“Just that four letter word, hope”: stroke survivors’ perspectives of participation in an intensive upper limb exercise program; a qualitative exploration

Levy, Tamina; Christie, Lauren; Killington, Maggie; Laver, Kate; Crotty, Maria; Lannin, Natasha A.

doi:10.1080/09593985.2021.1875525

Cited by 13 publications

(20 citation statements)

References 29 publications

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“…Referring to Table 1 , studies were primarily qualitative and used semi-structured interviews. Out of the twenty papers reviewed; one study was on the evaluation of a randomised control trial using the COM-B framework [ 16 ]; one study involved the evaluation of a sustained lifestyle modification program [ 25 ]; ten studies were on behavioural analysis using the COM-B framework for health conditions [ 16 , 17 , 20 , 21 , 24 , 26 – 30 ]; and eight were on developing a PA intervention based on patient and clinician responses to questions guided by the COM-B framework [ 18 , 19 , 22 , 23 , 31 – 34 ].…”

Section: Resultsmentioning

confidence: 99%

“…[ 19 ] Cardiovascular disease Stroke victims Qualitative Clinician and patient workshops CF, CB CF, CB CF, CB Levy et al . [ 34 ] Cardiovascular disease Stroke victims Qualitative Patient interviews PF, PB PF, PB PF, PB a PF, Patient Facilitator; PB, Patient Barrier; CF, Clinician Facilitator; CB, Clinician Barrier …”

Section: Resultsmentioning

confidence: 99%

“…The types of health conditions and rehabilitation types included: fall prevention in older adults [ 15 , 21 ], pregnancy-related conditions [ 16 , 25 , 26 , 28 , 33 ], musculoskeletal disease [ 17 ], physical inactivity [ 20 , 30 , 32 ], cancer [ 27 ], respiratory disease [ 22 , 23 ], neurological disease [ 24 , 29 ], type II diabetes [ 31 ], and cardiovascular disease [ 18 , 19 , 34 ].…”

Section: Resultsmentioning

confidence: 99%

“…Developing behavioural regulation skills (action planning and action control) [ 24 , 27 – 29 , 32 , 34 ]…”

Section: Resultsmentioning

confidence: 99%

“…Types of health knowledge included: knowledge of personal health and health conditions [ 15 , 21 , 25 , 30 , 32 ], suitable PA intervention strategies [ 15 , 22 , 26 , 28 , 30 – 32 ], PA guidelines [ 31 , 32 ], and benefits of PA for their well-being [ 15 , 21 , 22 , 30 , 32 ]. Two main forms of behavioural regulation skills were noted in several articles to influence behaviour, these being action-planning and action-control [ 22 , 24 , 27 – 29 , 32 , 34 ]. Action-planning was defined as being able to make detailed plans on how to complete target behaviour, while action-control was defined as the automaticity to control habits leading to target behaviour [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

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Identifying the factors affecting ‘patient engagement’ in exercise rehabilitation

Teo

Zheng

Bird

2022

BMC Sports Sci Med Rehabil

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Background Despite the proven benefits of exercise rehabilitation for numerous health conditions, musculoskeletal injuries and recovery from surgery, patient adherence to such programs is reported to often be less than 35%. Increasing patient engagement therefore has the potential to improve patient health outcomes, benefiting the patient, their carers and the services that support them. The aims of this review were to identify the factors that contribute to ‘patient’ engagement in prescribed exercise rehabilitation using the COM-B (capability, opportunity, motivation-behaviour) framework of behavioural analysis. Methods Five electronic databases (PubMed, Embase, Cochrane, Web of Science, and ClinicalTrials.gov) were searched. ‘COM-B’ was the key word searched for specifically within titles and abstracts, combined with either ‘physical activity’ OR ‘exercise’ included using the ‘AND’ operation. Records were then filtered and excluded following full-text screening based on the predetermined eligibility criteria. Results Twenty studies were included in the review. The main COM-B themes highlighted for improving patient engagement were: capability—improving patient knowledge and cognitive skills for behavioural regulation, such as ‘action planning’ and ‘action control’, which could also benefit time-management; opportunity—a balanced life situation that enabled time to be devoted to the exercise program, social support, easily accessible and affordable resources and services; and motivation—increasing patient levels of self-efficacy and autonomous motivation, which were noted to be influenced by levels of perceived ‘capability’, additionally ‘motivation’ was noted to be influenced by patients perceiving the benefits of the exercise, and adherence to the program was promoted by ‘goal-setting’. Other issues in the ‘capability’ domain included a fear and/or dislike of exercise. Conclusion Patient engagement behavior has been shown to be influenced by both external (opportunity) and intrapersonal variables (capability and motivation). Those prescribing exercises within a rehabilitation program need to discuss these factors with their patients and co-design the exercise rehabilitation program in partnership with the patient, since this is likely to improve patient engagement, and thereby result in superior health outcomes. Furthermore, these factors need to be a consideration in clinical trials, if the findings from such trials are to translate into mainstream healthcare settings.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Developing behavioural regulation skills (action planning and action control) [ 24 , 27 – 29 , 32 , 34 ]…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Identifying the factors affecting ‘patient engagement’ in exercise rehabilitation

Teo

Zheng

Bird

2022

BMC Sports Sci Med Rehabil

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Adult experiences of constraint-induced movement therapy programmes: a qualitative study using the Theoretical Domains Framework and Capability, Opportunity, Motivation – Behaviour system

et al. 2022

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Aim: To explore the experiences of adults who completed a constraint-induced movement therapy (CIMT) programme, and the barriers and enablers to their participation. Methods: Qualitative design using semi-structured interviews. Stroke and brain injury survivors (n = 45) who had completed CIMT as part of their usual rehabilitation were interviewed 1 month post-CIMT. Interviews were audio-recorded, transcribed and imported into Nvivo for analysis. Inductive coding was used to identify initial themes. Themes were then deductively mapped to the Capability, Opportunity, Motivation – Behaviour system, a behaviour change model, to identify barriers and enablers to CIMT programme adherence and engagement. Results: Enablers influencing participation included being provided with education about the programme (Capability – psychological), seeing improvements in arm function (Motivation – reflective), being committed to the programme (Motivation – reflective) and having strong social support from staff, family and allied health students (Opportunity – social). The structured programme was a motivator and offered a way to fill the time, particularly during inpatient rehabilitation (Opportunity – physical). Barriers to participation included experiencing physical and mental fatigue (Capability – physical) and frustration early in the CIMT programme (Motivation – automatic), and finding exercises boring and repetitive (Motivation – automatic). Conclusion: Therapist provision of educational supports for CIMT participants and their families is important to maximise CIMT programme uptake. During CIMT delivery, we recommend the provision of positive feedback and coaching in alignment with CIMT principles, and the inclusion of social supports such as group-based programmes to enhance participant adherence.

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Perseverance with home-based upper limb practice after stroke: perspectives of stroke survivors and their significant others

Neibling

Hayward

Smith

et al. 2023

Disability and Rehabilitation

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“Just that four letter word, hope”: stroke survivors’ perspectives of participation in an intensive upper limb exercise program; a qualitative exploration

Cited by 13 publications

References 29 publications

Identifying the factors affecting ‘patient engagement’ in exercise rehabilitation

Identifying the factors affecting ‘patient engagement’ in exercise rehabilitation

Adult experiences of constraint-induced movement therapy programmes: a qualitative study using the Theoretical Domains Framework and Capability, Opportunity, Motivation – Behaviour system

Perseverance with home-based upper limb practice after stroke: perspectives of stroke survivors and their significant others

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