Factors influencing physical activity engagement amongst those living with pulmonary hypertension in the UK

This study explored attitudes towards exercise, recollections of physical activity advice received, and the dimensions that influence physical activity (PA) engagement in individuals diagnosed with pulmonary hypertension. Virtual semi-structured interviews (n = 21) were conducted with those diagnosed with pulmonary hypertension. Participants (mean age 57.4 (SD ± 13.1) were recruited through the Pulmonary Hypertension Association of the UK. Interviews were transcribed verbatim and analysed using reflexive thematic analysis. Four main themes were generated: (i) Fear of breathlessness and overdoing it; (ii) lack of motivation and desire for monitoring and targets; (iii) self-presentation: keeping up appearances, and (iv) Little PA advice: patient-driven communication. A lack of motivation was a common barrier to PA engagement amongst PH patients. Other dimensions included fear and anxiety related to dyspnoea and overexertion and protective self-presentation. The influence of self-presentation and identity in exercise-avoidance in PH is a novel finding. The study also found recollections of little PA advice from treating clinicians and a tendency for patient driven PA information. Future PA interventions that alleviate fear and anxiety through cognitive restructuring, provide reassurance on the safety and benefits of exercise, and include clear instruction on behaviour and graded exposure would be worthwhile to increase PA in PH. Interventions that broaden the conception of PA and promote lifestyle-based PA alongside fostering patient motivation for PA through goal setting, self-monitoring and review of behaviour are also likely to be valuable.