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Eur Respir J. 2014 Nov;44(5):1223-33. doi: 10.1183/09031936.00004814. Epub 2014 Jul 17.

The PROactive innovative conceptual framework on physical activity.

Author information

1
Health Services and Nursing Research, University of Leuven, Leuven, Belgium fabienne.dobbels@med.kuleuven.be.
2
Dept of General Practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands These authors equally contributed.
3
ELEGI Laboratory, Center for Inflammation Research, University of Edinburgh, Edinburgh, UK These authors equally contributed.
4
Lung Foundation Netherlands, Amersfoort, The Netherlands These authors equally contributed.
5
Dept of Critical Care Medicine and Pulmonary Services, Thorax Foundation, Athens, Greece These authors equally contributed.
6
Health Services and Nursing Research, University of Leuven, Leuven, Belgium These authors equally contributed.
7
ELEGI Laboratory, Center for Inflammation Research, University of Edinburgh, Edinburgh, UK.
8
Horten Centre and Institute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland.
9
Lung Foundation Netherlands, Amersfoort, The Netherlands.
10
Dept of General Practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
11
Outcomes and Evidence, Global Health and Value, Pfizer, Walton Oaks, UK.
12
Allergy and Respiratory Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK.
13
Dept of Rehabilitation Sciences, University of Leuven, Leuven, Belgium.
14
AstraZeneca, Research and Development, Health Economics and Outcomes Research, Medical Science, Mölndal, Sweden.
15
Patient Reported Outcomes Division, Novartis, Basel, Switzerland.

Abstract

Although physical activity is considered an important therapeutic target in chronic obstructive pulmonary disease (COPD), what "physical activity" means to COPD patients and how their perspective is best measured is poorly understood. We designed a conceptual framework, guiding the development and content validation of two patient reported outcome (PRO) instruments on physical activity (PROactive PRO instruments). 116 patients from four European countries with diverse demographics and COPD phenotypes participated in three consecutive qualitative studies (63% male, age mean±sd 66±9 years, 35% Global Initiative for Chronic Obstructive Lung Disease stage III-IV). 23 interviews and eight focus groups (n = 54) identified the main themes and candidate items of the framework. 39 cognitive debriefings allowed the clarity of the items and instructions to be optimised. Three themes emerged, i.e. impact of COPD on amount of physical activity, symptoms experienced during physical activity, and adaptations made to facilitate physical activity. The themes were similar irrespective of country, demographic or disease characteristics. Iterative rounds of appraisal and refinement of candidate items resulted in 30 items with a daily recall period and 34 items with a 7-day recall period. For the first time, our approach provides comprehensive insight on physical activity from the COPD patients' perspective. The PROactive PRO instruments' content validity represents the pivotal basis for empirically based item reduction and validation.

PMID:
25034563
PMCID:
PMC4216453
DOI:
10.1183/09031936.00004814
[Indexed for MEDLINE]
Free PMC Article

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