| Objective:The Behaviour change wheel(BCW)theory was used as a guide to construct a pulmonary rehabilitation care program of chronic obstructive pulmonary disease(COPD)patients in the elderly,and to investigate the impacts of pulmonary rehabilitation care based on the Behaviour change wheel theory on COPD patients in the elderly.The impact of pulmonary rehabilitation care based on the behavior change wheel theory on elderly COPD patients was investigated.Methods:(1)This is a class experimental study,100 COPD inpatients who met the inclusion criteria in the respiratory ward of a tertiary care hospital in Hohhot from May 2022 to February 2023 were selected and grouped by ward,with respiratory and critical care department 1 as the interference arm and a respiratory and critical care unit 2 as the treatment arm,with 50 each of the intervention and control groups,numbered according to the order of enrollment.(2)In the control group,patients were given the usual care during the hospitalization in Respiratory and Critical Care II and were followed up by telephone every 2 weeks after discharge.The treatment patients in the intervention group received pulmonary rehabilitation based on the behavior change wheel theory,which consisted of forming an intervention team,formulating an intervention plan,and using 7 types of intervening skills: education,training,motivation,realization,modeling,persuasion,and environmental reconstruction,as well as 22 behavior change techniques to intervene on the "motivation","ability",and "opportunity" of COPD patients’ disease-related knowledge and pulmonary rehabilitation exercises."The intervention was conducted at 3-5 days after hospital admission,1 month later and 2 months later by using the General Self-efficacy Scale(CSES)to measure COPD self-efficacy.The results of the evaluation were assessed by the General Self-efficacy Scale(CSES),the Chinese version of the COPD assessment test(CAT),the 6-minute walk distance(6MWD),and the COPD-related knowledge survey at three timepoints: 3-5 days after enrollment,1month later,and 2 months later.SPSS22.0 software was used to enter the data,and the data were statistically analyzed using chi-square test,t-test,rank sum test,repeated measures ANOVA,and generalized estimating equation to compare the differences of each evaluation index.Results:(1)A totally of the 91 cases finished this study,46 cases in the intervention group and 45 cases in the control group.The differences between the two groups were not statistically significant(P>0.05)when comparing the general information of the patients,and were comparable.(2)Before the intervention,the total score of self-efficacy and each dimension were compared between the two groups,and the difference was not statistically significant(P>0.05);after 1month of intervention,the total score of self-efficacy in the intervention group(100.22±3.74)was higher than that in the control group(91.09±3.66),and the difference was statistically significant(P<0.05),except for two dimensions of emotional fluctuation and weather environment,which were not statistically significant(P>0.05)compared with the control group.After 2 months of intervention,the total self-efficacy score of the intervention group(104.20±4.87)was higher than that of the control group(92.56±2.39),and the differences were statistically significant(P<0.05)when comparing the scores of each dimension between the two groups;repeated measures ANOVA The results showed that the differences in total self-efficacy scores were statistically significant(P<0.05)for time effects,between-group effects and interaction effects.By the generalized estimates of equations were analyzed: the differences between group effects and time effects were statistically significant(P<0.05)for each CAT item,and the differences between interaction effects were statistically significant(P<0.05)for all items except cough and sleep.(3)Before intervention,there was no statistically significant difference between the CAT scores and the scores of each of the dimensions in the two groups(P>0.05);after 1 month of treatment,the CAT score in the interference group was(25.09±1.84)and the CAT score in the control group was(27.47±1.35),and the difference was statistically significant(P<0.05);after2 months of treatment,the CAT score in the interference group was(19.02±1.93)and the CAT score in the control group was(25.36±3.86),and the difference was statistically significant(P<0.05).After 2 months of intervention,the CAT score in the intervention group was(19.02±1.93),and the CAT score in the control group was(25.36±3.86),with statistically significant differences(P<0.05);by repeated measures ANOVA,the differences in the total CAT score were statistically significant(P<0.05)in terms of time effect,between-group effect and interaction effect.)After 1 month of intervention,the differences in CAT scores were statistically significant(P<0.05),except for the scores of ability to exit,energy,and mobility;after 2 months of intervention,the differences in CAT scores were statistically significant(P<0.05).The differences were statistically significant(P<0.05),and the differences in the interaction effects of each entry were statistically significant(P<0.05),except for cough and sleep.(4)After 1 month of intervention,the compliance score of pulmonary rehabilitation exercise was higher in the intervention group than in the treatment group,and the difference was statistically significant(P<0.05);the median score of pulmonary rehabilitation exercise frequency was 3 in the intervention group and 1 in the control group;after 2 months of intervention,the compliance score of pulmonary rehabilitation exercise was higher in the intervention group than in the treatment group and the difference was statistically significant(P<0.05);the median scores of pulmonary rehabilitation exercise frequency were The median score of pulmonary rehabilitation exercise frequency was 4 points in the intervention group and 1 point in the treatment group;the difference was statistically significant(P<0.05)when compared within the group of interference;there was no statistical significance(P>0.05)when compared within the group of the control.(5)Comparing the 6MWD of patients in both groups before the intervention,the difference was not statistically significant(P>0.05);the 6MWD of patients in both groups was higher than the one before the intervention after 1 month,and the 6MWD of the intervention group(294.35±24.17)was higher than the 6MWD of the control group(281.11±22.40),and the difference was statistically significant(P<0.05);after 2 months of the intervention,the6 MWD in the intervention group(314.89±24.93)was higher than 6MWD in the control group(287.11±22.06),and the difference was statistically significant(P<0.05);by repeated-measures ANOVA,the differences in the time effect,between-group effect and interaction effect of 6MWD were statistically significant(P<0.05).(6)The comparison of the score of disease-related knowledge between the two sets of subjects in the pre-intervention period was not considered statistically significant(P>0.05);one month after the infection,the score of disease-related knowledge in both sets of subjects was higher than that in the pre-intervention period,and the score of disease-related knowledge in the interference set was 6.5(5,7)higher than that in the control set of 3(3,3),and the difference was statistically significant(P<0.05);two months after the infection,the score of disease-related knowledge in the intervention set was 8(7,8)higher than that in the control set of 2(2,3),and the difference was statistically significant(P<0.05).After 2 months of intervention,the disease related knowledge scores were higher in the intervention group 8(7,8)than in the control group 2(2,3),and the differences were statistically significant(P<0.05);by generalized estimating equation analysis,the differences were statistically significant(P<0.05)when comparing the time effect,component effect and interaction effect of disease related knowledge scores.Conclusion:Pulmonary rehabilitation care based on BCW theory can improve self-efficacy,improve quality of life,increase compliance with pulmonary rehabilitation exercises,improve patients’ exercise tolerance,and increase patients’ disease knowledge in elderly COPD patients. |
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