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慢性阻塞性肺疾病-坐姿与急性加重试验(COPD-SEAT)研究方案:一项基于家庭的自我监测久坐行为干预的随机对照可行性试验

Study protocol for Chronic Obstructive Pulmonary Disease-Sitting and ExacerbAtions Trial (COPD-SEAT): a randomised controlled feasibility trial of a home-based self-monitoring sedentary behaviour intervention.

作者信息

Orme Mark W, Weedon Amie E, Esliger Dale W, Saukko Paula M, Morgan Mike D, Steiner Michael C, Downey John W, Singh Sally J, Sherar Lauren B

机构信息

National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.

Department of Social Sciences, School of Social, Political and Geographical Sciences, Loughborough University.

出版信息

BMJ Open. 2016 Oct 3;6(10):e013014. doi: 10.1136/bmjopen-2016-013014.

Abstract

INTRODUCTION

An acute exacerbation of chronic obstructive pulmonary disease (COPD) marks a critical life event, which can lower patient quality of life and ability to perform daily activities. Patients with COPD tend to lead inactive and highly sedentary lifestyles, which may contribute to reductions in functional capacity. Targeting sedentary behaviour (SB) may be more attainable than exercise (at a moderate-to-vigorous intensity) for behaviour change in patients following an exacerbation. This study aims to evaluate the feasibility and acceptability of a 2-week at-home intervention providing education and self-monitoring to reduce prolonged periods of SB in patients with COPD discharged following an acute exacerbation.

METHODS AND ANALYSIS

Patients will be randomised into 1 of 3 conditions: usual care (control), education or education+feedback. The education group will receive information and suggestions about reducing long periods of sitting. The education+feedback group will receive real-time feedback on their sitting time, stand-ups and step count at home through an inclinometer linked to a smart device app. The inclinometer will also provide vibration prompts to encourage movement when the wearer has been sedentary for too long. Data will be collected during hospital admission and 2 weeks after discharge. Qualitative interviews will be conducted with patients in the intervention groups to explore patient experiences. Interviews with healthcare staff will also be conducted. All data will be collected January to August 2016. The primary outcomes are feasibility and acceptability, which will be assessed by qualitative interviews, uptake and drop-out rates, reasons for refusing the intervention, compliance, app usage and response to vibration prompts.

ETHICS AND DISSEMINATION

The research ethics committee East Midlands Leicester-Central has provided ethical approval for the conduct of this study. The results of the study will be disseminated through appropriate conference proceedings and peer-reviewed journals.

TRIAL REGISTRATION NUMBER

ISRCTN13790881; Pre-results.

摘要

引言

慢性阻塞性肺疾病(COPD)急性加重是一个关键的生命事件,会降低患者的生活质量和日常活动能力。COPD患者往往过着不活跃且久坐不动的生活方式,这可能导致功能能力下降。对于急性加重后的患者,改变行为方面,针对久坐行为(SB)可能比运动(中等至剧烈强度)更易于实现。本研究旨在评估一项为期2周的居家干预措施的可行性和可接受性,该干预措施提供教育和自我监测,以减少急性加重后出院的COPD患者长时间的SB。

方法与分析

患者将被随机分为3种情况之一:常规护理(对照组)、教育组或教育+反馈组。教育组将获得关于减少长时间坐着的信息和建议。教育+反馈组将通过与智能设备应用程序相连的倾角仪在家中获得关于其坐姿时间、站立次数和步数的实时反馈。当佩戴者久坐时间过长时,倾角仪还将提供振动提示以鼓励活动。数据将在住院期间和出院后2周收集。将对干预组的患者进行定性访谈,以探索患者的体验。还将对医护人员进行访谈。所有数据将于2016年1月至8月收集。主要结局是可行性和可接受性,将通过定性访谈、参与率和退出率、拒绝干预的原因、依从性、应用程序使用情况以及对振动提示的反应来评估。

伦理与传播

东米德兰兹莱斯特-中心研究伦理委员会已为本研究的开展提供伦理批准。研究结果将通过适当的会议记录和同行评审期刊进行传播。

试验注册号

ISRCTN13790881;预结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1575/5073551/7fab1d69d1d0/bmjopen2016013014f01.jpg

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