Physical activity participation in community dwelling stroke survivors: Synergy and dissonance between motivation and capability. A qualitative study

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Date
2016
DOI
10.1016/j.physio.2016.05.001
Open Access Location
http://discovery.dundee.ac.uk/ws/files/18367581/PA_participation_Final_Manuscript_Revision_ACCEPTED_track_changes_removed.pdf
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Publisher
Elsevier
Rights
© 2017. This manuscript version is made available under the CC-BY-NC-ND 4.0 license
Abstract
Objectives The evidence supporting benefits of physical activity (PA) on fitness, functioning, health and secondary prevention after strokeis compelling. However, many stroke survivors remain insufficiently active. This study explored survivors’ perspectives and experiences ofPA participation to develop an explanatory framework that physiotherapists and other health professionals can use to develop person-specificstrategies for PA promotion.Design Qualitative study using semi-structured in-depth interviews. Data was audio-recorded and transcribed. Analysis followed theFramework Approach.Setting Community setting, interviews conducted within participants’ homes.Participants Community dwelling stroke survivors (n = 38) six months or more after the end of their rehabilitation, purposively selected bydisability, PA participation and socio-demographic status.Results Findings suggest that survivors’ beliefs, attitudes, and physical and social context generated synergy or dissonance between motivation(desire to be active) and capability (resources to be active) for PA participation. Dissonance occurred when motivated survivors had limitedcapability for activity, often leading to frustration. Confidence to achieve goals and determination to overcome barriers, acted as activitycatalysts when other influences were synergistic. We illustrate these relationships in a dynamic explanatory model that can be used to supportboth novel interventions and personal activity plans.Conclusions This study suggests a shift is required from purely pragmatic approaches to PA promotion towards conceptual solutions. Under-standing how synergy or dissonance between motivation and capability influence individual survivors’ behaviour will support physiotherapists and other health professionals in promoting PA. This study provides a model for developing person-centred, tailored interventions that address barriers encountered by stroke survivors.
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Keywords
Exercise, Physical activity, Qualitative evaluation, Stroke, Adult, Aged, Aged, 80 and over, Cognition, Disabled Persons, Exercise, Female, Health Knowledge, Attitudes, Practice, Humans, Independent Living, Interviews as Topic, Male, Middle Aged, Motivation, Qualitative Research, Socioeconomic Factors, Stroke, Survivors, Young Adult
Citation
Physiotherapy, 2017, 103 (3), pp. 311 - 321
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