-physical activity of patients;Modified British medical research council scale(mMRC),Breathlessness Beliefs Questionnaire(BBQ),Brief Fatigue Inventory(BFI),Anxiety Inventory for Respiratory Disease(AIR),COPD Assessment Test(CAT),COPD self-efficacy scale(CSES),Exercise Benefits/Barriers Scale(EBBS)and Social Support Rating Scale(SSRS)were used to explore the factors influencing the physical activity levels of COPD patients.The database was established by EpiData 3.0 software.Data was analyzed using SPSS 25.0 software and Mplus 7.0 software.Results:1.The median score of IPAQ(except for sitting energy consumption)was 3.85(0.00,11.55)MET.h/week;The median score of GPAQ(except for sitting energy consumption)was 23.10(11.55,32.43)MET.h/week;The median score of activity limitations of PFSDQ-M was 1.70(0.90,2.90).And the two most limited activities were walking on slopes and walking on rough terrain.2.The results of Univariate analysis:I:Age,course of disease,the number of hospitalizations for COPD in the last year,the scores of mMRC,the scores of CAT,fatigue,exercise barriers and fear-activity sensation were negatively correlated with the level of physical activity in the last seven days(P<0.05).Exercise benefits,self-efficacy and social support were positively correlated with the level of physical activity in the last seven days(P<0.05).Male,patients with spouse had higher level of physical activity in the past seven days;II:Age,course of disease,the number of hospitalizations in the last year,the number of complications,the scores of mMRC,the scores of CAT,exercise barriers and fear-activity sensation were negatively correlated with the level of physical activity in the last year(P<0.05).Exercise benefits,self-efficacy and social support were positively correlated with the level of physical activity in the last year(P<0.05).Patients without spouse and retired or unemployed patients had lower level of physical activity in the last year(PP<0.05);III:Age,course of disease,the number of hospitalizations in the last year,the scores of mMRC,the scores of CAT,fatigue,exercise barriers and Fear-activity sensation were positively correlated with activity limitations(P<0.05).BMI,exercise.benefits,self-efficacy and social support were negatively correlated with activity limitations(P<0.1).Female,Patients without spouse and less activity before being diagnosed with COPD had more activity limitations(P<0.1).3.The results of structural equation model:I:gender,whether be informed of exercise benefits,self-efficacy,fear-activity sensation and exercise benefits had direct effects on the level of physical activity in the last seven days.The number of hospitalizations because of exacerbation of COPD in the last year,the number of complications,mMRC and fatigue affected physical activity in the last seven days through self-efficacy.Whether be informed of exercise benefits,CAT and mMRC affected physical activity in the last seven days through fear-activity sensation.Whether be informed of exercise benefits,physical activity before being diagnosed with COPD and mMRC affected physical activity in the last seven days through exercise benefits;?:Self-efficacy and mMRC had direct effects on the level of physical activity in the last year.The number of hospitalizations because of exacerbation of COPD in the last year,the number of complications,mMRC and fatigue affected physical activity in the last year through self-efficacy;III:CAT,mMRC,gender,BMI and self-efficacy had direct effects on activity limitations.The number of hospitalizations because of exacerbation of COPD in the last year,the number of complications,mMRC and fatigue affected activity limitations through self-efficacy.Conclusions:1.Patients with COPD had lower levels of physical activity and more activity limitations.2.Health Promotion Model was suitable for exploring the influencing factors of physical activity of patients with COPD.Cognition and feeling of physical activity played an intermediary role between individual characteristics,activity experience and physical activity in COPD patients.