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Adding Behaviour-Change Counselling to an Exercise Program for Adults Preparing for Hip and Knee Arthroplasty Improves Psychological and Physical Wellness: Focus Group Reflections

Author

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  • Marie-Louise Bird

    (School of Health Sciences, University of Tasmania, Launceston, TAS 7250, Australia
    Department of Physical Therapy, University of British Columbia, Vancouver, BC V6T 1Z3, Canada)

  • Jonathan Mulford

    (Launceston General Hospital, Launceston, TAS 7250, Australia)

  • Andrew Daffyd Williams

    (School of Health Sciences, University of Tasmania, Launceston, TAS 7250, Australia)

  • Michael Cheney

    (School of Health Sciences, University of Tasmania, Launceston, TAS 7250, Australia)

  • Jane O’Brien

    (School of Nursing and Midwifery, University of Tasmania, Launceston, TAS 7250, Australia
    School of Nursing, Queensland University of Technology, Brisbane, QLD 4059, Australia)

Abstract

Purpose: To explore participant experiences for people on an arthroplasty waitlist, randomised to an exercise and behaviour-change counselling program (ENHANCE). The ENHANCE program for arthroplasty patients was led by an accredited exercise physiologist who delivered an individually tailored and structured exercise program. Included in the exercise program were up to five in-person counselling sessions, based on the Health Action Process Approach (HAPA) applied specifically to people with osteoarthritis. Nine adults (mean 69.4 years) who were on the waiting list for a total hip or knee arthroplasty and who had completed a 12-week program (ENHANCE) as part of a randomised controlled trial were recruited for this study. Methods: Two focus groups were conducted to explore participant experiences of ENHANCE. Data were analysed using inductive thematic analysis with constructs of the HAPA (motivational and volitional factors) as a framework. Results: We identified three themes (1) ‘The structured program addressed inactivity and improved feelings of wellness and preparation for the operation’. The benefits were not only physical, but psychological and were contextualised in terms of preparation for the upcoming surgery. (2) ‘People as enablers of participation’: Participants identified that the attitude, and skill of the experienced instructor were supportive and motivating, especially in tailoring the intervention. Within the program, the support of the group was considered a positive attribute (3) ‘Improved awareness changed attitudes to self-efficacy and perceived self-control’. Participants described an increased awareness of their condition and a better understanding of health expectations. They felt more control and ownership over their health journey. Conclusion: Goal setting and social support were identified factors in a behaviour-change counselling program, delivered in conjunction with structured exercise that led to a positive experience. Improved psychological and physical health were described. Participants were better prepared for their upcoming surgery, with increased self efficacy and mastery to support long-term physical-activity engagement.

Suggested Citation

  • Marie-Louise Bird & Jonathan Mulford & Andrew Daffyd Williams & Michael Cheney & Jane O’Brien, 2023. "Adding Behaviour-Change Counselling to an Exercise Program for Adults Preparing for Hip and Knee Arthroplasty Improves Psychological and Physical Wellness: Focus Group Reflections," IJERPH, MDPI, vol. 20(20), pages 1-10, October.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:20:p:6960-:d:1265212
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    References listed on IDEAS

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    1. Daniel Collado-Mateo & Ana Myriam Lavín-Pérez & Cecilia Peñacoba & Juan Del Coso & Marta Leyton-Román & Antonio Luque-Casado & Pablo Gasque & Miguel Ángel Fernández-del-Olmo & Diana Amado-Alonso, 2021. "Key Factors Associated with Adherence to Physical Exercise in Patients with Chronic Diseases and Older Adults: An Umbrella Review," IJERPH, MDPI, vol. 18(4), pages 1-24, February.
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