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

Corresponding author: JIAO Dan-dan▲, jdd201304@163.com

DOI: 10.12201/bmr.202611.00001

•  

  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.

  Submit time: 1 November 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
• html

• 图表

• Lidan Zhang, Junyi Li, Jie Huang, Rui Gao. Meta-synthesis of qualitative research on cognitive impairment experience in cancer patients. 2026. doi: 10.12201/bmr.202607.00034

  YANG Ruyi, ZHAO Wenling. Research Progress on Clinical Efficacy of Adjuvant Traditional Chinese Medicine Therapy for Acute Exacerbation of Chronic Obstructive Pulmonary Disease. 2026. doi: 10.12201/bmr.202609.00010

  Chen Cuiyan, Liang Huiying. Development of an Ensemble Screening Model for Chronic Obstructive Pulmonary Disease Using Multimodal Data. 2026. doi: 10.12201/bmr.202604.00086

  Wang Nan, Chen Zhen. Correlation between the Expression of Peripheral Blood miR-145-5p and miR-223 and Treatment Response and Prognosis in Patients with Chronic Obstructive Pulmonary Disease Complicated with Pulmonary Tuberculosis. 2026. doi: 10.12201/bmr.202604.00163

  刘倩, zhoujing, Han Shan, Chen Min, Wu Haiqin, Hu Yiwen. . 2026. doi: 10.12201/bmr.202603.00042

  何飞龙, Liu Qianqian, Liu Yangkun, ChenYunfeng. Progress in research on the comorbidity of interstitial lung disease and obstructive sleep apnea. 2026. doi: 10.12201/bmr.202607.00016

  xuyangpo, zhanairong. . 2026. doi: 10.12201/bmr.202608.00041

  MO wenjuan, FENG jia, LI mengnan, LIU zhangyue, SU tong. Evidence Map of Exercise Rehabilitation for Elderly Patients After Hip Arthroplasty. 2025. doi: 10.12201/bmr.202512.00031

  chenyajuan. . 2026. doi: 10.12201/bmr.202605.00037

  CHEN Jiayu, CHEN Bin, LI Fang. . 2025. doi: 10.12201/bmr.202511.00090

• ID	Submit time	Number	Download
  1	2026-09-08	10.12201/bmr.202611.00001V1	Download

• Public  Anonymous  To author only Submit Comments