A Qualitative Exploration of Exercise Among Pulmonary Rehabilitation Participants: Insight From Multiple Sources of Social Influence.
BACKGROUND
Exercise training within the pulmonary rehabilitation (PR) context is considered the most effective strategy to reduce COPD symptoms. However, participation in PR and continued exercise training following program completion are low. Previous research examined factors related to attendance and adherence, but the knowledge base to date has been limited to quantitative findings that focus solely on participants diagnosed with COPD. In addition to quantitative research, exploring multiple perspectives (eg, PR participants, significant others, staff, and stakeholders) using qualitative research methods opens a window of additional understanding. The goal of this study was to obtain multiple perspectives on PR to gain insight into factors that affect exercise participation among individuals diagnosed with COPD.


METHODS
A total of 26 participants were interviewed via telephone, including 8 individuals diagnosed with COPD (4 men and 4 women, mean age of 67 [range of 58-77] y), 4 family members, 11 PR staff, and 3 community stakeholders.


RESULTS
Analysis revealed 3 themes: task self-efficacy for exercise, provision of support and encouragement, and perceptions of gender differences. Despite initial concerns, individuals diagnosed with COPD reported becoming more confident during PR and emphasized the importance of being supported by staff. PR staff perceived that men tended to approach exercise in a more eager and aggressive manner compared with women, who were more cautious and hesitant.


CONCLUSIONS
In addition to enhancing task self-efficacy, findings suggest that exercise participation and adherence within the PR environment may be improved by adopting a gender-tailored approach.
Public Health Program, Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada. chad.witcher@uleth.ca.
Chad S G
CS
Witcher
School of Human Kinetics, Laurentian University, Sudbury, Ontario, Canada.
Kerry R
KR
McGannon
Department of Medicine.
Paul
P
Hernandez
School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada.
Gail
G
Dechman
Cardiovascular Research Unit, Capital Health, Halifax, Nova Scotia, Canada.
Suzanne
S
Ferrier
Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada.
John C
JC
Spence
Behavioural Medicine Laboratory, Faculty of Education, University of Victoria, Victoria, British Columbia, Canada.
Ryan E
RE
Rhodes
Department of Medicine.
Chris M
CM
Blanchard
D000368:Aged; D001291:Attitude of Health Personnel; D015444:Exercise / Q000523:psychology*; D005081:Exercise Therapy / Q000379:methods / Q000523:psychology*; D005190:Family; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology* / Q000534:rehabilitation*; D036301:Qualitative Research; D020377:Self Efficacy; D012737:Sex Factors; D012944:Social Support
COPD; exercise self-efficacy; gender; qualitative; rehabilitation