How and Why Patients Adhere to a Prescribed Cardiac Rehabilitation Program: A Longitudinal Phenomenological Study of Patients with Acute Coronary Syndrome
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Data Collection
2.3. Data Analysis
2.4. Trustworthiness and Rigor
3. Results
3.1. Motivation to Follow the Prescribed Exercise Program
“I feel self-motivated. Sometimes my schedule is pretty busy. But when I return to the (swimming) pool, I remember that I really enjoy it.”(interview 3) [P01].
“Results of my blood tests motivated me to continue attending the (rehabilitation) center.”(interview 1) [P02].
“I noticed I lost a lot of weight and I feel motivated to work on strength and endurance training.”(interview 3) [P03].
3.2. Volitional Decision
“My initial goal was to attend (the gym) three times/week, but I changed it to twice per week. It has been more realistic for my schedule.”(interview 2) [P01].
“My schedule is not consistent, so I change my exercise timings to fit.”(interview 3) [P04].
“I am not in a group, but when I see an interesting one I join.”(interview 2) [P05].
“In the long run, I feel motivated because I only participate in exercise (that) I like, so I stick with those that I find enjoyable…it keeps me motivated.”(interview 1) [P01].
“I bought a rubber stretch mat that I like to take with me.”(interview 1) [P02].
“I want to make some memory aid after the trainings to be able to reproduce the exercises at home.”(interview 2) [P03].
3.3. Capability of Performing Exercise
3.4. Connectedness to Peers
3.5. Planning
“I use my planner to help maintain my training schedule.”(meeting 1) [P01].
“I found the planner to be a helpful tip presented at the meeting.”(interview 2) [P04].
“Being consistent was important to me, and my planner helped.”(interview 2) [P05].
3.6. Habit Formation
“I don’t need to make any changes. My workout habit has been established after three months.”(interview 1) [P05].
“it’s in my head….it has become a habit.”(interview 3) [P05].
“Having my sport bag ready was a helpful note (from the presentation) that was a solution to my obstacles.”(interview 3) [P01].
“I keep my sport bag ready for the gym.”(interview 3) [P01].
“The worksheet was useful: my bag, and all my training gear is ready when the activity is scheduled.”(interview 1) [P03].
3.7. Adopting Healthy Behaviors beyond Exercise
“I used the worksheet to also make sure I eat my lunch on time. Keeps things easy”(interview 1) [P01].
“I am motivated to improve my health. I check my cholesterol on the morning.”(interview 2) [P03].
“I have a new challenge which is to decrease my alcohol intake to have better performance at the gym. I also go out more often, not just to the gym.”(interview 3) [P04].
4. Discussion
4.1. Self-Determination Theory
4.2. Autonomous Motivation
4.3. Psychological Needs
4.4. Behavioral Maintenance Constructs
4.5. Adopting Healthy Behaviors beyond Exercise
4.6. Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Technique Application in the current study |
1. Interrater reliability |
The statements were independently coded by two different reviewers. Any discrepancies in coding were discussed until mutual agreement was achieved |
2. Member checking |
Member checking was performed by reviewing the transcribed statements with each participant |
3. Bracketing/researcher reflexivity |
Potential for bias interviewing was prevented by having a data coder who was a trained qualitative researcher but from a different discipline. Bias was also prevented by ensuring that the PI did not conduct the interview or code the data |
4. Theoretical coherence |
The aim of the study was to gather data of patients’ experience of exercising regularly. The methodological approach, phenomenology, is congruent with this aim as the approach does not attempt to explore hypotheses or causalities, but only attempts to understand [41] |
5. Outsider/expert check |
An outsider (DN), who was not involved in prior stages of the study, reviewed if the results were theoretically sound |
6. Critical friends |
N.K. served as the critical friend for the data collected by R.G., M.P., and B.B. |
7. Researcher background |
All individuals involved in participation interaction (M.P., B.B., and R.G.) provided an introduction of themselves along with their research backgrounds to the participants |
8. Pilot interviews |
The study is a pilot investigation, and so these interviews will support the design of a larger scale study |
9. Multiple methods/triangulation |
Two forms of data were collected from the participants, which included written data (planning sheets) and semi-structured interviews. Some data overlap of these two methods was expected, which helped in triangulating the findings. |
10. Audit trail/transparency |
All the raw participant data, including the coding, and their interpretation are available |
Theme Subtheme Data Sample |
1. Motivation to follow a prescribed exercise program |
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2. Volitional decision |
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3. Capability of performing exercise |
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4. Connectedness to Peers |
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5. Planning |
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6. Habit formation |
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7. Adopting healthy behaviors beyond exercise |
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Kaushal, N.; Nemati, D.; Gauthier-Bisaillon, R.; Payer, M.; Bérubé, B.; Juneau, M.; Bherer, L. How and Why Patients Adhere to a Prescribed Cardiac Rehabilitation Program: A Longitudinal Phenomenological Study of Patients with Acute Coronary Syndrome. Int. J. Environ. Res. Public Health 2022, 19, 1482. https://doi.org/10.3390/ijerph19031482
Kaushal N, Nemati D, Gauthier-Bisaillon R, Payer M, Bérubé B, Juneau M, Bherer L. How and Why Patients Adhere to a Prescribed Cardiac Rehabilitation Program: A Longitudinal Phenomenological Study of Patients with Acute Coronary Syndrome. International Journal of Environmental Research and Public Health. 2022; 19(3):1482. https://doi.org/10.3390/ijerph19031482
Chicago/Turabian StyleKaushal, Navin, Donya Nemati, Raphaëlle Gauthier-Bisaillon, Marie Payer, Béatrice Bérubé, Martin Juneau, and Louis Bherer. 2022. "How and Why Patients Adhere to a Prescribed Cardiac Rehabilitation Program: A Longitudinal Phenomenological Study of Patients with Acute Coronary Syndrome" International Journal of Environmental Research and Public Health 19, no. 3: 1482. https://doi.org/10.3390/ijerph19031482