Physical activity participation in community dwelling stroke survivors: synergy and dissonance between motivation and capability. A qualitative study.
OBJECTIVE
The evidence supporting benefits of physical activity (PA) on fitness, functioning, health and secondary prevention after stroke is compelling. However, many stroke survivors remain insufficiently active. This study explored survivors' perspectives and experiences of PA participation to develop an explanatory framework that physiotherapists and other health professionals can use to develop person-specific strategies for PA promotion.


METHODS
Qualitative study using semi-structured in-depth interviews. Data was audio-recorded and transcribed. Analysis followed the Framework Approach.


METHODS
Community setting, interviews conducted within participants' homes.


METHODS
Community dwelling stroke survivors (n=38) six months or more after the end of their rehabilitation, purposively selected by disability, PA participation and socio-demographic status.


RESULTS
Findings suggest that survivors' beliefs, attitudes, and physical and social context generated synergy or dissonance between motivation (desire to be active) and capability (resources to be active) for PA participation. Dissonance occurred when motivated survivors had limited capability for activity, often leading to frustration. Confidence to achieve goals and determination to overcome barriers, acted as activity catalysts when other influences were synergistic. We illustrate these relationships in a dynamic explanatory model that can be used to support both novel interventions and personal activity plans.


CONCLUSIONS
This study suggests a shift is required from purely pragmatic approaches to PA promotion towards conceptual solutions. Understanding how synergy or dissonance between motivation and capability influence individual survivors' behaviour will support physiotherapists and other health professionals in promoting PA. This study provides a model for developing person-centred, tailored interventions that address barriers encountered by stroke survivors.
Social Dimensions of Health Institute, University of Dundee, 11 Airlie Place, Dundee DD1 4HJ, Scotland, United Kingdom. Electronic address: jacqui.morris@gcu.ac.uk.
Jacqui H
JH
Morris
Social Dimensions of Health Institute, University of Dundee, 11 Airlie Place, Dundee DD1 4HJ, Scotland, United Kingdom. Electronic address: t.oliver@dundee.ac.uk.
Tracey
T
Oliver
Social Dimensions of Health Institute, University of Dundee, 11 Airlie Place, Dundee DD1 4HJ, Scotland, United Kingdom. Electronic address: t.kroll@dundee.ac.uk.
Thilo
T
Kroll
Nursing, Midwifery and Allied Health Professions Research Unit, Unit 13 Scion House, Stirling University Innovation Park, University of Stirling, Stirling FK9 4LA, Scotland, United Kingdom. Electronic address: s.a.joice@massey.ac.nz.
Sara
S
Joice
Nursing, Midwifery and Allied Health Professions Research Unit, Unit 13 Scion House, Stirling University Innovation Park, University of Stirling, Stirling FK9 4LA, Scotland, United Kingdom. Electronic address: brian.williams@stir.ac.uk.
Brian
B
Williams
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D006233:Persons with Disabilities; D015444:Exercise / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D057187:Independent Living / Q000523:psychology*; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009042:Motivation; D036301:Qualitative Research; D012959:Socioeconomic Factors; D020521:Stroke / Q000523:psychology*; D017741:Survivors / Q000523:psychology*; D055815:Young Adult
Exercise; Physical activity; Qualitative evaluation; Stroke