It is like someone holding your hand when you need it – lived experiences of patients with cardiovascular disease participating in a digital health intervention focusing on the maintenance of physical activity after cardiac rehabilitation

Abstract

Purpose

To explore patients with cardiovascular diseases’ lived experiences of the support given by a text message intervention focusing on the maintenance of physical activity after supervised cardiac rehabilitation.

Methods

In a qualitative study, participants from the feasibility trial FAIR were interviewed individually twice to disclose their lived experiences during and after the trial. Transcribed interviews were analysed based on a phenomenological-hermeneutic method, inspired by Paul Ricoeur’s philosophy on narrative and interpretation.

Results

Interviews of eight patients with cardiovascular disease (3 females, median age 57 years (range 37 to 74 years)) revealed two themes, The FAIR intervention as a bridge builder in the transition to being physically active in everyday life and Meaningful conditions for maintaining physical activity. Action plans guided physical activity, while text messages facilitated actions and left an impression of still being under supervision. A frame of reference with physical activity, family, being monitored, having to report back, and getting feedback, were incentives for being physically active.

Conclusion

From a patient perspective, the text message intervention in the feasibility trial FAIR was valuable to support the maintenance of physical activity in the transition from a supervised exercise-based cardiac rehabilitation programme to everyday life on an individual basis. Participants experienced the intervention to hold their hands in changing behaviour and redefining themselves. Yet, there is an extended need for belonging and personal interactions in future interventions.

IMPLICATIONS FOR REHABILITATION

• Patients with cardiovascular disease experience a need for support to maintain physical activity after completing a supervised rehabilitation programme, which is not a part of standard practice

• In a sample of patients with cardiovascular disease, a text message intervention was experienced to provide useful support in the transition from supervised cardiac rehabilitation to being physically active in everyday life

• Changing behaviour is challenging, and digital health interventions give the advantage of influencing health behaviour in real-time with the potential to reach a vast population

Keywords:

• Cardiovascular disease
• rehabilitation
• digital health
• physical activity
• qualitative

Acknowledgements

The authors thank the participants in the study for taking the time to share their stories and contribute valuable knowledge to the research field. The authors also thank the Department of Physiotherapy and Occupational Therapy at Holbæk Hospital, the rehabilitation unit in the City of Slagelse, and the Department of Physiotherapy and Occupational Therapy at Slagelse Hospital and Research assistant Ida Marie Marcussen for their contribution to the FAIR intervention.

Author contributions

All authors designed the study, TGH and CS designed the interview guide, TGH conducted the interviews, RMA assisted with practicalities and facilitated contact with site and study personnel, TGH and CS performed data analysis, TGH drafted the manuscript, and all authors performed manuscript revision, reviewed and approved the final manuscript.

Disclosure statement

The authors declare no conflicts of interest with respect to the research, authorship, and publication of this article.

Additional information

Funding

The FAIR intervention is funded by Region Zealand (Exercise First) and Næstved-Slagelse-Ringsted Hospitals under Grant (project no. A841 & A1290) without them being involved in designing, conducting, or reporting of the study. All authors are funded by Region Zealand under Grant (Project: Exercise First). Dr. Tang is further funded by The Danish Health Confederation through the Development and Research Fund for financial support under Grant (project no. 2703) and Næstved-Slagelse-Ringsted Hospitals Research Fund, Denmark under Grant (project no. A1277). Dr. Skou is further funded by two grants from the European Union’s Horizon 2020 Research and Innovation Program, one from the European Research Council (MOBILIZE, grant agreement No 801790) and the other under grant agreement No 945377 (ESCAPE). MSc. Hamborg is further funded by Region Zealand Health Science Research Fund under Grant (project no. A1049).