Overcoming barriers to engagement and adherence to a home-based physical activity intervention for patients with heart failure: a qualitative focus group study
Objectives 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...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/9/e036382.full |
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| author | Guy A MacGowan Sarah Charman Djordje G Jakovljevic Nduka C Okwose Nicola O'Brien Sophie Cassidy David Brodie Kristian Bailey Leah Avery |
| author_facet | Guy A MacGowan Sarah Charman Djordje G Jakovljevic Nduka C Okwose Nicola O'Brien Sophie Cassidy David Brodie Kristian Bailey Leah Avery |
| author_sort | Guy A MacGowan |
| collection | DOAJ |
| description | Objectives 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.Design A qualitative focus group study was conducted. Data were analysed using thematic analysis.Participants A purposive sample of 16 patients, 82% male, aged 68±7 years, with heart failure duration of 10±9 years were recruited.Intervention A 12-week behavioural intervention targeting physical activity was delivered once per week by telephone.Results 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.Conclusions 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.Trial registration number NCT03677271. |
| format | Article |
| id | doaj-art-a6725d9d75bd4e5990caac44547dc288 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-a6725d9d75bd4e5990caac44547dc2882025-01-08T22:20:13ZengBMJ Publishing GroupBMJ Open2044-60552020-09-0110910.1136/bmjopen-2019-036382Overcoming barriers to engagement and adherence to a home-based physical activity intervention for patients with heart failure: a qualitative focus group studyGuy A MacGowan0Sarah Charman1Djordje G Jakovljevic2Nduka C Okwose3Nicola O'Brien4Sophie Cassidy5David Brodie6Kristian Bailey7Leah Avery8Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom2Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, UKTranslational and Clinical Research Institute, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, United KingdomTranslational and Clinical Research Institute, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, United KingdomDepartment of Psychology, Northumbria University - City Campus, Newcastle upon Tyne, Tyne and Wear, United KingdomPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UKSchool of Health and Social Sciences, Buckinghamshire New University, High Wycombe, Buckinghamshire, United Kingdom3Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle UniversitySchool of Health & Life Sciences, Teesside University, Middlesbrough, UKObjectives 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.Design A qualitative focus group study was conducted. Data were analysed using thematic analysis.Participants A purposive sample of 16 patients, 82% male, aged 68±7 years, with heart failure duration of 10±9 years were recruited.Intervention A 12-week behavioural intervention targeting physical activity was delivered once per week by telephone.Results 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.Conclusions 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.Trial registration number NCT03677271.https://bmjopen.bmj.com/content/10/9/e036382.full |
| spellingShingle | Guy A MacGowan Sarah Charman Djordje G Jakovljevic Nduka C Okwose Nicola O'Brien Sophie Cassidy David Brodie Kristian Bailey Leah Avery 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 |
| title | Overcoming barriers to engagement and adherence to a home-based physical activity intervention for patients with heart failure: a qualitative focus group study |
| title_full | Overcoming barriers to engagement and adherence to a home-based physical activity intervention for patients with heart failure: a qualitative focus group study |
| title_fullStr | Overcoming barriers to engagement and adherence to a home-based physical activity intervention for patients with heart failure: a qualitative focus group study |
| title_full_unstemmed | Overcoming barriers to engagement and adherence to a home-based physical activity intervention for patients with heart failure: a qualitative focus group study |
| title_short | Overcoming barriers to engagement and adherence to a home-based physical activity intervention for patients with heart failure: a qualitative focus group study |
| title_sort | overcoming barriers to engagement and adherence to a home based physical activity intervention for patients with heart failure a qualitative focus group study |
| url | https://bmjopen.bmj.com/content/10/9/e036382.full |
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