Rees-Roberts Melanie, Borthwick Rachel, Santer Ellie, Darby John, West Alan, O'Driscoll Jamie M, Pellatt-Higgins Tracy, Gousia Katerina, Short Vanessa, Doulton Tim, Wiles Jim, Farmer Chris, MacInnes Douglas
Centre for Health Services Studies, University of Kent, Canterbury, UK.
Public co-applicant, Kent, UK.
Pilot Feasibility Stud. 2024 Aug 26;10(1):113. doi: 10.1186/s40814-024-01539-8.
Healthy lifestyle changes for patients with stage 1 hypertension are recommended before antihypertensive medication. Exercise has antihypertensive benefits; however, low adoption and high attrition are common. Patients need easily adoptable, effective and manageable exercise interventions that can be sustained for life. We present participant and stakeholder perceptions of an isometric exercise intervention for stage 1 hypertension delivered in the National Health Service (NHS, UK).
An embedded qualitative study within a randomised-controlled feasibility study included intervention arm participants (n = 10), healthcare professionals from participating NHS sites (n = 3) and non-participating NHS sites (n = 5) taking part in semi-structured interviews to explore feasibility of delivering an isometric exercise intervention within the study design and an NHS context. Data was analysed using reflective thematic analysis.
Three themes were identified: study deliverability; motivators and barriers; support for study participation. Findings indicated that the study was well designed. Health benefits, unwillingness to take medication, altruism and interest in the study helped motivation and adherence. Study support received was good, but healthcare professionals were insecure in intervention delivery with regular training/supervision needed. Perception of health improvement was mixed, but, in some, uptake of wider lifestyle changes resulted from participation. Stakeholders felt that current service challenges/demand would make implementation challenging.
Despite participant positivity, delivery of an isometric intervention in an NHS setting was considered challenging given the current service demand, although possible with robust effectiveness evidence. Findings support further effectiveness data and implementation development of the isometric exercise intervention.
ISRCTN, ISRCTN13472393 . Registered 18 September 2020.
对于1期高血压患者，建议在使用抗高血压药物之前先进行健康的生活方式改变。运动具有降压益处；然而，采用率低和流失率高的情况很常见。患者需要易于采用、有效且易于管理的运动干预措施，以便能够终身维持。我们介绍了在英国国家医疗服务体系（NHS）中为1期高血压患者提供等长运动干预时参与者和利益相关者的看法。
在一项随机对照可行性研究中进行的嵌入式定性研究，包括干预组参与者（n = 10）、参与研究的NHS站点的医疗保健专业人员（n = 3）和未参与研究的NHS站点的医疗保健专业人员（n = 5），他们参与了半结构化访谈，以探讨在研究设计和NHS背景下提供等长运动干预的可行性。使用反思性主题分析对数据进行分析。
确定了三个主题：研究的可交付性；动机和障碍；对研究参与的支持。研究结果表明该研究设计良好。健康益处、不愿服药、利他主义和对研究的兴趣有助于激发积极性和坚持性。获得的研究支持良好，但医疗保健专业人员在干预实施方面缺乏信心，需要定期培训/监督。对健康改善的看法不一，但在一些人中，参与导致了更广泛的生活方式改变。利益相关者认为当前的服务挑战/需求将使实施具有挑战性。
尽管参与者持积极态度，但鉴于当前的服务需求，在NHS环境中提供等长运动干预被认为具有挑战性，尽管有强有力的有效性证据时是有可能的。研究结果支持进一步的有效性数据以及等长运动干预的实施发展。
ISRCTN，ISRCTN13472393。2020年9月18日注册。
