Physical training moves mountains in COPD, but people with COPD lack information about it

Relevance:
This research study relates to the congress themes ‘Research, education and practice’ and ‘Public health prevention and social care’ because the results outlines the impact of education and health promotion on prevention – if you manage to change your life style, it will move mountains in the long term.
Surprisingly few people in Denmark with Chronic Obstructive Pulmonary Disease (COPD) engage in physical activity although pulmonary rehabilitation has well documented positive effects on level of activity, dyspnea, anxiety, fatigue and quality of life. Recently much attention has been paid discussing potential benefits of early discovery of COPD, but to make an impact it has to be combined with information from the general practitioner (GP) about the benefits of physical training and the negative consequences of an inactive lifestyle.
Purpose: To explore why people with COPD do not engage in physical activity and to gain insight in the motivational factors for being physically active, as well as the barriers.
Methods/Analysis: Fieldwork among five people with COPD in Jutland, Denmark 2013-2015 using semi-structured interviews. Supplementary, unstructured interviews with three GPs, and participation in a closed Facebook-group for people with COPD, were conducted. We transcribed the interviews, transformed the spoken language to a written language and made a thematic analysis based on The Health Belief Model and Self Determination Theory.
Results: One of the main reasons for not doing physical activity until years after the diagnosis was that people with COPD did neither receive the necessary information from the GPs about the benefits of physical training nor about the negative consequences of an inactive lifestyle.
Motivational factors for living a physically active life were first of all information about COPD and the benefits of physical training and secondly to experience the benefits on one’s own body (“I get more energy when I train”). Other motivational factors were experiencing that it was not dangerous to feel breathless and to have success coping with breathlessness. Functional tests like walking tests were very useful for the participants because they outlined the progress achieved during training and were much easier to comprehend than spirometry tests.

Discussion and conclusions: It is of paramount importance that people with COPD, as early as possible receive information about the benefits of physical training and the negative consequences of an inactive lifestyle. Physical training can lead the ways to move mountains in COPD.
Impact and implications:
It is important to uncover the motivational factors and the possible barriers for physical activity among persons with COPD - especially because of the proven benefits of physical training.
It is relevant to examine how, when and where people, recently diagnosed with COPD, are equipped with knowledge regarding the benefits of physical training.
Doing functional tests like walking tests is useful for persons with COPD because they outline the progress achieved during training, and are much easier to comprehend than spirometry tests and thus motivate and encourage focusing on the possibilities rather than the limitations. This knowledge can be extremely useful in prevention and health promotion. It holds the possibility to move mountains in COPD.
3 Key words:
COPD, Rehabilitation, Education.
Funding and acknowledgements:
The work was funded by VIA University College, Faculty of Health Sciences, www.via.dk .
ETHICALLY CONSIDERATONS:
Our work was approved by The Regional Committee on Biomedical Research Ethic of The Central Denmark Region, Skottenborg 26, Postboks 21, DK-8800 Viborg, Denmark the 31th of May 2015 by mail.
According to The Declaration of Helsinki (World Medical Association, 2013) we anonymized the names and the data of the participants. We informed the participants about the aim of this study, the method, anonymity and our professional secrecy before collecting written informed consent.
We use people-first language (‘people with COPD’) to emphasize a holistic perspective to signal that the participants are more important than the disease and to avoid stigmatization.