Perceptions of sedentary behaviour in people with chronic obstructive pulmonary disease (COPD) following a recent hospital-managed exacerbation: A qualitative exploration

Background
Individuals with chronic obstructive pulmonary disease (COPD) often lead sedentary lives, which is linked to negative health outcomes. Understanding the causes of this behaviour is essential for designing effective interventions. In the time following a hospital discharge, people with COPD may be especially sedentary and develop habits that contribute to this behaviour. Therefore, this is an important point at which to evaluate the reasons behind sedentary behaviour.

Methods
From one acute hospital in England, 12 participants with a recent COPD exacerbation were recruited. Following discharge, semi-structured interviews were conducted to identify perceptions of and barriers and facilitators to reducing sedentary behaviour. Reflexive thematic analysis was employed.

Findings
Two themes developed: “Focusing on survival” and “Loneliness, social isolation and lack of purpose”. Factors contributing to sedentary behaviour include the need for rest, social isolation, symptom management, fear of dying or being readmitted to hospital from over-exertion, adherence to health professional advice, and lack of motivation and purpose. Concerns about socioeconomic disparities were noted. Participants were ready to embrace positive lifestyle changes.

Conclusion
Our study found some people with COPD, recently discharged from hospital, may adopt a sedentary lifestyle to manage symptoms and daily activities. Interviews highlight the need to tackle socioeconomic disparities, social support, and feelings of social disconnection. Misconceptions about sedentary behaviour being part of recovery underline the need for education for individuals with COPD and health professionals. The findings suggest strategies to reduce sedentary time, such as enjoyable activities, community involvement, and incorporating sedentary behaviour reduction into pulmonary rehabilitation.