Motivational orientation and influencing factors of older adults with chronic obstructive pulmonary disease in community dwellings: a latent profile analysis

Abstract

Chronic obstructive pulmonary disease (COPD) poses a serious threat to older adults’ health. Promoting the adoption of health behaviors among community-dwelling patients is essential for improving prognosis, with motivational orientation serving as a key determinant of health behaviors. Therefore, this study aims to identify latent categories of motivational orientation and its influencing factors among community-based older adults with COPD. This study was conducted between November 2024 and March 2025, with 246 patients from the communities at two community health centers in China. Data were collected using the general information questionnaire, the Behavioral Inhibition/ Activation System Scale, the Generalized Anxiety Disorder 7-item Scale and the Center for Epidemiological Studies Depression Scale. A latent profile analysis was performed to analyze latent categories of motivational orientation. Multiple logistic regression was used to analyze the influencing factors of their latent profiles. Three latent categories of motivational orientation among COPD patients were identified: ‘avoidance motivation dominated group’(10.2%), ‘conflict motivation group’ (29.7%) and ‘approach motivation dominated group’ (60.1%). The best-fitting model demonstrated robust fit indices: AIC = 4484.372, BIC = 4547.468, aBIC = 4490.409, Entropy = 0.983. Patients with higher depression scores were more likely to be in the ‘avoidance motivation dominated group’ than those in the ‘conflict motivation group’ (OR = 1.506, 95% CI: 1.230–1.842). Patients with younger age (OR = 0.480, 95% CI: 0.288–0.802), higher income (OR = 3.257, 95% CI: 1.486–7.140), and shorter duration of illness (OR = 0.608, 95% CI: 0.377–0.982) were more likely to be in the ‘approach motivation dominated group’. In clinical practice, older COPD patients present significant variations in motivational orientation, these differences are influenced by individual characteristics such as age, long disease duration, and psychological factors. Healthcare professionals should provide individualized psychological support and health education programs to promote the development of proactive health behaviors.