People with COPD perceive ongoing, structured and socially supportive exercise opportunities to be important for maintaining an active lifestyle following pulmonary rehabilitation: a qualitative study

QUESTION: What are the views and perceptions of people with chronic obstructive pulmonary disease (COPD) regarding maintaining an active lifestyle following a course of pulmonary rehabilitation? DESIGN: Qualitative study of two focus groups using a grounded theory approach. PARTICIPANTS: Sixteen people with COPD who had completed a course of pulmonary rehabilitation. RESULTS :Data from focus groups concurred and five main themes emerged: value of pulmonary rehabilitation, ongoing exercise, professional support, peer social support, and health status. Pulmonary rehabilitation was seen as facilitating greater participation in everyday activity by improving physical ability and confidence to manage breathlessness, and reducing fear about exertional activity. An exercise routine following rehabilitation was perceived as essential for maintaining activity, with participants voicing a need for ongoing, structured and supervised sessions to maintain new found abilities. The exercise facility presented a possible barrier to attendance due to its potential to provoke feelings of embarrassment or intimidation. Professional and peer support were identified as key elements; participants expressed a desire to exercise within a peer group combined with an opportunity for social interaction. Health status relating to COPD symptoms was also identified as negatively impacting on physical activity participation. Confidence or self-efficacy for physical activity emerged as a prominent factor within main themes. CONCLUSION: The opportunity for structured, ongoing exercise with peer and professional support, in a suitable venue, is perceived as important to people with COPD in facilitating a physically active lifestyle following pulmonary rehabilitation. This desire for such opportunities may be related to individuals' self-efficacy towards physical activity