ABSTRACT

Embracing the Bayesian approach, we aimed to synthesise evidence regarding barriers and enablers to physical activity in adults with heart failure (HF) to inform behaviour change intervention. This approach helps estimate and quantify the uncertainty in the evidence and facilitates the synthesis of qualitative and quantitative studies. Qualitative evidence was annotated using the Theoretical Domains Framework and represented as a prior distribution using an expert elicitation task. The maximum a posteriori probability (MAP) for the probability distribution for the log OR was used to estimate the relationship between physical activity and each determinant according to qualitative, quantitative, and qualitative and quantitative evidence combined. The probability distribution dispersion (SD) was used to evaluate uncertainty in the evidence. Three qualitative and 16 quantitative studies were included (N = 2739). High pro-b-type natriuretic peptide (MAP = −1.16; 95%CrI: [−1.21; −1.11]) and self-reported symptoms (MAP = − 0.48; 95%CrI: [ −0.40; −0.55]) were suggested as barriers to physical activity with low uncertainty (SD = 0.18 and 0.19, respectively). Modifiable barriers were symptom distress (MAP = −0.46; 95%CrI: [−0.68; −0.24], SD = 0.36), and negative attitude (MAP = −0.40; 95%CrI: [−0.49; −0.31], SD = 0.26). Modifiable enablers were social support (MAP = 0.56; 95%CrI: [0.48; 0.63], SD = 0.26), self-efficacy (MAP = 0.43; 95%CrI: [0.32; 0.54], SD = 0.37), positive physical activity attitude (MAP = 0.92; 95%CrI: [0.77; 1.06], SD = 0.36).

摘要

采用贝叶斯方法，我们的目标是综合有关心力衰竭（HF）成人体力活动的障碍和推动因素的证据，为行为改变干预提供信息。这种方法有助于估计和量化证据中的不确定性，并促进定性和定量研究的综合。定性证据使用理论领域框架进行注释，并使用专家启发任务表示为先验分布。log OR概率分布的最大后验概率 ( MAP )用于根据定性、定量以及定性和定量证据相结合来估计体力活动与每个决定因素之间的关系。概率分布离散度（SD）用于评估证据的不确定性。纳入 3 项定性研究和 16 项定量研究 ( N  = 2739)。高b型利钠肽（MAP = -1.16；95% CrI：[-1.21；-1.11]）和自我报告症状（MAP = - 0.48；95% CrI：[ -0.40；-0.55]）建议作为体力活动的障碍，不确定性较低（SD 分别 = 0.18 和 0.19）。可改变的障碍是症状困扰（MAP = -0.46；95% CrI：[-0.68；-0.24]，SD  = 0.36）和消极态度（MAP = -0.40；95% CrI：[-0.49；-0.31]，SD  = 0.26）。可修改的促成因素包括社会支持（MAP = 0.56；95% CrI：[0.48；0.63]，SD  = 0.26）、自我效能感（MAP = 0.43；95% CrI：[0.32；0.54]，SD = 0.37）、积极的身体素质活动态度（MAP = 0.92；95% CrI：[0.77；1.06]，SD  = 0.36）。