What Makes Exercise Enjoyable For People With Arthritis? A Q Methodology Study of Shared Opinions

Abstract

People who enjoy exercising are more likely to maintain good fitness habits and achieve health enhancing benefits. A large percentage of people with arthritis do not meet the recommended levels of physical activity, which is concerning as exercise can assist with the management of the disease. The overall goal of this study was to investigate the importance of enjoyment of exercise for people with arthritis. The specific aims were to see what groupings of participants are formed when individually interviewed about exercise, and what similarities there are across the groupings. In this Q method study 12 participants with arthritis were recruited from the Dunedin Hospital, exercise clinics around central Dunedin, and through poster advertising. Six men and six women participated and they ranged in age from 20 to 85 years (mean age 50). The participants attended two individual interviews with the primary researcher. The first interview was for generation of statements, regarding exercise, from which the Q set was developed. The same participants then went through the ranking procedure interview in which they ranked the 51 statements according to how much they agreed with them using normal distribution response matrix (from -5 to +5). A Q method factor analysis using the participants as the ‘items’ was carried out and four groupings of 2-4 participants were formed and defined in terms of shared rankings and illustrative quotes from the sorting process. The first grouping related to the relevance of change in exercise behaviours after diagnosis of arthritis. The second grouping had a shared enjoyment for walking. The third grouping expressed how it is important to be knowledgeable about arthritis and exercise. And the fourth grouping shared a sense of importance of being responsible for their health by exercising. In addition, four themes across all participants were found in an inductive thematic analysis of transcripts of the ranking process. The first theme revealed two types of enjoyment in relation to other people: being with or without others when exercising; and the element of competition, which was only enjoyed by one participant. The second theme centred on the benefits of exercise, both psychological and physical. The third theme related to the physical and psychological barriers to exercising. And the fourth theme focused on the idea of achieving a balanced lifestyle by doing the right amount of exercise (i.e., not too much and not too little). Triangulation of the four groupings and four themes revealed that the second theme of benefits was the one only idea that was shared across all groupings of participants. The psychological and physical benefits from exercise are important to the participants of this study. These findings provide information about exercise that health professionals can share with newly diagnosed people with arthritis.