RESUMING EVERYDAY LIFE AND PHYSICAL ACTIVITY AFTER AN ACUTE PULMONARY EMBOLISM: A QUALITATIVE EXPLORATIVE STUDY

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Rolving N1, Brocki B2, Andreasen J21Silkeborg Regional Hospital, Diagnostic Centre, Silkeborg, Denmark, 2Aalborg University Hospital, Dep. of Occupational Therapy and Physical Therapy, Aalborg, DenmarkBackground: International guidelines for treatment of acute pulmonary embolism (APE) focus primarily on recommendations regarding diagnostics and medical treatment of the condition, while rehabilitation and patient-related outcomes are not addressed issues. However, qualitative studies and clinical experience show that patients often worry about their health condition and fear a new APE, and many experience negative long-term physical consequences, like dyspnea and fatigue. For some this leads to a changed health behavior with reduced physical activity or cessation of sports. This is important in a rehabilitation perspective, as reduced physical activity following APE will further reduce patients´ physical capacity and quality of life, and increase the risk of a new cardiovascular event. Although a few qualitative studies have investigated patients' experience of being struck by an APE, none have focused on their experience of resuming everyday life and physical activity, and what strategies they use to overcome various barriers hindering their return to everyday life and sports.Purpose: The purpose of the study was to explore how patients manage to return to everyday life following an APE, and specifically how they experience resuming physical activities and exercise, with the aim to inform and potentially change future practice in the field.Methods: The qualitative methodological approach was interpretive description, using data from 16 individual semi-structured interviews. The participants were adult patients, who were interviewed 7 to 12 months following an APE.Results: The analysis showed that participants found their everyday life to be negatively influenced in different ways by the APE even a year following the event. Most still felt limited by fatigue, worries or anxious thoughts, and experienced an increased alertness towards bodily signs that could indicate a new APE, which influenced negatively on their well-being. An increased focus on staying healthy in terms of diet and exercise, and different strategies to achieve these targets were described. Some participants experienced it as challenging to change everyday patterns. Lastly, family and friends were experienced both as being a barrier and as a support for returning to everyday life. Some experienced, that spouses and children were very concerned and therefore they did not involve them much. Conversely, others found spouses and friends to be a major support in terms of resuming daily life and physical activity or exercise.Conclusion(s): Although most participants had managed to resume their everyday life 6-12 months after the APE event, most were still limited in their daily activities in some way and found it difficult to uphold a sufficient level of physical activity. They focused on staying healthy, and described different barriers and facilitators, which would be relevant to consider in future rehabilitation interventions.Implications: This study reveals several problematic issues experienced by patients following an APE event, both related to resuming everyday life, and becoming physically active again. These issues should be addressed by health professionals in future practice, and especially physiotherapists have an important role to play in terms of helping patients return to physical activities and exercise again.Keywords: Pulmonary Embolism, Physical activity, Qualitative studyFunding acknowledgements: The study was supported by the Danish foundation TrygfondenTopic: CardiorespiratoryEthics approval required: YesInstitution: Central Denmark RegionEthics committee: Ethics Committee of Central Denmark RegionEthics number: Journal no. 1-10-72-243-15All authors, affiliations and abstracts have been published as submitted.

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