The Effect Of Pulmonary Rehabilitation Program Based On Self-determination Theory In Patients With CRDs

ObjectivesAccording to the self-determination theory(SDT),the study developed a pulmonary rehabilitation(PR)program to explore the effect of PR program based on SDT with chronic respiratory diseases(CRDs)patients,in order to provide reference and theoretical support for clinical development and improvement of PR.MethodsThis study is a quasi experimental study.A total of 56 CRDs patients who met the inclusion and exclusion criteria were randomly assigned to the intervention group and control group in 5 communities in Changchun,with 28 patients in each group.The intervention group received PR based on SDT for 12 weeks,while the control group maintained original lifestyle.Before the intervention,general information questionnaire,the modified Medical Research Council Dyspnea Scale(mMRC),St George’s Respiratory Questionnaire(SGRQ),Psychological Need Satisfaction in Exercise Scale(PNSE)and Behavioral Regulation in Exercise Questionnaire-2(BREQ-2)were used to evaluate the baseline data of the subjects.After 12 weeks of intervention,mMRC,SGRQ,PNSE,BREQ-2 and rehabilitation adherence record form were used to evaluate the effects of the intervention.SPSS 24.0 was used for descriptive analysis,t-test,nonparametric test and chi square test.Results1.General informationA total of 50 patients completed the study,25 in the intervention group and 25 in the control group.There were 10 COPD patients(40%),9 asthma patients(36%)and6 bronchiectasis patients(24%)in the intervention group,while there were 9 patients V(36%),9 patients(36%)and 7 patients(28%)in the control group.The results showed that there was no significant difference in demographic differences between two groups(P>0.05),and the data balance was comparable.2.Comparison between groups(1)Rehabilitation adherence: after 12 weeks of intervention,there were 12patients(48%),9 patients(36%)and 4 patients(16%)in the intervention group with complete adherence,partial adherence and non-adherence,while there were 6 patients(24%),8 patients(32%)and 11 patients(44%)in the control group.The pulmonary rehabilitation adherence of the intervention group was significantly higher than that of the control group(P<0.05).(2)Dyspnea: there was no significant difference in mMRC score between the two groups before intervention(P>0.05).After 12 weeks of intervention,the dyspnea of the intervention group was significantly reduced,the difference was statistically significant(P<0.001).(3)Quality of life: before the intervention,there was no significant difference in SGRQ total score,symptoms,activities and impact between the two groups(P>0.05).After 12 weeks of intervention,compared with the control group,the total score,activities and impact of the intervention group were significantly improved(P<0.001).There was no significant difference in symptoms between the two groups(P>0.05).(4)Exercise psychological needs and behavior regulation: before the intervention,there was no significant difference between the two groups in total score and the dimensions of PNSE and BREQ-2(P>0.05).After 12 weeks of intervention,compared with the control group,the competence need,autonomy need of the intervention group were better satisfied,the difference was statistically significant(P<0.001);the improvement of external regulation,internal regulation,identity regulation,internal motivation and total score of the intervention group was better than that of the control group,the difference was statistically significant(P<0.001),and non-motivation was no significant difference between the two groups(P>0.05).3.Comparison in the group(1)Dyspnea: The mMRC score of the intervention group was lower compared with before the intervention,dyspnea was significantly reduced,the difference was statistically significant(P<0.001).The dyspnea of the control group was also significantly reduced,the difference was statistically significant(P<0.05).(2)Quality of life: compared with before intervention,after 12 weeks of intervention,the total score and each dimension of SGRQ of the intervention group were significantly decreased,and the quality of life was significantly improved(P<0.001).The total score,symptoms and activity limitation of the control group were significantly improved(P<0.05).(3)Exercise psychological needs and behavior regulation: after 12 weeks of intervention,compared with before intervention,the competence need,autonomy need,relatedness need and total score of the PNSE,as well as the total score and each dimension of the BREQ-2 in intervention group were improved,and the difference was statistically significant(P<0.05).After 12 weeks of intervention,there was no significant difference in the total score,each dimension of the PNSE and BREQ-2 in the control group(P>0.05).Conclusion1.Compared with the control group,the intervention group can reduce the dyspnea of CRDs patients.2.The PR based on SDT has positive effects on symptoms,limited activity and disease effects,which can significantly improve their quality of life.3.The PR based on SDT can meet the competence need,autonomy need and relatedness need of patients with CRDs,significantly regulate the behavior motivation of patients,and promote the internalization of exercise motivation of patients.4.The PR program based on SDT has a positive effect on the rehabilitation adherence of patients with CRDs.