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.

Design

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.

Participants

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 <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.

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