DOI: 10.5061/dryad.g79cnp5tx
title: Barriers to home exercise for patients with Parkinson’s disease – a qualitative study

description: Objective: This study aimed to explore the barriers to home exercise for
 patients with Parkinson’s disease (PwPDs) and provide
 guidelines for healthcare providers (HcPs) to
  build and implement home exercise strategies for PwPDs.
 Design: A qualitative descriptive method was used.
 Semi-structured interviews were conducted and thematic
 analysis was employed. Setting: The study was conducted in the Department
 of Neurology at a Grade 3 Class A general hospital in China. Participants:
 A total of 22 participants were interviewed, including 10 PwPDs, seven
 caregivers, two nurses, one head nurse, and two Parkinson's
 clinicians. Results: Five themes were identified in this analysis. (1)
 Psychosomatic stress and low activity; (2) lack of early rehabilitation
 authorisation; (3) poor "flow" state of home exercise; (4)
 inaccessibility of continued service; (5) sociocultural impact on family
 coping. Conclusion: PwPDs, caregivers, and specialised medical staff
 raised the challenges faced by patients' home exercises from
 different perspectives. Interventions can improve services and
 integrate resources through the management of multi-disciplinary, early
 rehabilitation authorisation, exercise experience, continuous service
 mode, and family coping strategies under different cultures to gradually
 adjust the home exercise behaviour of PwPDs.
description: <strong>Design</strong> We
 employed a descriptive qualitative method, which is widely used in
 health-related qualitative research. Semi-structured interviews were
 conducted, and thematic analysis was employed.
 <strong>Participants</strong>
 Purposeful sampling and maximum difference sampling methods were
 utilised to recruit PwPDs with different disease stages, ages, and sex, as
 well as caregivers and Parkinson’s clinicians and nurses who were likely
 to provide a rich and in-depth description. Clinical records were screened
 to determine eligible patients. The inclusion criteria were as follows: 1)
 Patients diagnosed with PD using the "Chinese Parkinson's
 Disease Diagnostic Criteria" (2016 version) and not diagnosed for the
 first time; 2) age ≥18 years; 3) patients undertaking home-based
 autonomous exercise rehabilitation; and 4) voluntarily participation and
 signing an informed consent. Patients with severe heart, liver, and kidney
 failure; advanced cancer; history of mental illness; dementia (mini-mental
 state examination score &lt;24); and hearing or vision impairment were
 excluded. The nurses and head nurse who had worked in the Parkinson’s ward
 for more than 2 years and Parkinson's clinicians with a rank of
 intermediate and above were selected. When the
 participants agreed to participate in the study, they were required to
 complete a short questionnaire that included sociodemographic information.
 We performed an analysis while conducting the interview to help us
 determine the next interviewee to be selected. When the interview reached
 data saturation, that is, when it no longer provided new information and
 voice, it was discontinued. A total of 22 participants were interviewed,
 including 10 PwPDs, seven caregivers, and seven HcPs.
description: Excel