Abstract
Objectives To identify implicit and more profound barriers and facilitators and involving context elements to accomplish sustained physical activity (PA) in patients with a chronic disease. Understanding these barriers and facilitators may help develop future strategies to be used by healthcare professionals in primary care to support patients with a chronic disease to reach sustained PA. Design and methods The qualitative, narrative research method storytelling was applied. Perspectives of both patients with a chronic disease (n=12) and involved healthcare professionals (n=11) were collected. Stories were audiotaped and retrieved from the transcriptions. Analysis involved a cyclic process of constant comparison. Main themes were arranged in the theoretical framework of the Capability, Opportunity, Motivation and Behaviour (COM- B) model. Participants Patients were adults with a chronic disease or at high risk of developing a chronic disease who participated in a PA promoting programme. Eligible healthcare professionals were those involved in these PA promoting programmes in primary care, such as physiotherapists, nurse practitioners or sports consultants. Results From 176 stories, 62 relevant and unique stories were selected for further analysis. Eleven main themes were identified and afterwards linked to the COM- B model. Trust in one’s own capabilities and in the healthcare professional were relevant themes. Also, health literacy and coping with temporary interruption were important capabilities. Important motivators were customised PA, increasing awareness, meaningful activities, exercising in a group and success experiences. Aversion to sports was seen as a barrier. Interprofessional collaboration and prerequisites can be a facilitator or a barrier. Conclusions This study provides insight into deeper motivations, barriers and facilitators of sustained PA from both the patients’ and healthcare professionals’ perspective. Comparing these perspectives revealed different views and beliefs on some themes. Attention for temporary interruptions, aversion to sports and health literacy were identified to be important for sustained PA. Strengths and limitations of this study ► By using storytelling implicit barriers and facilitators important for sustainable physical activity (PA) are explored among patients with a chronic disease. ► Perspectives of both patients and healthcare professionals were included and compared, providing relevant clues for the improvement of support for sustainable PA. ► Researchers were trained to improve their storytelling skills, which is important to ensure a narrative climate during the interviews, in order to collect reallife stories. ► Intersubjectivity was reached among four researchers, increasing the quality of the study. ► Patients participating in this study took part (at least once) in a PA- promoting programme, limiting the transferability of results to a population less motivated.