How relationships with exercise change: A qualitative study on the influences of exercise decision-making with systemic lupus erythematosus and cardiovascular disease

Background: Greater than 50% of individuals with systemic lupus erythematosus (SLE) will develop cardiovascular disease (CVD). Moderate-intensity aerobic exercise significantly reduces CVD risk, morbidity, and mortality, yet most persons with SLE do not meet the minimum recommendations for physical activity. Purpose: To explore specific barriers to exercise that afflict those with both SLE and CVD, as well as how these factors may change over time. Research Design: Qualitative. Study Sample: Individuals with self-reported SLE and CVD. Data Collection: Researchers conducted 1:1 semi-structured interviews and administered a battery of surveys. Analysis. Researchers used an inductive, interpretive phenomenological analysis qualitative approach to understand patients’ perspectives on what influences perception and decision-making of exercise. Results: Five participants completed the study. Four overarching themes were identified. The first, “Short-term Risks versus Long-term Benefits of Exercise,” exemplifies the temporal nature of the perception of exercise risk throughout the diagnostic timeline and explains how this relationship changes over time. The second, “Pacing,” defines the struggle that these participants face when allocating energy to everyday tasks. The third, “Foundational and Nurturing Supports for Exercise,” describes the impact that medical and family/friends have on exercise adherence as primary methods of support. The fourth highlights a “Need for Tailored Intervention” for each patient with SLE and CVD, as general recommendations from health professionals are often described as difficult to adhere to. Conclusion: Understanding exercise adherence in this population represents a dynamic and individualized process. The success of long-term decisions to engage in exercise may result from targeting natural intervention areas across the diagnostic timeline, encouraging support from healthcare providers, friends, and family members, and implementing personalized exercise programs for this population.