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Lange E1,2, Palstam A3, Gjertsson I2,4, Mannerkorpi K1,2
1University of Gothenburg, Sahlgrenska Academy, Institut of Neuroscience and Physiology, Department of Health and Rehabilitation, Göteborg, Sweden, 2University of Gothenburg, Sahlgrenska Academy, Gothenburg Center for Person-Centered Care, Göteborg, Sweden, 3University of Gothenburg, Sahlgrenska Academy, Institute of Neuroscience and Physiology, Göteborg, Sweden, 4University of Gothenburg, Sahlgrenska Academy, Institute of Medicine, Göteborg, Sweden
Background: Exercise is, besides being health enhancing and disease preventing, an important part of the management of chronic conditions, including the inflammatory joint disease Rheumatoid Arthritis (RA). Despite a diagnosis, the need for disability-preventing physical activity increases with age. However, it has proven difficult to promote physical activity in older adults (>65 years) with chronic diseases and indeed, older adults with RA present a lower level of physical activity than healthy older adults. Both older adults without RA and younger adults with RA describe that physical gains of, and physical barriers to exercise are related to age- or diagnosis-related physical capacity. To manage barriers to exercise for older adults with RA a person-centered approach, emanating from the narrative of the person, considering both personal resources and wishes, has been suggested for exercise introduction and guidance.
Purpose: The aim of this qualitative study was to explore the experiences of partaking in exercise with guidance according to a person-centered approach and the experiences of independent exercise in the months following among older adults with RA.
Methods: A qualitative interview study was conducted. In-depth interviews with older adults, above 65 years, with RA who had taken part in a randomized controlled trial studying exercise with person-centered guidance were analyzed with qualitative content analysis according to Graneheim and Lundman.
Results: The analysis resulted in six main categories: A feasible opportunity to adopt to exercise, Contextual factors affect the experience of exercise, Experiencing positive effects of exercise, Developing knowledge and thinking, Finding one's way and Managing barriers for exercise.. The exercise was described as a feasible opportunity to start exercising. The experience was affected by different contextual factors and the participants describe how they developed their knowledge and thinking about exercise during the intervention. To find one's way for exercise became important to maintain exercise. Lastly, barriers to exercise and strategies for managing these were described.
Conclusion(s): The participants of this study describe experiencing exercise as manageable and positive despite age and diagnosis. This seems to have been facilitated by a careful introduction and development of exercise in partnership with a physiotherapist as well as the opportunity to identify with an age- and diagnosis-matched group. Reductions in physical health, both temporary and permanent, was described as the most prominent barrier to exercise. The personal process of trying to make the exercise one's own, to develop knowledge about exercise and new thoughts about oneself seemed to prepare the participants for handling independent exercise and managing barriers.
Implications: The knowledge from this study could be used to facilitate a process of adopting to and maintaining exercise for older adults with RA. The results also add to the understanding of person-centeredness in physiotherapy.
Keywords: Person-centered, qualitative research, exercise
Funding acknowledgements: Supported by the Gothenburg Center for person-centered care and the local research and development council of Gothenburg and Bohuslän.
Purpose: The aim of this qualitative study was to explore the experiences of partaking in exercise with guidance according to a person-centered approach and the experiences of independent exercise in the months following among older adults with RA.
Methods: A qualitative interview study was conducted. In-depth interviews with older adults, above 65 years, with RA who had taken part in a randomized controlled trial studying exercise with person-centered guidance were analyzed with qualitative content analysis according to Graneheim and Lundman.
Results: The analysis resulted in six main categories: A feasible opportunity to adopt to exercise, Contextual factors affect the experience of exercise, Experiencing positive effects of exercise, Developing knowledge and thinking, Finding one's way and Managing barriers for exercise.. The exercise was described as a feasible opportunity to start exercising. The experience was affected by different contextual factors and the participants describe how they developed their knowledge and thinking about exercise during the intervention. To find one's way for exercise became important to maintain exercise. Lastly, barriers to exercise and strategies for managing these were described.
Conclusion(s): The participants of this study describe experiencing exercise as manageable and positive despite age and diagnosis. This seems to have been facilitated by a careful introduction and development of exercise in partnership with a physiotherapist as well as the opportunity to identify with an age- and diagnosis-matched group. Reductions in physical health, both temporary and permanent, was described as the most prominent barrier to exercise. The personal process of trying to make the exercise one's own, to develop knowledge about exercise and new thoughts about oneself seemed to prepare the participants for handling independent exercise and managing barriers.
Implications: The knowledge from this study could be used to facilitate a process of adopting to and maintaining exercise for older adults with RA. The results also add to the understanding of person-centeredness in physiotherapy.
Keywords: Person-centered, qualitative research, exercise
Funding acknowledgements: Supported by the Gothenburg Center for person-centered care and the local research and development council of Gothenburg and Bohuslän.
Topic: Rheumatology; Health promotion & wellbeing/healthy ageing; Older people
Ethics approval required: Yes
Institution: The Sahlgrenska academy, The University of Gothenburg
Ethics committee: Regional Ethical Review Board in Gothenburg
Ethics number: 2016-01-14/969-15
All authors, affiliations and abstracts have been published as submitted.
