Article

This study explores the experience of participants taking part in a hand
exercise programme for people with rheumatoid arthritis with a focus on
adherence. The exercise programme was tested in a randomised controlled trial.
This parallel qualitative study will inform future implementation into clinical
practice. METHOD: Twenty-seven semi-structured interviews from 14 participants
were undertaken at two time points (4 and 12 months after randomisation). We
collected data of participants' experiences over time.
This was guided by an
interview schedule. Interview data were analysed using interpretative
phenomenological analysis which is informed by phenomenological and hermeneutic
theory. We recruited participants from National Health Service rheumatology and
therapy departments. RESULTS: At 4 months, 11/14 participants reported continuing
with the exercises. By 12 months, 7/13 participants still reported exercising.
The ability to establish a routine determined whether participants adhered to the
exercise programme. This was sometimes influenced by practical issues. We also
identified facilitators and barriers to regular exercise in the themes of the
following: the therapeutic encounter, perceived benefit of exercises, attitude of
mind, confidence, and unpredictability. CONCLUSIONS: Establishing a routine was
an important step towards participants being able to exercise independently.
Therapists provided participants with skills to continue to exercise while
dealing with changes in symptoms and schedules. Potential barriers to long-term
exercise adherence need to be taken into account and addressed for successful
implementation of this programme. Implications for Rehabilitation Behavioural
change components such as the use of an exercise planner (stating intentions of
where, when and how), daily diary sheets, and joint goal setting enhance
adherence to a hand exercise programme for RA by helping to establish routines.
Exercise routines need to be flexible enough to fit in with life and symptom
changes whilst delivering a sufficient dosage. Therapists facilitate this process
by using behavioural components alongside more commonly used aspects of care
(assessment, education, advice, and encouragement) to enable people with RA to
become independent exercisers.

Langue : ANGLAIS