The goal of this qualitative study was to investigate which factors influence physical activity from the viewing point of patients that are eligible for CR, their partners, CR healthcare professionals, and researchers.
A qualitative study was conducted using a inductive thematic analysis with the constant comparison technique. Semi-structured interviews were conducted and think-aloud protocols were performed between January and September 2024 at the intake screening of cardiac rehabilitation. The Capability Opportunity Motivation Behavior model was used as a guideline for the topic guide. Cardiac patients and their partners, cardiologists, physiotherapists, nurses, and social workers were recruited via purposive sampling in three hospitals in the Netherlands. Researchers were recruited through a snowball technique. The semi-structured interviews and thinking-aloud protocols were performed by two researcher (RS and AS). The identified themes were validated by the research consortium. The findings were reported in accordance with the Consolidated Criteria for Reporting Qualitative Research checklist.
In total, twenty participants were included (7 cardiac patients, 3 physio’s, 3 nurses, 3 researchers, 2 partners of cardiac patients, 1 social worker, 1 cardiologist). In total 14 semi-structured interviews and 6 thinking aloud protocols were performed. The inductive thematic analysis resulted in 12 main themes which describe factors that influence PA: 1) psychosocial, 2) personal, 3) physical, 4) social, 5) lifestyle, 6) environmental, 7) personal goal setting, 8) work-related, 9) demographic, 10) motivational, 11) comorbidities, 12) treatment. During an expert meeting with the research consortium, no new themes arose.
From the viewing point of several stakeholders, a wide variety of factors are associated with PA among patients awaiting CR. The factors should be taken into account when optimizing PA levels in patients eligible for CR. Future research should validate these factors in quantitative research by developing clusters or phenotypes of cardiac patients. Furthermore, proposed themes can be further investigated through qualitative research methods to gain a deeper understanding of the working mechanisms behind the factors.
Application of these factors might improve personalization of CR in the near future, offering the right care at the right time.
Physical Activity
Risk Factors
