Affiliations: Adult Community Health Services, Chippenham Community Hospital, Rowden Hill, Chippenham, Wiltshire, England | Department of Allied Health Professions, Faculty of Health and Life Sciences, University of the West of England, Bristol, England
Abstract: Aims: To explore the attitudes of people with COPD to exercise and reasons for non-concordance with exercise maintenance post-pulmonary rehabilitation. Methods: A qualitative study using a focus group of six people recruited through the patient support group Breathe Easy. Mean age = 69.3 years. COPD disease severity, as defined by GOLD, ranged from moderate (n=4) to severe (n=1) to very severe (n=1) with Medical Research Council dyspnoea scores of 2 (n=5) and 4 (n=1). All subjects had completed a pulmonary rehabilitation programme and were exercising at the time of the study. The data was analysed using inductive thematic analysis and the results subjected to peer and member checking. Results: From the focus group discussion, three main themes were identified: • effects of exercise • facilitators of exercise • barriers to exercise The effects of exercise were perceived to be mainly positive, although tiredness was also mentioned. Facilitators of exercise included encouragement, company, professional support, goal setting, personal attributes, and availability of a range of exercise options. Barriers to exercise included changing health status, fear, lack of support, and environment. Conclusion: The above themes may guide service providers in planning maintenance exercise sessions and in assisting people with COPD to strengthen exercise facilitators and overcome barriers to exercise. As individuals have different needs and their health status and circumstances change, communication needs to be ongoing and the exercise maintenance adaptable. A range of exercise options need to be available and combined with professional support, goal setting, encouragement, company and a suitable environment.
Keywords: Exercise maintenance, COPD, pulmonary rehabilitation, barriers, facilitators, focus group