一项基于网络的身心干预（正念步骤）促进慢性心肺疾病患者步行的质性研究见解
A Web-Based Mind-Body Intervention (Mindful Steps) for Promoting Walking in Chronic Cardiopulmonary Disease: Insights From a Qualitative Study.
作者信息
Kraemer Kristen M, Kilgore Karen, Litrownik Daniel, Jean-Laurent Brianna, Wayne Peter M, Richardson Caroline R, Moy Marilyn L, Yeh Gloria Y
机构信息
Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States.
Harvard Medical School, Boston, MA, United States.
出版信息
Glob Adv Integr Med Health. 2023 Dec 2;12:27536130231212169. doi: 10.1177/27536130231212169. eCollection 2023 Jan-Dec.
BACKGROUND
Given the deleterious effects of physical inactivity in persons with chronic obstructive pulmonary disease (COPD) and/or heart failure (HF), interventions that promote long-term daily physical activity are needed. Mindful Steps, designed to promote walking behaviors in COPD and HF, is a multicomponent intervention that integrates mind-body content with other self-regulatory components. The aim of the current qualitative study was to characterize participants' experiences with Mindful Steps and understand the perceived influence of the intervention on walking and health.
METHOD
In the context of a pilot randomized controlled feasibility trial comparing the year-long Mindful Steps program to usual care among individuals with COPD and HF, semi-structured qualitative interviews were administered at 6- and 12-months. Interviews were audio recorded and transcribed. The constant comparative method was used to code transcripts, identify categories, and develop interrelated themes.
RESULTS
Nineteen participants (63% female; = 70.2 years, = 6.95) who were randomized to the intervention group completed the 6-month interview and 17 completed the 12-month interview. The pedometer with feedback, live group classes, and mind-body videos were described as the most helpful intervention components. Participants learned several strategies that helped their walking (e.g., breathing regulation and awareness, body awareness, mind-body techniques, pacing), described walking as enjoyable, and identified internal reasons for walking (e.g., to feel good). They also reported several physical and mental health benefits of the intervention. Some participants reported limited influence of the intervention on walking or health. Many participants continued to use the strategies they learned in the first half of the intervention at 12-months.
CONCLUSIONS
The mind-body content of Mindful Steps appeared to positively influence walking behaviors. Participants' experiences with the intervention helped to identify areas for future intervention refinement. Future quantitative work is needed to corroborate these qualitative findings and assess the efficacy of the intervention on long-term physical activity engagement.
TRIAL REGISTRATION
This trial is registered in Clinical Trials.gov, ID number NCT01551953.
背景
鉴于身体缺乏活动对慢性阻塞性肺疾病（COPD）和/或心力衰竭（HF）患者的有害影响，需要采取促进长期日常身体活动的干预措施。旨在促进COPD和HF患者步行行为的“正念步程”是一种多成分干预措施，它将身心内容与其他自我调节成分相结合。本定性研究的目的是描述参与者对“正念步程”的体验，并了解该干预措施对步行和健康的感知影响。
方法
在一项将为期一年的“正念步程”计划与COPD和HF患者的常规护理进行比较的试点随机对照可行性试验中，在6个月和12个月时进行了半结构化定性访谈。访谈进行了录音和转录。采用持续比较法对转录本进行编码、识别类别并形成相关主题。
结果
随机分配到干预组的19名参与者（63%为女性；平均年龄 = 70.2岁，标准差 = 6.95）完成了6个月的访谈，17名完成了12个月的访谈。带有反馈的计步器、现场小组课程和身心视频被描述为最有帮助的干预成分。参与者学到了几种有助于步行的策略（如呼吸调节与意识、身体意识、身心技巧、步速控制），将步行描述为令人愉快的，并确定了步行的内在原因（如感觉良好）。他们还报告了该干预措施对身心健康的多项益处。一些参与者报告该干预措施对步行或健康的影响有限。许多参与者在12个月时仍继续使用他们在干预前半年学到的策略。
结论
“正念步程”的身心内容似乎对步行行为有积极影响。参与者对该干预措施的体验有助于确定未来干预改进的领域。需要开展进一步的定量研究来证实这些定性研究结果，并评估该干预措施对长期身体活动参与度的疗效。
试验注册
本试验已在ClinicalTrials.gov注册，注册号为NCT01551953。
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