Configurational patterns associated with relatively higher recent home-based exercise behavior among lung transplant recipients: a fuzzy-set qualitative comparative analysis.
- 1Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Abstract
Background
Home-based exercise supports functional recovery after lung transplantation, yet exercise behavior varies among recipients. Guided by the capability, opportunity, motivation, and behavior (COM-B) model, this study examined configurations associated with relatively higher recent home-based exercise behavior among lung transplant recipients.Methods
This cross-sectional study included adult lung transplant recipients within the first year after transplantation at a tertiary hospital in Zhejiang, China. Five COM-B-related conditions were assessed: 6-min walk distance, exercise rehabilitation knowledge, perceived social support, exercise self-efficacy, and exercise automaticity. Recent home-based exercise behavior during the previous 7 days was assessed through structured retrospective interviews and calculated as MET-min/week. Fuzzy-set qualitative comparative analysis examined necessary conditions, sufficient configurations, and the negated outcome; exploratory univariate analyses described clinical context.Results
Among 139 lung transplant recipients, no single condition was necessary for relatively higher recent home-based exercise behavior. Four sufficient configurations were identified (solution coverage, 0.675; consistency, 0.827). Exploratory analyses highlighted postoperative stage and pulmonary function; the negated-outcome analysis supported causal asymmetry. The configurations were summarized as motivation-characterized and multi-condition synergistic patterns. Motivation-characterized configurations combined higher exercise self-efficacy and higher exercise automaticity, although one configuration involving relatively limited exercise capacity was calibration-sensitive. Multi-condition synergistic configurations involved favorable combinations of capability-, social opportunity-, and motivation-related conditions.Conclusion
Relatively higher recent home-based exercise behavior was associated with multiple COM-B-related configurations rather than any single necessary condition. These findings may inform multidimensional assessment and clinically contextualized rehabilitation support during post-transplant home recovery.
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BibTeX
@article{zhu2026configurational,
title = {{Configurational patterns associated with relatively higher recent home-based exercise behavior among lung transplant recipients: a fuzzy-set qualitative comparative analysis.}},
author = {Qianyin Zhu and Leiwen Tang and Pan Lin and Fei Zeng and Meijuan Lan},
journal = {Annals of medicine},
year = {2026},
month = nov,
doi = {10.1080/07853890.2026.2756039},
url = {https://europepmc.org/article/MED/42969928},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Configurational patterns associated with relatively higher recent home-based exercise behavior among lung transplant recipients: a fuzzy-set qualitative comparative analysis.
AU - Qianyin Zhu
AU - Leiwen Tang
AU - Pan Lin
AU - Fei Zeng
AU - Meijuan Lan
PY - 2026
DA - 2026/11/02
JO - Annals of medicine
DO - 10.1080/07853890.2026.2756039
UR - https://europepmc.org/article/MED/42969928
AB - Background Home-based exercise supports functional recovery after lung transplantation, yet exercise behavior varies among recipients. Guided by the capability, opportunity, motivation, and behavior (COM-B) model, this study examined configurations associated with relatively higher recent home-based exercise behavior among lung transplant recipients.Methods This cross-sectional study included adult lung transplant recipients within the first year after transplantation at a tertiary hospital in Zhejiang, China. Five COM-B-related conditions were assessed: 6-min walk distance, exercise rehabilitation knowledge, perceived social support, exercise self-efficacy, and exercise automaticity. Recent home-based exercise behavior during the previous 7 days was assessed through structured retrospective interviews and calculated as MET-min/week. Fuzzy-set qualitative comparative analysis examined necessary conditions, sufficient configurations, and the negated outcome; exploratory univariate analyses described clinical context.Results Among 139 lung transplant recipients, no single condition was necessary for relatively higher recent home-based exercise behavior. Four sufficient configurations were identified (solution coverage, 0.675; consistency, 0.827). Exploratory analyses highlighted postoperative stage and pulmonary function; the negated-outcome analysis supported causal asymmetry. The configurations were summarized as motivation-characterized and multi-condition synergistic patterns. Motivation-characterized configurations combined higher exercise self-efficacy and higher exercise automaticity, although one configuration involving relatively limited exercise capacity was calibration-sensitive. Multi-condition synergistic configurations involved favorable combinations of capability-, social opportunity-, and motivation-related conditions.Conclusion Relatively higher recent home-based exercise behavior was associated with multiple COM-B-related configurations rather than any single necessary condition. These findings may inform multidimensional assessment and clinically contextualized rehabilitation support during post-transplant home recovery.
SN - 0785-3890
SN - 1365-2060
ER -