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Updated: Sep 19, 2025

Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease
Published on: August 24, 2019
The Basic Science of Behavior Change in COPD: Testing Self-Determination Theory to Support Home-Based Rehabilitation
Maria Benzo1, Minji Lee, Matthew M Clark
1Author Affiliations: Division of Pulmonary, Critical Care and Sleep Medicine, Mindful Breathing Laboratory (Drs Benzo and Dr Benzo), Department of Quantitative Health Sciences (Dr Lee), and Department of Psychiatry and Psychology (Dr Clark), Mayo Clinic, Rochester, Minnesota.
Home-based pulmonary rehabilitation with health coaching improves quality of life in COPD patients by fostering autonomy, competence, and relatedness, as supported by Self-Determination Theory.
Area of Science:
- Pulmonary Rehabilitation
- Behavioral Science
- Health Psychology
Background:
- Home-based pulmonary rehabilitation (HBPR) with health coaching (HC) improves physical activity and quality of life (QoL) in COPD patients.
- A theoretical framework explaining this behavior change in COPD patients is lacking.
Purpose of the Study:
- To examine the mechanism of HBPR with HC on physical and emotional QoL in COPD patients.
- To test the Self-Determination Theory (SDT) as a framework for observed behavior change.
Main Methods:
- Secondary analysis of a 12-week HBPR with HC intervention in moderate to very severe COPD.
- Structural Equation Models (Path Analysis) assessed the role of competence, autonomy, and relatedness.
Main Results:
- Path models confirmed HBPR with HC directly impacts physical and emotional QoL through competence and relatedness (P < .01).
- Autonomy indirectly influenced QoL via competence and relatedness.
Conclusions:
- Self-Determination Theory mechanistically supports the effectiveness of HBPR with HC in COPD patients.
- Addressing autonomy, competence, and relatedness in pulmonary rehabilitation is crucial for improving QoL.
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