Patients’ experiences of promoting and hindering factors in daily physical activity with chronic obstructive pulmonary disease: a qualitative systematic review

BACKGROUND AND OBJECTIVES: Physical activity (PA) is essential for maintaining function and quality of life in patients with chronic obstructive pulmonary disease (COPD). Yet, many return to sedentary behaviors after pulmonary rehabilitation. Identifying facilitators and barriers to daily activity is crucial for developing patient-centered interventions. However, qualitative evidence on patients' experiences and perceptions remains limited. METHODS: A qualitative systematic review was conducted following the Joanna Briggs Institute (JBI) Evidence Synthesis Manual. Twelve databases, including Cochrane Library, PubMed, Embase, CINAHL, and major Chinese databases, were searched up to December 5, 2023. Study quality was appraised using the JBI Checklist for Qualitative Research. Data were extracted with the JBI tool and synthesized using a meta-aggregative approach. RESULTS: A total of 1,540 records were screened, and 11 studies were included. Forty findings were aggregated into 13 categories and synthesized into five themes: confronting symptom management and psychological challenges; lacking compliance, behavior change capacity, and autonomy in decision-making; stimulating motivations for engaging in activities; managing activity plans, respiratory aspects during activities, and activity safety; and optimizing family, peer, and medical support systems. Confidence in the synthesized findings ranged from low to high according to the ConQual assessment. CONCLUSIONS: COPD patients' engagement in daily physical activity is influenced by a complex interplay of physical, psychological, behavioral, and social factors. These findings may inform the development of multidisciplinary, patient-centered strategies to support daily physical activity engagement among adults with COPD, including integrated symptom management, motivational support, individualized activity planning, safety monitoring, and strengthened social and professional support.