Self-efficacy for physical activity and insight into its benefits are modifiable factors associated with physical activity in people with COPD: A mixed-methods study

Questions: What are the perceived reasons for people with chronic obstructive pulmonary disease (COPD) to be physically active or sedentary? Are those reasons related to the actual measured level of physical activity? Design: A mixed-methods study combining qualitative and quantitative approaches. Participants: People with mild to very severe COPD. Outcome measures: Participants underwent a semi-structured interview and physical activity was measured by a triaxial accelerometer worn for one week. Results: Of 118 enrolled, 115 participants (68% male, mean age 65 years, mean FEV1 57 % predicted, mean modified Medical Research Council dyspnoea score 1.4) completed the study. The most frequently reported reason to be physically active was health benefits, followed by enjoyment, continuation of an active lifestyle from the past, and functional reasons. The most frequently reported reason to be sedentary was the weather, followed by health problems, and lack of intrinsic motivation. Mean steps per day ranged between 236 and 18 433 steps. A high physical activity level was related to enjoyment and self-efficacy for physical activity. A low physical activity level was related to the weather influencing health, financial constraints, health and shame. Conclusion: We identified important facilitators to being physically active and barriers that could be amenable to change. Furthermore, we distinguished three important potential strategies for increasing physical activity in sedentary people with COPD, namely reducing barriers and increasing insight into health benefits, tailoring type of activity, and improvement of self-efficacy