Patients’ Perceptions of Exercise-Based Cardiac Telerehabilitation after a Myocardial Infarction—A Qualitative Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design
2.2. Patients
2.3. Setting
2.4. Procedure
2.5. Data Analysis
3. Results
3.1. The Important Role of a Physiotherapist with Expert Knowledge
3.1.1. Provides Safety
“It’s a sense of security, that someone who actually has in-depth expertise and knows what I need to exercise in terms of fitness and strength, both how much and what is best for me, because I’m not fully aware of that.” (7)
“I think more about safety, during exercise, I unlocked the door at home, because I did not know how my body would react.” (8)
3.1.2. Encouraging
“I think it’s necessary to have a physiotherapist who motivates you by your side for a long time. It’s a bit of encouragement, I think it’s very important.” (13)
3.1.3. Need for Clear Instructions
“Yes, she [the physiotherapist] was very clear, she knows what she is doing and talked and explained why we did what we did, so that was great.” (5)
“We have two different physiotherapists and they have slightly different styles and it is also good that they have different balance exercises, it’s good to have different versions.” (1)
“If there is a new instructor who performs another exercise or does it another way, then I have to check again and then I can’t keep up.” (3)
3.1.4. The Importance of Interaction
“Yes, you can ask questions afterwards, if someone asks a more personal question, then the physiotherapist says, ‘Yes, we can talk about that afterwards’ and it also feels very good to be able to do that.” (1)
“When I have to exercise myself, it becomes so much more inefficient. The breaks between the intervals are far too long and, although I can see the exercise instructions and read the text, it becomes stagnant.” (6)
3.2. Prerequisites Playing an Important Role in the Willingness to Participate
3.2.1. Perceptions and Expectations Are Important When It Comes to Participating in Telerehabilitation
“I thought it worked out very positively, smoothly and easily. I have always been a little fascinated by new thinking and new stuff, so, when I got the question about the study, I said yes and I had a positive input to this, so to speak, but I also think it has met the expectations I had.” (7)
“I am an old man when it comes to electronics and computers and everything like that. I don’t really agree with all this modern technology, there was resistance, but the physiotherapist managed to convince me to try.” (6)
3.2.2. Fear of Movement
“Every time I make an extra effort, there is always a slight worry that has not existed before.” (3)
“I was never afraid of having another heart attack, rather the opposite, it may have been a push in the back that you can now actually start a little aerobic exercise.” (9)
3.2.3. The Impact of Previous Experience of Exercise
“I have performed many of these exercises previously, so I recognized a lot of it. So, for me, there was nothing strange.” (14)
3.2.4. Significance of Computer Skills
“I use a computer a lot at work, so the technical part wasn’t an obstacle for me, but I can imagine that many people will think it is.” (1)
3.3. Making Exercise Accessible and Adjustable
3.3.1. Availability
“It easily takes two, two and a half hours if you don’t do the exercise at home and therefore I think this is great, because it cuts the timeframe.” (7)
“The advantage of this is that you don’t need any equipment, more than an elastic band, so, wherever you go, you can just bring an elastic band and your pants and a sweater.” (4)
“If you have already booked exercise at a certain time, it’s much easier to just do it, than if I have to think, when should I exercise?” (3)
3.3.2. Feeling of Being a Group Member or a Single Participant
“You feel like you’re a group, even though I don’t know exactly what everyone looks like, you know that there are others out there doing the same thing as me. That’s quite fun, I think.” (9)
“I did not experience it as a group really, it was like between me and the person who led it, so to speak. I knew there were others participating, but I didn’t really care about that, except that I sometimes saw them.” (14)
3.3.3. The Opportunity to Self-Regulate Exercise
“Yes, it went well, I think. Since these are the exercises that everyone does the same amount of and she [the physiotherapist] says that, if you can’t go all the way, then adapt like this and so on.” (4)
3.3.4. User Acceptance
”For my generation and those who are older, I think you perhaps need to be a little more hands-on and show how it works on a computer.” (1)
“It has worked very well, it was just a question of getting started and then, when you figured out how to use the settings, it was very simple, no problems. I got the link and just clicked on it and got started.” (5)
“The first time, you should perhaps allocate a small section of 15 min where you show how it works, this is how you ‘pin’ and here is the sound.” (7)
3.3.5. Simple, Enjoyable Exercises Contributed to Implementation
“It has been very good, I think, and in a form that suits me very well.” (5)
“The exercises you can do are a bit limited, of course, so you must be a little clever. But I think it has worked well. I can definitely imagine doing more exercises via telerehabilitation.” (3)
3.4. Inspiring Future Exercise
3.4.1. Perceived Benefits of Exercise
“So, all of a sudden, I discovered that I like exercising, so I now find that I am just getting better and better and both my wife and my children can see that I have improved.” (15)
3.4.2. Inspiration for Future Exercise
“Yes, I would like to continue, but my exercise period is over, I understand. But then it is good that I have already established a routine to continue on my own.” (13)
“Some tips on what exercises I can do on my own, when you can’t go to the gym, I need that. As well as what kind of aerobic exercise I can do myself, either at home or outside or wherever.” (9)
4. Discussion
Methodological Considerations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
- Can you tell me about your perceptions of participating in exercise-based cardiac telerehabilitation?
- Which factors have been important for you when performing the exercise-based telerehabilitation program?
- Did you perceive anything that was particularly positive in connection with the exercise-based telerehabilitation?
- Did you perceive any obstacles or concerns in connection with exercise-based telerehabilitation?
- How did you experience exercise-based telerehabilitation compared with previous exercise experiences?
- How did you perceive the interaction with the physiotherapist during the exercise-based telerehabilitation sessions?
- How did you perceive the interaction with peers during the exercise-based telerehabilitation sessions?
- How do you perceive the physiotherapist’s role in exercise-based telerehabilitation after a myocardial infarction?
- Now that you have completed the exercise program, do you need any support to be able to continue exercising?
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Meaning Unit | Condensed Meaning Unit | Code | Sub-Category | Category |
---|---|---|---|---|
Can you tell us about your perceptions of exercising via telerehabilitation? I think it has been very positive. I see it as a very big advantage that you can do it at home. I live in the country and have about 15 km to the nearest gym, so this is a very convenient way. | Positive, I see it as an advantage to exercise at home. | Exercising at home | Availability | Making exercise accessible and adjustable |
Theme | Cardiac telerehabilitation—a new alternative for exercising that is easily accessible and up to date. | |||
Category | The important role of a physiotherapist with expert knowledge | Prerequisites play an important role in the willingness to participate | Making exercise accessible and adjustable | Inspiring future exercise |
Sub-category | Provides safety Encouraging Need for clear instructions The importance of interaction | Perceptions and expectations are important when it comes to participating in telerehabilitation Fear of movement The impact of previous experience with exercise Significance of computer skills | Availability Feeling of being a group member or a single participant The opportunity to self-regulate exercise User acceptance Simple and enjoyable exercises contributed to implementation | Perceived benefits of exercise Inspiration for future exercise |
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Nilsson, U.; Öberg, B.; Bäck, M. Patients’ Perceptions of Exercise-Based Cardiac Telerehabilitation after a Myocardial Infarction—A Qualitative Study. Int. J. Environ. Res. Public Health 2023, 20, 5420. https://doi.org/10.3390/ijerph20075420
Nilsson U, Öberg B, Bäck M. Patients’ Perceptions of Exercise-Based Cardiac Telerehabilitation after a Myocardial Infarction—A Qualitative Study. International Journal of Environmental Research and Public Health. 2023; 20(7):5420. https://doi.org/10.3390/ijerph20075420
Chicago/Turabian StyleNilsson, Ulrika, Birgitta Öberg, and Maria Bäck. 2023. "Patients’ Perceptions of Exercise-Based Cardiac Telerehabilitation after a Myocardial Infarction—A Qualitative Study" International Journal of Environmental Research and Public Health 20, no. 7: 5420. https://doi.org/10.3390/ijerph20075420