Evidence map›Paper›PMID 40463723›Full record

ArticleFrontiers in public health2025

Understanding facilitators and barriers to adherence in home-based pulmonary rehabilitation for chronic obstructive pulmonary disease patients using the Health Belief Model: a qualitative study.

Qiuxuan Zeng, Wenli Chen, Siyi Xu, Xu Yang, Dandan Xue, Yuhang Peng, Xiaohong Lin, Yingwen Yu, Huixin Huang, Ping Huang and 2 more

Abstract read
In one paragraph

Article in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Qiuxuan Zeng *The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Wenli Chen *The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Siyi XuSchool of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Xu YangThe First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Dandan XueLi Ka Shing Faculty of Medicine, School of Nursing, The University of Hong Kong, Hong Kong SAR, China.
Yuhang PengThe First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Xiaohong LinThe First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Yingwen YuThe First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Huixin HuangThe First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Ping HuangThe First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Min DongThe First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Jiaying LiSchool of Nursing, Johns Hopkins University, Baltimore, MD, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Home-based pulmonary rehabilitation (PR) is a key non-pharmacological intervention for chronic obstructive pulmonary disease (COPD), but poor adherence limits its effectiveness. The factors influencing adherence, particularly from the patients' perspective, are not well understood. This study aims to identify the factors that promote or hinder adherence to home-based rehabilitation in COPD patients, to inform more effective and personalized strategies. Methods: This study guided by Health Belief Model (HBM), and data were collected through semi-structured in-depth interviews with eligible COPD patients during May and July 2024. Deductive thematic analysis approach was used to analyze the data. Results: Eighteen patients were recruited through purposive sampling. Two main themes emerged-facilitating health beliefs and challenges- along with five subthemes under the HBM framework: perceived threats, perceived benefits, cues to action, self-efficacy, and perceived barriers. In total, 28 categories were identified (21 facilitators, 7 barriers), including 11 newly discovered facilitators and one new barrier. Newly identified facilitators included physical limitations and fatigue, emotional distress, perceived ineffectiveness, time constraints, caregiving responsibilities, lack of support, cost, poor exercise conditions, reduced medical dependence, self-awareness of functional decline, attention-seeking behaviors, environmental cues, mental resilience, and religious beliefs. The new barrier related to environmental limitations and poor exercise conditions. Conclusion: This study underscores facilitators and barriers influencing home-based PR adherence within the HBM framework. Facilitators include broad factors related to perceived benefits, cues to action, self-efficacy, and perceived threats, while barriers encompass physical limitations, time constraints, and insufficient support. Flexible, personalized programs and greater family involvement can enhance adherence, improve long-term outcomes, and mitigate the rising burden of chronic diseases in aging societies.

Indexed as

Health Belief ModelHome Care ServicesPatient CompliancePulmonary Disease, Chronic ObstructiveAgedAged, 80 and overFemaleHumansInterviews as TopicMaleMiddle AgedQualitative ResearchSelf Efficacyadherencebarrierschronic obstructive pulmonary diseasefacilitatorsHealth Belief Modelhome-based pulmonary rehabilitationqualitative research

Identifiers

PMID40463723
PMCPMC12129764

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.