They took me this far but I’ve gotta do it on my own now: How can self-determination theory explain patients’ uptake and adherence of physical activity-based cardiac and pulmonary rehabilitation?
ISPAH ePoster Library. Whittaker E. Oct 15, 2018; 225514; 399
Eleanor Whittaker
Eleanor Whittaker
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Abstract
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Abstract Background:<\b>
Less than 50% of adults meet the minimum recommended levels of PA, with this figure even further reduced amongst patient groups. Despite being recognised as a goal-standard non-pharmacological treatment for CVD and COPD patients, completion rates of cardiac and pulmonary rehabilitation programmes, where PA is a central component, remain low. Aims: To investigate perceived facilitators of cardiac and pulmonary rehabilitation patients’ engagement with PA-based rehabilitation programmes. Method: Semi-structured interviews were conducted with a purposive sample of 19 cardiac and pulmonary rehabilitation patients and staff. Data were analysed using both inductive and deductive thematic analysis. Results:<\b>
In line with self-determination theory, patients reported that staff provided an environment that facilitated the development of feelings of relatedness and autonomy, which in turn drove the development of competence. The development of these three factors allowed patients to feel more comfortable in the rehabilitation environment, in turn driving their intention to engage with PA following programme completion. Specifically, for older patients, relatedness was a particularly salient factor influencing their adherence to rehabilitation. Further, staff reported that the most salient factor driving patients’ rehabilitation adherence was patients’ development of autonomy and the subsequent ability to effectively self-initiate PA. Conclusions: Future interventions aiming to increase patients’ levels of PA should consider contextually-relevant factors that influence patients’ uptake and adherence of PA. By taking this approach to intervention development, and aligning with the features of the context, the likelihood of interventions’ effects washing out of a context is mitigated.
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