Overcoming barriers to engagement and adherence to a home-based physical activity intervention for patients with heart failure: a qualitative focus group study.

Okwose, Nduka C, O'Brien, Nicola, Charman, Sarah, Cassidy, Sophie, Brodie, David, Bailey, Kristian, MacGowan, Guy A, Jakovljevic, Djordje G and Avery, Leah (2020) Overcoming barriers to engagement and adherence to a home-based physical activity intervention for patients with heart failure: a qualitative focus group study. BMJ open, 10 (9). e036382. ISSN 2044-6055

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Abstract

Clinical guidelines recommend regular physical activity for patients with heart failure to improve functional capacity and symptoms and to reduce hospitalisation. Cardiac rehabilitation programmes have demonstrated success in this regard; however, uptake and adherence are suboptimal. Home-based physical activity programmes have gained popularity to address these issues, although it is acknowledged that their ability to provide personalised support will impact on their effectiveness. This study aimed to identify barriers and facilitators to engagement and adherence to a home-based physical activity programme, and to identify ways in which it could be integrated into the care pathway for patients with heart failure. A qualitative focus group study was conducted. Data were analysed using thematic analysis. A purposive sample of 16 patients, 82% male, aged 68±7 years, with heart failure duration of 10±9 years were recruited. A 12-week behavioural intervention targeting physical activity was delivered once per week by telephone. Ten main themes were generated that provided a comprehensive overview of the active ingredients of the intervention in terms of engagement and adherence. Fear of undertaking physical activity was reported to be a significant barrier to engagement. Influences of family members were both barriers and facilitators to engagement and adherence. Facilitators included endorsement of the intervention by clinicians knowledgeable about physical activity in the context of heart failure; ongoing support and personalised feedback from team members, including tailoring to meet individual needs, overcome barriers and increase confidence. Endorsement of interventions by clinicians to reduce patients' fear of undertaking physical activity and individual tailoring to overcome barriers are necessary for long-term adherence. Encouraging family members to attend consultations to address misconceptions and fear about the contraindications of physical activity in the context of heart failure should be considered for adherence, and peer-support for long-term maintenance. NCT03677271. [Abstract copyright: © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.]

Item Type: Article
Additional Information: ** From PubMed via Jisc Publications Router
Keywords: Cardiovascular medicine, 1506, 1683, heart failure, qualitative research, adult cardiology
SWORD Depositor: JISC Router
Depositing User: JISC Router
Date Deposited: 07 Oct 2020 08:26
Last Modified: 10 Nov 2020 08:27
URI: https://bucks.repository.guildhe.ac.uk/id/eprint/18082

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