Nichols, Vivien P., Williamson, Esther M., Toye, Francine and Lamb, S. E. (Sallie E.) (2017) A longitudinal, qualitative study exploring sustained adherence to a hand exercise programme for Rheumatoid Arthritis evaluated in the SARAH Trial. Disability and Rehabilitation, 39 (18). pp. 1856-1863. doi:10.1080/09638288.2016.1212111

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Abstract

Purpose:
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 2 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 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.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Rheumatoid arthritis
Journal or Publication Title:	Disability and Rehabilitation
Publisher:	Taylor & Francis Ltd.
ISSN:	0963-8288
Official Date:	2017
Dates:	Date Event 2017 Published 24 August 2016 Available 8 July 2016 Accepted 11 August 2015 Submitted
Volume:	39
Number:	18
Page Range:	pp. 1856-1863
DOI:	10.1080/09638288.2016.1212111
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Funder:	National Institute for Health Research (Great Britain) (NIHR)

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