Study on Reducing Relapse from the Perspective of Patients with Chronic Obstructive Pulmonary Disease Based on the COM-B Framework
Objective To explore the evolution of psychological behavior change and the influence of motivation,ability and opportunity on smoking cessation behavior in COPD patients.Methods Based on COM-B behavioral change framework,four patients with COPD from two third-grade grade A hospitals in Beijing were selected for semi-structured in-depth interviews from January to December 2019.Each patient was followed up 4 times for 1 year(3 males,1 female;1 case of successful smoking cessation,3 cases of relapse).Multiple qualitative studies tracked the mental state and behavioral characteristics of the patients.Results Ability factor:① physiological ability-disease factor,disease aggravation promoted smoking cessation,while getting better could promote smoking cessation and relapse,as well as smoking cessation.②The psychological ability of the factors that were not conducive to smoking cessation:(a)knowing the knowledge of smoking cessation but do not recognize;(b)lacking of awareness of the effects of smoking cessation on the body;(c)perceptions of smoking as a habit that was difficult to change;among the factors of mental ability in favor of smoking cessation:strong willpower and self-control.Opportunity factors:① factors that were not conducive to smoking cessation in physical opportunities:people around smoking and smoking at home during holidays;②social opportunities-family support,when somebody had weak personal drive and general family support,the effect of smoking cessation was moderate;③social opportunity-job restriction,work system would have certain constraints on smoking,but after leaving the system or work environment,they would still smoke again.Motivation factors:① automatic motivation-the influence of mood,when the mood was bad would cause relapse,smoking cessation needed to be prepared psychologically;②reflective motivation-cognitive change happiness shift,tea or exercise shift attention,was conducive to reduce relapse;③reflect on the motivation-ideals and hopes,ideals and hopes could help to smoking cessation.Studies had found that there was a situation in which patients will voluntarily not smoke,and that was when they focus on doing what they love.Conclusion In terms of motivation,if the motivation of patients to quit smoking is not strong,it is generally difficult to trigger the change of behavior.Therefore,it is necessary to change the motivation of patients from reluctance to willingness.In terms of ability and opportunity,when patients have the intention to quit smoking,it does not mean that the quitting behavior will be successful.They need to be prepared and trained repeatedly.Over time,reflective motivation gradually gives way to automatic motivation,and the process of controlling behavior shifts from conscious decision making to routine and environmental triggering,thus enabling behavior to occur with minimal effort and ultimately successful quitting.
万方数据
维普
