Exploring determinants of physical activity at home in the first year after hospital or rehabilitation discharge using patient narratives

Physical activity at home is vital after hospital or rehabilitation admission to support recovery and participation in society. This study aimed to identify determinative factors for physical activity at home during the first year post-discharge from the patient’s perspective.
Narrative storytelling was used to explore the underlying emotions and motivations behind physical activity behavior among orthopedic and neurological patients during the first year post-discharge. Analysis included extracting multiple real-life stories from each interview, followed by reflexive thematic analysis.
Fourteen participants (9 orthopedic, 5 neurological) were interviewed. Across the extracted stories, 45 topics were identified and grouped into 4 main themes and 9 subthemes. Findings underscore that long-term physical activity requires rehabilitation to be rooted in patients’ life roles, values, and priorities, enhancing autonomy and opportunities for personal functional activities in supportive clinical and home environments. Positive reinforcement and involvement of significant others, provided with practical strategies, were seen as essential for sustaining activity at home. Across neurological and orthopedic subgroups, shared determinative factors included focusing on daily life participation and fostering patients’ responsibility and resilience.
Emphasizing participation in personal environments and fostering self-management, autonomy, and resilience may enhance physical activity at home.

Rehabilitation professionals should explore deeper understandings of patients’ life roles, values and priorities and use these to set meaningful long-term physical activity goals that support both recovery and sustainable participation at home.
A supportive environment in the clinic and at home that promotes autonomy and personal functional activities, combined with positive experiences and reinforcement, can strengthen patient independence and self-management.
Involving significant others in rehabilitation and equipping them with practical strategies can promote physical activity and independence for neurological and orthopedic patients at home.
Focusing rehabilitation on daily life and participation in personal environments, and fostering patients’ responsibility and resilience, are determinative factors shared across neurological and orthopedic patients for promoting long-term physical activity.

Rehabilitation professionals should explore deeper understandings of patients’ life roles, values and priorities and use these to set meaningful long-term physical activity goals that support both recovery and sustainable participation at home.
A supportive environment in the clinic and at home that promotes autonomy and personal functional activities, combined with positive experiences and reinforcement, can strengthen patient independence and self-management.
Involving significant others in rehabilitation and equipping them with practical strategies can promote physical activity and independence for neurological and orthopedic patients at home.
Focusing rehabilitation on daily life and participation in personal environments, and fostering patients’ responsibility and resilience, are determinative factors shared across neurological and orthopedic patients for promoting long-term physical activity.