A Qualitative Exploration of Exercise Among Pulmonary Rehabilitation Participants: Insight From Multiple Sources of Social Influence

Abstract

BACKGROUND: Exercise training within the pulmonary rehabilitation (PR) context is considered the most effective strategy to reduce COPD symptoms. However, participation in PR and continued exercise training following program completion are low. Previous research examined factors related to attendance and adherence, but the knowledge base to date has been limited to quantitative findings that focus solely on participants diagnosed with COPD. In addition to quantitative research, exploring multiple perspectives (eg, PR participants, significant others, staff, and stakeholders) using qualitative research methods opens a window of additional understanding. The goal of this study was to obtain multiple perspectives on PR to gain insight into factors that affect exercise participation among individuals diagnosed with COPD. METHODS: A total of 26 participants were interviewed via telephone, including 8 individuals diagnosed with COPD (4 men and 4 women, mean age of 67 [range of 58 -77] y), 4 family members, 11 PR staff, and 3 community stakeholders. RESULTS: Analysis revealed 3 themes: task self-efficacy for exercise, provision of support and encouragement, and perceptions of gender differences. Despite initial concerns, individuals diagnosed with COPD reported becoming more confident during PR and emphasized the importance of being supported by staff. PR staff perceived that men tended to approach exercise in a more eager and aggressive manner compared with women, who were more cautious and hesitant. CONCLUSIONS: In addition to enhancing task self-efficacy, findings suggest that exercise participation and adherence within the PR environment may be improved by adopting a gender-tailored approach.

A new pulmonary rehabilitation maintenance strategy through home-visiting and phone contact in COPD

“…During the follow-up, although the improvement of emotional function after PR was not changed over time compared with post-PR in both groups, our home-based maintenance could also provide family support and professional health education to increase the confidence of patients to overcome depression and anxiety, as described in previous research. 34 …”

Experiences of people with Parkinson's disease and their views of physical activity interventions: a qualitative systematic review protocol

“…Results from research across a variety of populations [13][14][15][16] suggests that recidivism upon cessation of intervention is a reality. This is likely to be the case for pwPD unless strategies for the maintenance of long-term participation in physical activity are developed.…”

Healthcare professionals’ perceptions of pulmonary rehabilitation as a management strategy for patients with chronic obstructive pulmonary disease: a critical interpretive synthesis

“…Increase in patient confidence: Healthcare professionals recognised that a group setting assists with social and psychological aspects; connecting and creating bonds with others whose circumstances bear a close resemblance to their own [42,49,52,55]. The programme was perceived to increase quality of life by giving patients a purpose; this newfound confidence was achieved as pulmonary rehabilitation provides hope and a more positive outlook on life [52].…”

“…The programme was perceived to increase quality of life by giving patients a purpose; this newfound confidence was achieved as pulmonary rehabilitation provides hope and a more positive outlook on life [52]. A Canadian qualitative interview study with healthcare professionals who delivered pulmonary rehabilitation (n=11), highlighted patients are anxious upon commencement, however healthcare professionals felt a sense of accomplishment when patients recognised their ability to exercise and achieve goals [55]. Similarly, the initial assessment was viewed as an opportunity to encourage, give hope and discuss useful tips, and a chance to improve adherence to pulmonary rehabilitation [42].…”