Page 74 - Physical activity in recipients of solid organ transplantation - Edwin J. van Adrichem

Chapter 4
Discussion

is qualitative research identi
recipients.

ed the perceived barriers to and facilitators of PA in SOT

fear, and comorbidities.
e most common and important barriers were physical limitations, energy level,

e most frequently indicated and important facilitators were
motivation, coping, consequences of (in)activity, routine/habit, goals/goal priority, and the
transplanted organ. Important neutral factors that acted as barriers or facilitators included
self-e
surgery’.

cacy and the expertise of personnel.
Several factors that were classi
limitations, lack of energy, co-morbidity, weight, age),
39

ed in the personal components:
(routine/habit, consequences of (in)activity) are also indicated as barriers
physical
(motivation, coping,
(physical
psychological
goals) and
other
and facilitators to PA in the general population and in older adults.
35–38

e same applies to
the majority of factors classi
physical environment

ed in
(weather) and
social environment
role),
other
(

(social support, group activity, social
nancial resources).
Although little
studies are available, remarkable agreements in barriers to and facilitators of PA are seen
35–38
with patients that underwent coronary artery bypass graft (CABG) surgery. In a recent
qualitative study in CABG patients the most commonly cited barriers were ‘other time
commitment’, ‘inclement weather’, and ‘pain/injury/illness related or unrelated to the
present in the current study as well.

di

e priority of the barriers, however, seems to be
erent for CABG patients and recipients of SOT. Physical limitations (pain/injury/
illness related or unrelated to the surgery) are the number one barrier in recipients of SOT
where it has a lower priority in CABG patients, as is also the case for energy level being a
barrier. Where the weather is a highly salient barrier in CABG patients the priority was
clearly lower in recipients of SOT.

e most commonly mentioned facilitators in CABG
patients were ‘it feels good to exercise’, and ‘improving physical health’.
39

ese most salient
facilitators, but also the other indicated facilitators in the study are very similar to the
indicated facilitators in the current study.
Furthermore, the items classi

e priority of facilitators also seems to concur.
physical
and
psychological an
d
in the
social
physical environment
ed in the personal components
and
corresponding to those experienced in the general
population also show many similarities with the barriers and facilitators in patients with
end-stage organ disease.
It therefore seems likely that the majority of these barriers
ese most salient barriers, but also almost all other indicated barriers are
factors speci
72.

21–28
and facilitators are already present in the pre-transplant phase. Whether the number and/or
severity of barriers and facilitators change from the pre-transplant phase to the post-
transplant phase has not been reported so far.
Besides the barriers and facilitators similar to those experienced in the general
population, CABG patients, and in the end-stage organ disease phase, there are several
c to SOT recipients. Perhaps the most striking is that several participants
described to be inactive or moderately active before they became ill and during the period
before transplantation, however, are now more active due to a feeling of responsibility to
take good care of the received organ. Where earlier research demonstrated that previous
exercise participation in adulthood is associated with current exercise participation,
35,36,40
it
seems that this association may not apply to all SOT recipients. Also associated with the