Barriers and motivational factors towards physical activity in daily life living with COPD – an interview based pilot study

ABSTRACT

Background: In Denmark, few people with Chronic Obstructive Pulmonary Disease (COPD) engage in physical activity although it is evident that pulmonary rehabilitation has positive effects on physical activity, dyspnoea, anxiety, fatigue and quality of life.

Objective: The purpose of this pilot study was to explore why people with COPD do not engage in physical activity and to explore motivational factors and barriers towards physical activity. Furthermore, to explore the role general practitioners have in this matter.

Design: We conducted fieldwork among five people with COPD and three general practitioners using qualitative semi-structured interviews. We made a thematic analysis and our analytical perspective was based on The Health Belief Model and Self Determination Theory.

Results: Findings revealed that people with COPD was not active because they did not receive the necessary information from the general practitioners about the benefits of physical activity neither about the negative consequences of an inactive lifestyle. Motivational factors were knowledge about COPD and benefits of physical activity. Experiencing the benefits on their own bodies, feeling that it was not dangerous to feel breathless and being successful coping with breathlessness were motivational. Functional tests like walking tests were very important and motivational for the participants because they outlined the progress achieved during activity and provided evidence of progress that was easy to comprehend compared with spirometry tests. General practitioners did not inform about the benefits of physical activity because they felt that medication was more important than physical activity and that people with COPD would not be motivated to be active.

Conclusions: The main reason for people with COPD not being physically active in our study was lack of sufficient information from their general practitioners. This study described some barriers, enablers and motivational factors for a physically active lifestyle and the general practitioners’ role in this. Thus, it is important that people with COPD receive early information about physical activity - and it should start with the general practitioners, who are the gate keepers in the health care system. We recommend that lung function test results are never used as a single indicator of disease progression and that more focus should be paid to functional tests like The Shuttle Walking Test or The Six Minute Walking Test.Further studies to identify barriers to, and facilitators for referral people with COPD to physical activity in daily life from the perspective of Danish general practitioners are required.

KEYWORDS:

• Chronic obstructive pulmonary disease (COPD)
• rehabilitation
• physical activity in daily life (PADL)
• exercise
• general practitioners
• barriers
• enablers
• motivation
• information
• physical and psychological benefits

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The work was supported by VIA University College, Faculty of Health Sciences.

Notes on contributors

Elisabeth Bomholt Østergaard

Elisabeth Bomholt Østergaard is a senior lecturer at the Faculty of Health Sciences, Department of Physiotherapy Aarhus, VIA University College of Aarhus. She is a physiotherapist and has a Master in the Anthropology of Health. Her interests and research are mainly focused on daily life and physical activity when living with COPD; and additionally on daily life, identity, bodily changes, incorporation of prosthesis, obtaining and maintaining phantom sensations after leg amputation; implications of categorizing way of speaking; implications of screening programmes; education, teaching, learning and didactics.

Sajitha Sophia Sritharan

Sajitha Sophia Sritharan is a resident at the Department of Respiratory Diseases and Allergy, Aarhus University. She is a M.D. who started specialising in Pulmonology in March 2018. Her interests in Respiratory medicine are broad and yet to be discovered but obstructive airways diseases and interstitial lung diseases is currently her research field.

Anne Dal Kristiansen

Anne Dal Kristiansen is a physiotherapist at the Department of Training in Hjørring Municipality. Among other things, she is working with physical activity and rehabilitation for people with COPD. Her interests and challenges in the job are how to make the people adhere to the course and how to motivate them to keep training after finishing the course.

Pernille Maja Thomsen

Pernille Maja Thomsen is a physiotherapist at the Health Unit of the Central Department in the municipality of Aarhus. Her focuses are hydrotherapy and elderly people with increased mobility and rehabilitation after hospitalization or functional decline. Her interests are broad in the field of physiotherapy, but definitely with a biopsychosocial approach to health and with a hope to make exercising meaningful.

Anders Løkke

Anders Løkke, MD, is a consultant at The Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Denmark. He is a specialist in pulmonary diseases, and his main research focus is COPD.