Perceptions of barriers to and facilitators of exercise rehabilitation in adults with lung transplantation: a qualitative study in China

Abstract

Background Exercise is crucial for pulmonary rehabilitation and improving the prognosis of lung transplantation (LTx) patients. However, many LTx patients in China have low exercise tolerance and compliance, and the reasons behind these challenges have not been fully elucidated. Therefore, this qualitative research aims to identify the barriers to and facilitators of exercise rehabilitation in LTx patients. Methods From January to July 2023, 15 stable LTx patients were recruited and participated in in-depth, semi-structured, face-to-face interviews at Henan Provincial People’s Hospital. The interview transcripts were analyzed using the COM-B model and the Theoretical Domains Framework (TDF). Results Six general themes including 19 barriers and 14 facilitators for the exercise rehabilitation of LTx patients were identified based on the COM-B model and TDF. The barriers to exercise included physical limitations, insufficient exercise endurance, lack of knowledge, and lack of motivation. The facilitators of exercise included motivation, self-efficacy, perceived significance of exercise rehabilitation, and social support. Conclusion The study offers detailed insight into the development and implementation of exercise rehabilitation intervention strategies for LTx patients. By combining COM-B model and TDF, the study provides strong evidence that active behavior change strategies are required for LTx patients to promote their participation in exercise rehabilitation. Professional support, pulmonary rehabilitation training, behavior change technology, and digital health tools are essential for strengthening the evidence system for reporting exercise efficacy and effectiveness.

Development and validation of a clinical model of second fractures for hip fracture patients after surgery

“…regular exercise emerged as a protective predictor against second fractures in our study. Many scholars believe that in China, due to the lack of rehabilitation units and economic constraints, patients are often discharged directly to their private homes, with only a small number of wealthy patients admitted to nursing homes [24,25]. Consequently, limited access to rehabilitation services and resources outside the hospital setting means that most patients in China are unable to engage in regular exercise postdischarge, increasing the risk of second fractures.…”