The Influence of Pulmonary Rehabilitation and Counselling on Perceptions of Physical Activity in Individuals with COPD - A Qualitative Study

Mandy Scheermesser, Leah Reicherzer, Swantje Beyer, David Gisi, Spencer Rezek, Thomas Hess, Markus Wirz, Anne-Kathrin Rausch Osthoff, Mandy Scheermesser, Leah Reicherzer, Swantje Beyer, David Gisi, Spencer Rezek, Thomas Hess, Markus Wirz, Anne-Kathrin Rausch Osthoff

Abstract

Objective: The aim of this study was to explore to what extent a combined counselling and pulmonary rehabilitation program (PR) influences the perception of physical activity (PA) and motivation for behavioral change in PA in individuals with COPD. The results of previous quantitative trial that investigated the effect of this combined treatment on daily PA were inconclusive. It is conjectured that a more targeted tailoring of the counselling and PR intervention could improve its effectiveness.

Patients and methods: Eighteen individuals with COPD (median age 69, 8 females) who had participated in the PneumoReha program were interviewed twice (following PR and at three-month follow-up). These interviews were transcribed and analyzed thematically. Based on the codes thus identified, three categories 'perception of PA intensity', 'quality of motivation to perform PA', and 'strategies to cope with barriers' were used to differentiate 'types' of participants.

Results: Four different types of COPD individuals were distinguished. Study findings indicate that those individuals who participated in the PR program combined with embedded counselling tended to be more active and intrinsically motivated.

Conclusion: A typology of four types of people with COPD was developed, characterized by their perception of activity, individual motivation and strategies for managing barriers. The patients' physical activity level might be influenced by their concept of physical activity and the quality of motivation. Recognizing patients' different activity behaviors is important for improving the quality of outpatient PR programs and developing tailored (according to each type) counselling interventions embedded in outpatient PR programs.

Clinical trial registration: The study was registered on the website of https://www.clinicaltrials.gov/ with the identifier NCT02455206 (27/05/2015), as well as on the Swiss National Trails Portal SNCTP000001426 (05/21/2015).

Keywords: COPD; behavioral change; motivational interviewing; physical activity promotion; qualitative study.

Conflict of interest statement

All authors declare that they have no competing interests.

© 2021 Scheermesser et al.

Figures

Figure 1
Figure 1
Flowchart of the study.
Figure 2
Figure 2
Development of types. Each participant is represented by a circle with their corresponding ID-number. Participants were grouped according to motivational quality (continuum from extrinsic to intrinsic) and PA (continuum from low intensity to high intensity).
Figure 3
Figure 3
Distribution of participants by study group (Intervention=counselling intervention group, Control=control group) and ID-number, according to motivational quality and PA intensity.

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