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Journal of Nursing ›› 2024, Vol. 31 ›› Issue (5): 44-49.doi: 10.16460/j.issn1008-9969.2024.05.044

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Barriers to and facilitators of exercise rehabilitation in patients with COPD: a CFIR-based systematic review

WU Lin-mei1, LIANG Zhi-jin2, LIU Rui-jie1, ZHONG Jing-jing1, QIU Yu-hua2   

  1. 1. School of Nursing, Guangxi University of Chinese Medicine, Nanning 530001, China;
    2. Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning 530001, China
  • Received:2023-12-18 Online:2024-03-10 Published:2024-04-08

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Abstract: Objective To identify the barriers to and facilitators of exercise rehabilitation in patients with chronic obstructive pulmonary disease (COPD), and to provide reference for the formulation of exercise programs. Methods We conducted systematical research in 8 Chinese and English databases for qualitative, quantitative, and mixed studies on facilitators to and barriers of exercise rehabilitation in patients with COPD, and the retrieval period spanned from the inception of the databases to August 2023. The facilitating and hindering factors influencing exercise rehabilitation in patients with COPD were identified and coded according to the multilevel theory of Consolidated Framework for Implementation Research (CFIR), and the influencing factors were categorized based on the 5 dimensions of CFIR. Results Totally 31 studies were included, involving 2,458 COPD patients, 4 family members, 48 rehabilitators, 3 general practitioners, and 9 stakeholders. A total of 19 facilitators and 21 barriers were summarized, including 5 categories of intervention characteristics, external factors, internal factors, individual characteristics and implementation process. Most influencing factors were found in the category of individual characteristics, but less attention was paid to the importance of roles such as leaders and facilitators in exercise rehabilitation of COPD patients. Conclusion The identification of facilitators of and barriers to exercise rehabilitation based on the 5 dimensions of CFIR can inform the development of exercise rehabilitation strategies for patients with COPD; however, some subcategories, such as external policies, external assistance, leaders, and facilitators, have received less attention. It is recommended that the potential of these subcategories in facilitating exercise rehabilitation for patients with COPD should be further explored, while adopting multifaceted strategies based on a comprehensive assessment of the patient to address factors in multiple domains to enhance adherence to exercise rehabilitation in patients with COPD.

Key words: chronic obstructive pulmonary disease, exercise rehabilitation, barrier, facilitator, systematic review, Consolidated Framework for Implementation Research

CLC Number: 

  • R473.56
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