scholarly journals SAT0617-HPR QUALITATIVE STUDY EXPLORING THE BARRIERS AND FACILITATORS TO HOME-BASED EXERCISE PROGRAMS ADHERENCE WITH KNEE OSTEOARTHRITIS: THE PERSPECTIVES PHYSIOTHERAPISTS AND PATIENTS.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1268.3-1269
Author(s):  
H. Akgül ◽  
N. Sermenlİ Aydin ◽  
Z. Sari ◽  
M. Bİrtane ◽  
E. Tonga
Keyword(s):  
Patient Education ◽  
Focus Group ◽  
Qualitative Study ◽  
Knee Osteoarthritis ◽  
Exercise Adherence ◽  
Barriers And Facilitators ◽  
Home Exercise ◽  
Exercise Programs ◽  
Home Based ◽  
Turkish Patients

Background:Home exercise programs are widely used in the treatment of knee osteoarthritis (OA). However, adherence to these exercises decreases in the long term due to different factors. In recent years, new approaches are being developed to increase exercise adherence (EA) for patients with OA. Although it is known that EA is low in Turkish patients, there is no study that examines the barriers of adherence to home exercise programs in patients with OA by qualitative research methods.Objectives:Aim of our study was to investigate the barriers and facilitators for adherence of home-based exercises for knee osteoarthritis management from the perspective of physiotherapists and patients.Methods:A Qualitative study by using focus groups discussions and semi-structured interviews were designed to investigate the barriers and facilitators to home-based exercise program adherence for OA. Two researchers facilitated focus group interview. Participants of focus group members were eight physiotherapists (PT) working with OA with different experience levels. Third researcher conduct the interviews which lasted 30-60 minutes with patients (patients with knee OA, n=5 ages>50). Data were audio recorded, transcribed verbatim and thematically analyzed with NVIVO 12 software. Three researchers conducted the thematic analysis to ensure the validity.Results:In total, 25 main themes from the focus group discussions and interviews were determined. Major barrier themes from focus group were (a) beliefs to exercise benefits (b) patient education and (c)fear avoidance beliefs on exercise; from the interviews were (a)negligence of self-management (b)fatigue and (c)patient education. Patients and therapists all agreed for patient education is one of the most important factors for home EA. Patients wanted to get education on arthritis management. A patient said:“Actually, the clinicians should give information more deeply. I don’t know which is correct for me after therapy, resting or moving?”Major facilitator themes from the focus group were (a)motivation from PT (b)client-centred exercise (c)digital technology; from interviews were (a) motivational approaches of therapists (wats-up messages) (b) having pain and (c)patient education for disease management. Therapists agreed on that personalized exercise is the most important facilitator. A therapist commented,“If the personalized exercise given the patient with correct intensity and repetitions, I don’t think that patients would not do their home exercises.”Conclusion:This is the first qualitative study about exercise adherence in knee osteoarthritis in Turkey. It has been determined that the lack of education and motivation are the most important barriers. More studies are needed to examine the factors affecting EA for patients with OA. In future studies, implementations to increase home EA on Turkish patients with OA should be investigated by qualitative research methods.References:[1]MacKay C. Qualitative study exploring the factors influencing physical therapy management of early knee osteoarthritis in Canada. BMJ 2018 open.[2]Carmona-Terés, Understanding knee osteoarthritis from the patients’ perspective: a qualitative study.” BMC musculoskeletal disorders 18.1 (2017): 225.[3]Marlene F.Exercise for osteoarthritis of the knee: a Cochrane systematic review. British journal of sports medicine 2015 49(24).Disclosure of Interests:None declared

scholarly journals AB1351-HPR A HAND EXERCISES MHEALTH APP FOR PATIENTS WITH RHEUMATOID ARTHRITIS: DEVELOPMENT, DESIGN AND USABILITY STUDY IN TURKEY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1963.2-1964
Author(s):  
E. Tonga ◽  
C. Srikesavan ◽  
E. Williamson ◽  
S. Lamb
Keyword(s):  
Rheumatoid Arthritis ◽  
Focus Group ◽  
Phase 1 ◽  
Hand Function ◽  
Exercise Adherence ◽  
Smartphone Application ◽  
Home Based ◽  
User Centered

Background:The Strengthening and Stretching for Rheumatoid Arthritis of the Hand (SARAH) programme has been shown to provide long term improvement in hand function for patients with rheumatoid arthritis (RA) affecting their hands. In Turkey, limited number of physiotherapists work in rheumatology departments so there is an opportunity to use the digital technologies for exercise prescription and follow up to improve access to treatment.Growing research evidence supports the effectiveness of mHealth interventions for improving exercise adherence and motivation.To our knowledge,there is no hand exercises mHealth program for patients with rheumatoid arthritis designed by experts with the user-centered method.Objectives:The aim of our study is to develop and design a smartphone application for structured hand exercise program for patients with RA in Turkey and to test its usability.Methods:We used a qualitative user-centered design approach with 2 phases.PHASE 1:we conducted focus group meetings to discuss the content, feature and design of app to produce a prototype version of smartphone software for RA hand training program.The Focus Group consisted of two physiotherapists and three hand therapists working in the field in different rheumatology or hand rehabilitation clinics,two software-computer engineers, and three patients with RA who had previously participated in hand therapy. The focus group met 4 times during phase 1. PHASE 2:we investigated the usability of prototype version of the rheumatoid hand exercise smartphone app software. All focus group members (n=10) and 6 patients used the app for one week.All users filled the usability questionnaire and provided written feedback on the app. Revisions were made and the revised version was tested. We put the revised app in digital markets in Turkish and English.Results:The major themes identified from the Focus Group discussions during phase 1 were (a)Login techniques (b)self-monitoring (c)exercises types/frequency/diary, (d) patient education, (e)behavioral change and encouragement (f)exercise adherence. Patients and therapist all agreed the login needed to be easy. Patients wanted to be able to monitor their pain levels and hand function in the app. Patients thought the SARAH exercise were suitable for the app. A patient said:‘SARAH exercises is beneficial for my hand and tendon gliding exercise,I will be happy to see these exercises in app’. Patients wanted exercise reminders using push up notifications to encourage exercise were proposed and included.A patient commented ‘in themorning and after work, motivational push up messages could be beneficial for exercise habit.”During the phase 2,we identified a need for education on how to use digital app, ways to provide patient follow up to monitor adherence, the need to allow patients to select the amount of notifications. This feedback was incorporated into the final version.Conclusion:mHealth applications represent an easily accessible bridge between patients and health professionals for home-based programs. Using a user-centered approach ensured that we developed an application that met the needs of therapists and patients. Physiotherapists are using the app in rheumatology clinics in Turkey and long-term usability and feasibility studies are ongoing.References:[1]Argent R, Patient Involvement With Home-Based Exercise Programs: Can Connected Health Interventions Influence Adherence? JMIR Mhealth Uhealth 2018.[2]Lamb SE, Strengthening and Stretching for Rheumatoid Arthritis of the Hand Trial (SARAH).Lancet. 2015,385(9966).[3]Azevedo R, Smartphone application for rheumatoid arthritis self-management: cross-sectional study revealed the usefulness, willingness to use and patients’ needs.Rheumatol Int.2015, 35(10).Disclosure of Interests:None declared

scholarly journals Barriers and facilitators to neonatal health and care-seeking behaviours in rural Cambodia: a qualitative study

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e035449 ◽  
Author(s):  
Gabriella Watson ◽  
Kaajal Patel ◽  
Daly Leng ◽  
Dary Vanna ◽  
Sophanou Khut ◽  
...  
Keyword(s):  
Focus Group ◽  
Qualitative Study ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Barriers And Facilitators ◽  
Neonatal Health ◽  
Care Seeking ◽  
Focus Group Discussions ◽  
Group Discussions

ObjectivesNeonatal mortality remains persistently high in low-income and middle-income countries. In Cambodia, there is a paucity of data on the perception of neonatal health and care-seeking behaviours at the community level. This study aimed to identify influencers of neonatal health and healthcare-seeking behaviour in a rural Cambodian province.DesignA qualitative study using focus group discussions and thematic content analysis.SettingFour health centres in a rural province of Northern Cambodia.ParticipantsTwenty-four focus group discussions were conducted with 85 community health workers in 2019.ResultsCommunity health workers recognised an improvement in neonatal health over time. Key influencers to neonatal health were identified as knowledge, sociocultural behaviours, finances and transport, provision of care and healthcare engagement. Most influencers acted as both barriers and facilitators, with the exception of finances and transport that only acted as a barrier, and healthcare engagement that acted as a facilitator.ConclusionUnderstanding health influencers and care-seeking behaviours is recognised to facilitate appropriate community health programmes. Key influencers and care-seeking behaviours have been identified from rural Cambodia adding to the current literature. Where facilitators have already been established, they should be used as building blocks for continued change.

scholarly journals 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 ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e036382
Author(s):  
Nduka C Okwose ◽  
Nicola O'Brien ◽  
Sarah Charman ◽  
Sophie Cassidy ◽  
David Brodie ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
Focus Group ◽  
Family Members ◽  
Barriers And Facilitators ◽  
Behavioural Intervention ◽  
Focus Group Study ◽  
Home Based ◽  
Patients With Heart Failure

ObjectivesClinical 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.DesignA qualitative focus group study was conducted. Data were analysed using thematic analysis.ParticipantsA purposive sample of 16 patients, 82% male, aged 68±7 years, with heart failure duration of 10±9 years were recruited.InterventionA 12-week behavioural intervention targeting physical activity was delivered once per week by telephone.ResultsTen 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.ConclusionsEndorsement 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 numberNCT03677271.

scholarly journals Parents of children with physical disabilities perceive that characteristics of home exercise programs and physiotherapists’ teaching styles influence adherence: a qualitative study

2015 ◽  
Vol 61 (2) ◽  
pp. 81-86 ◽  
Author(s):  
Carmen Lillo-Navarro ◽  
Francesc Medina-Mirapeix ◽  
Pilar Escolar-Reina ◽  
Joaquina Montilla-Herrador ◽  
Francisco Gomez-Arnaldos ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Physical Disabilities ◽  
Teaching Styles ◽  
Home Exercise ◽  
Exercise Programs

scholarly journals POS1470-HPR BARRIERS AND FACILITATORS OF A NEW MODEL OF STRATIFIED EXERCISE THERAPY IN KNEE OSTEOARTHRITIS: A QUALITATIVE STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1020.1-1020
Author(s):  
J. Knoop ◽  
W. Van Berkel-de Joode ◽  
H. Brandt ◽  
J. Dekker ◽  
R. Ostelo
Keyword(s):  
Primary Care ◽  
Randomized Controlled Trial ◽  
Muscle Strength ◽  
Qualitative Study ◽  
Knee Osteoarthritis ◽  
Exercise Therapy ◽  
Controlled Trial ◽  
Barriers And Facilitators ◽  
Added Value ◽  
Randomized Controlled

Background:We have developed a model of stratified exercise therapy, in which three knee osteoarthritis (OA) subgroups (i.e., ‘high muscle strength subgroup’, ‘low muscle strength subgroup’ and ‘obesity subgroup’) can be distinguished and provided a subgroup-specific intervention. Currently, the (cost-)effectiveness of this model compared to usual exercise therapy is tested in a large-scaled randomized controlled trial (OCTOPuS-study [1]). Alongside this trial, we performed a qualitative study to explore perceived barriers and facilitators of the application of this model in primary care.Objectives:To explore barriers and facilitators of the application of this model in primary care, as perceived by patients, physiotherapists and dieticians.Methods:Qualitative data were collected through semi-structured interviews in a random sample of 15 patients (5 from each subgroup), 11 physiotherapists and 5 dieticians, from the experimental arm of the OCTUPuS trial. A thematic analysis of the data was performed.Results:We identified 14 themes in 5 categories. In general, patients and therapists were positive about the added value and applicability of the model, although some physiotherapists would prefer more flexibility. Regarding the ‘high muscle strength subgroup’, both patients and physiotherapists reported mixed feelings on the low number of supervised sessions, with some perceiving this low number as advantageous for stimulating the patient’s own responsibility, whereas others as hindering an optimally guided treatment. Regarding the ‘obesity subgroup’, dieticians and physiotherapists acknowledged the added value of the combined intervention, but both were disappointed by the lack of interdisciplinary collaboration. Moreover, those patients in this subgroup already following a diet restriction, therefore not perceiving any added value of the diet intervention.Conclusion:This qualitative study revealed relevant barriers and facilitators of our new model of stratified exercise therapy, which will help us interpreting the upcoming results on its (cost-) effectiveness [1]. If proven to be (cost-)effective, implementation strategies should specifically focus on guidance of patients from the ‘high muscle strength subgroup’ within only a few sessions, collaboration between physiotherapist and dietician in the ‘obesity subgroup’, and adequate use of booster sessions after the supervised period to optimize treatment adherence.References:[1]Knoop J, Dekker J, van der Leeden M, de Rooij M, Peter WFH, van Bodegom-Vos L, van Dongen JM, Lopuhäa N, Bennell KL, Lems WF, van der Esch M, Vliet Vlieland TPM, Ostelo RWJG. Stratified exercise therapy compared with usual care by physical therapists in patients with knee osteoarthritis: A randomized controlled trial protocol (OCTOPuS study). Physiother Res Int. 2020 Apr;25(2):e1819. doi: 10.1002/pri.1819. Epub 2019 Nov 28.Disclosure of Interests:None declared

scholarly journals Barriers and Facilitators of Physical Activity among Adolescents of Debre Berhan City Administration; Qualitative Study.

2019 ◽  
Author(s):  
Osman Yimer Mohammed ◽  
Esubalew Tesfahun ◽  
Abdurahman Mohammed
Keyword(s):  
Physical Activity ◽  
Urban Planning ◽  
Focus Group ◽  
Qualitative Study ◽  
School Environment ◽  
Role Model ◽  
Barriers And Facilitators ◽  
Personal Factors ◽  
City Administration ◽  
Debre Berhan

Abstract Background: Most adolescents are insufficiently physically active and it contributes to 3.2 million deaths each year. Environmental and systemic factors influence the level of physical activity. Sedentary work and living environments, socioeconomic status and limited access to facilities are barriers ofphysical activity. Objectives: The main objective of this study was to explore barriers and facilitators of physical activity among adolescents of Debre Berhan City Administration. Methodology: School based qualitative study was conducted among 64 adolescents in Debre Berhan City Administration from June 1-20 2019. Data was collected using eight focus group discussions with a focus group guide. Inductive analysis was done using ATLA.ti version 7. Result: A total of eight focus group discussion were conducted from June 1-20/2019. Three out of the sixty-four participants reported that they do physical activity on a regular basis. Social and personal factors (lack of role model, absence of family or friend influence, bad example, shortage of time, lack of interest and financial constraints) and environmental(Lack of access to play ground, lack of access to gymnasium, lack of conducive environment, poor school environment, harsh (polluted) environment, not friendly (girls) environment, poor urban planning and developmental activities) factors were reported to be barriers of physical activity while being member of a club, improving self-image and maintaining fitness are facilitators of physical activity. Conclusion and Recommendation: Lack of social support, lack of access to play ground and poor construction and developmental activities are the main barriers of physical activity. Therefore, Debre Berhan City Administration should work towards improving urban planning and avail girls’ friendly playground and gymnasium for every resident. Key Words Physical activity, Qualitative Study, Barriers, Facilitators

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