A Study on a Behavioral Intervention Program for Home Non-invasive Positive Pressure Ventilation in Stable COPD Patients Based on the Health Belief Model
DOI:
https://doi.org/10.71204/sc32kv02Keywords:
Chronic Obstructive Pulmonary Disease, Health Belief Model, Non-invasive Positive Pressure Ventilation, Behavioral Intervention, Treatment AdherenceAbstract
This study aimed to analyze factors influencing home non-invasive positive pressure ventilation (NPPV) adherence in patients with chronic obstructive pulmonary disease (COPD), and to construct and evaluate the clinical effectiveness of a behavioral intervention program based on the Health Belief Model (HBM). The intervention program was developed through questionnaire surveys and semi-structured interviews with 200 patients, followed by Delphi expert consultations. Subsequently, a 3-month randomized controlled trial (RCT) was conducted to evaluate its efficacy, with the control group receiving conventional health guidance.Post-intervention, the intervention group demonstrated significantly higher total Health Belief Scale scores (4.2 ± 0.3 vs. 2.5 ± 0.4), improved NPPV behavioral adherence (32.4 ± 1.8 vs. 20.1 ± 2.5), and lower CAT scores (10.3 ± 2.1 vs. 20.5 ± 3.2) compared to the control group. Furthermore, blood gas analysis, 6-minute walk test results, and lung function indices were all significantly better in the intervention group (all P < 0.001). Behavioral intervention based on the Health Belief Model can effectively improve NPPV treatment adherence in stable COPD patients, enhance their quality of life, and improve physiological function, demonstrating significant clinical value for promotion.
References
Alyafei, A., & Easton-Carr, R. (2024). The health belief model of behavior change. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559044/
Boers, E., Barrett, M., Su, J. G., et al. (2023). Global burden of chronic obstructive pulmonary disease through 2050. JAMA Network Open, 6(12), e2346598. DOI: https://doi.org/10.1001/jamanetworkopen.2023.46598
Butler, S. J., Desveaux, L., Lee, A. L., et al. (2020). Randomized controlled trial of community-based, post-rehabilitation exercise in COPD. Respiratory Medicine, 174, 106195. DOI: https://doi.org/10.1016/j.rmed.2020.106195
Chen, Y., Tan, R., Long, X., & Tu, H. (2024). Applying behavioral change theories to optimize pulmonary rehabilitation in COPD patients: A review. Medicine, 103(22), e38366. DOI: https://doi.org/10.1097/MD.0000000000038366
Hayes Watson, C., Nuss, H., Celestin, M., et al. (2019). Health beliefs associated with poor disease self-management in smokers with asthma and/or COPD: A pilot study. Journal of Asthma, 56(9), 1008-1015. DOI: https://doi.org/10.1080/02770903.2018.1509990
Janssens, J. P., Derivaz, S., Breitenstein, E., et al. (2003). Changing patterns in long-term noninvasive ventilation: A 7-year prospective study in the Geneva Lake area. Chest, 123(1), 67-79. DOI: https://doi.org/10.1378/chest.123.1.67
Janssens, J. P., Michel, F., Schwarz, E. I., Prella, M., Bloch, K., Adler, D., ... & Special Interest Group on Ventilation and Oxygen Therapy of the Swiss Society of Pneumology. (2021). Long-term mechanical ventilation: recommendations of the Swiss Society of Pulmonology. Respiration, 99(10), 867-902. DOI: https://doi.org/10.1159/000510086
Köhnlein, T., Schwarz, S. B., Nagel, S., & Windisch, W. (2022). Home non-invasive positive pressure ventilation in chronic obstructive pulmonary disease: Why, who, and how? Respiration, 101(8), 709-716. DOI: https://doi.org/10.1159/000525015
Nicolini, A., Lucazovitch, J., & Walterspacher, S. (2020). High-intensity noninvasive ventilation in stable hypercapnic COPD. In A. M. Esquinas et al. (Eds.), Noninvasive ventilation in sleep medicine and pulmonary critical care (pp. 55–70). Springer. DOI: https://doi.org/10.1007/978-3-030-42998-0_5
van der Leest, S., & Duiverman, M. L. (2019). High-intensity non-invasive ventilation in stable hypercapnic COPD: Evidence of efficacy and practical advice. Respirology, 24(4), 318-328. DOI: https://doi.org/10.1111/resp.13450
Volpato, E., Banfi, P. I., & Pagnini, F. (2023). Acceptance and adherence to non-invasive positive pressure ventilation in people with chronic obstructive pulmonary disease: A grounded theory study. Frontiers in Psychology, 14, 1134718. DOI: https://doi.org/10.3389/fpsyg.2023.1134718
Volpato, E., Banfi, P., & Pagnini, F. (2022). Promoting acceptance and adherence to noninvasive ventilation in chronic obstructive pulmonary disease: A randomized controlled trial. Psychosomatic Medicine, 84(4), 488–504. DOI: https://doi.org/10.1097/PSY.0000000000001053
Wang, T., Wang, H., Zeng, Y., Cai, X., & Xie, L. (2022). Health beliefs associated with preventive behaviors against noncommunicable diseases. Patient Education and Counseling, 105(1), 173-181. DOI: https://doi.org/10.1016/j.pec.2021.05.024
Windisch, W., Haenel, M., Storre, J. H., & Dreher, M. (2009). High-intensity non-invasive positive pressure ventilation for stable hypercapnic COPD. International Journal of Medical Sciences, 6(2), 72-76. DOI: https://doi.org/10.7150/ijms.6.72
World Health Organization. (2025, January). Chronic obstructive pulmonary disease (COPD). World Health Organization. https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd)
Yazar, E. E., Özlü, T., Sarıaydın, M., et al. (2018). Prospective cross-sectional multicenter study on domiciliary noninvasive ventilation in stable hypercapnic COPD patients. International Journal of Chronic Obstructive Pulmonary Disease, 13, 2367–2374. DOI: https://doi.org/10.2147/COPD.S164384
Yu, D. S. F., Li, P. W., Lau, J. C., et al. (2024). Health communication and adherence to noninvasive ventilation in chronic hypercapnic respiratory failure: A randomized clinical trial. JAMA Network Open, 7(12), e2451614. https://doi.org/10.1001/jamanetworkopen.2024.51614 DOI: https://doi.org/10.1001/jamanetworkopen.2024.51614
Zhou, L., Li, X., Guan, L., et al. (2017). Home noninvasive positive pressure ventilation with built-in software in stable hypercapnic COPD: A short-term prospective, multicenter, randomized, controlled trial. International Journal of Chronic Obstructive Pulmonary Disease, 12, 1279-1286. DOI: https://doi.org/10.2147/COPD.S127540
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Tulei Tian, Lifang Cao (Author); Hongbo Zhang (Translator); Jing Xia, Yanyuan Qi, Xiangkun Qu (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles published in this journal are licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author(s) and source are properly credited. Authors retain copyright of their work, and readers are free to copy, share, adapt, and build upon the material for any purpose, including commercial use, as long as appropriate attribution is given.
How to Cite
