Int J Nurs Stud. 2011;.
BACKGROUND: Research has highlighted the benefits of physical activity for people
with stable heart failure in improving morbidity and quality of life. However, adherence
to exercise among this patient group is low. Barriers and enablers to sustained physical
activity for individuals with heart failure have been little investigated. OBJECTIVES:
To explore reasons why people with heart failure do and do not engage in regular physical
activity. DESIGN: A qualitative, interview-based investigation. SETTINGS: Three heart
failure clinics held at hospitals in the UK. PARTICIPANTS: Purposive sampling was
adopted to provide maximum variation in terms of gender, age, heart failure duration
and severity, and current activity levels. Twenty two patients (7=female) were interviewed,
aged between 53 and 82 years. METHODS: Semi-structured interviews were conducted via
telephone. These were recorded and transcribed verbatim. Framework analysis was applied
to collected data. RESULTS: Interviewees' narratives suggested that adopting positive
health behaviours was complex, affected by internal and external factors. This was
reflected in the four themes identified during analysis: fluctuating health; mental
outlook; others' expectations; environmental influences. Failure to exercise arose
because of symptoms, co-morbidities, poor sense of self as active and/or lack of perceived
benefit. Likewise, encouragement from others and inclement weather affected exercising.
CONCLUSIONS: Areas identified during interviews as influencing activity levels relate
to those commonly found in behavioural change theories, namely perceived costs and
benefits, self-efficacy and social support. These are concepts that practitioners
may consider when devising interventions to assist patients with heart failure in
undertaking and maintaining regular exercise patterns.