Personal Characteristics Influencing Patients' Adherence to Home Exercise During Chronic Pain: a Qualitative Study

Objective: To identify the beliefs and perceptions of patients with chronic neck and low back pain that influence adherence to home exercise during exacerbation and/or remission of pain.

Design: Qualitative study using a focus group technique.

Subjects: Thirty-four patients (23 women, age range 26-70 years) with chronic neck or low back pain who had participated in a home exercise programme.

Methods: Seven focus groups were formed. Participants were sampled purposefully from all patients with chronic neck or low back pain who attended for physiotherapy at 4 primary healthcare centres. Patients were interviewed about how they perceived their adherence to a home exercise programme during chronic pain. Data were analysed using a phenomenographic method.

Results: Several themes about patients' beliefs and perceptions were identified as factors related to adherence. These factors change when pain or disabilities appear, decrease or disappear for an extended period. Beliefs about illness and treatment are more likely when pain is present and when pain disappears for an extended period. However, patients consider perceptions about barriers, social support and physical environment when pain decreases.

Conclusion: These findings may represent an important potential for improving the adherence of patients with chronic pain to home exercise programmes.