通讯作者: 焦丹丹▲, jdd201304@163.com

DOI：10.12201/bmr.202611.00001

Facilitators and barriers to exercise rehabilitation adherence in patients with chronic obstructive pulmonary disease: a qualitative meta-synthesis

• 摘要：目的：系统整合慢性阻塞性肺疾病患者运动康复依从性促进及阻碍因素，为精准化的肺康复护理支持系统提供依据。方法：检索MEDLINE、CINAHL、PsycINFO、Embase、Web of Science、Scopus、中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库中关于慢性阻塞性肺疾病患者运动康复依从性促进及阻碍因素的质性研究文献，检索时限为建库至2026年1月31日，由2名研究者采用澳大利亚循证卫生保健中心质性研究质量评价工具独立评价文献，使用Endnote软件进行文献筛选，通过主题整合方法整合结果。结果：共纳入18篇文献，提炼出28个原始结果，提炼为11个描述性主题，最终整合为4个分析性主题：个体层面的生理与心理阻碍；系统层面的环境与服务阻碍；个体层面的认知与动力促进；系统层面的支持与资源促进。结论：慢性阻塞性肺疾病患者运动康复依从性受生理、心理与系统多重阻碍影响；家庭、社群与制度支持在满足特定条件后可转化为实际助力；个体认知转变是患者由被动受限到主动调适的关键，可通过认知再构、动机性访谈与正向反馈提升康复韧性及长期依从性。

  关键词： 慢性阻塞性肺疾病; 运动康复; 依从性; 质性研究; Meta整合

   

  Abstract: Objective: To synthesize facilitators and barriers influencing adherence to exercise rehabilitation among patients with COPD, thereby informing precision-oriented pulmonary rehabilitation nursing support. Methods: A comprehensive literature search was conducted in MEDLINE, CINAHL, PsycINFO, Embase, Web of Science, Scopus, CNKI, Wanfang, VIP, and the Chinese Biomedical Literature Database from inception to January 31, 2026. Two reviewers independently appraised methodological quality using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Studies were screened using EndNote, and findings were synthesized through thematic synthesis. Results: 18 studies were included, yielding 28 original findings. These findings were synthesized into 11 descriptive themes and further integrated into 4 analytical themes: individual-level barriers: physical and psychological; system-level barriers: environmental and service-related; individual-level facilitators: cognitive and motivational; system-level facilitators: support and resource-related. Conclusion: Adherence to exercise rehabilitation in patients with chronic obstructive pulmonary disease is shaped by interacting physiological, psychological, and systemic barriers, while its promotion requires family, community, and institutional support to be translated into practical assistance once specific conditions are satisfied. Concurrently, cognitive transformation constitutes the pivotal gateway from passive restriction to active self-regulation, with cognitive reframing, motivational interviewing, and positive feedback enhancing patients'' long-term adherence.

  Key words: COPD; exercise rehabilitation; compliance; qualitative research; Meta-synthesis.

  提交时间：2026-11-01

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2026-09-08	10.12201/bmr.202611.00001V1	下载

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