br Functional limitations secondary to comorbid conditions

Functional limitations secondary to comorbid conditions were com-mon among study participants. For some, difficulty with activities of daily living (bathing, dressing) prohibited participation in any physical activity, including walking. Gait and balance issues limited mobility
and ambulation for patients. Use of assistive devices, such as single point cane (SPC), allowed some patients to ambulate for short distances. History of multiple falls that resulted in serious fractures, further prohibited participants' willingness to walk.
3.1.4. Theme 4: Anxiety/Feeling Overwhelmed
Emotional well-being, including anxiety, psychological distress, and stress, were common barriers to adherence for both patients and FCGs. Preoperative anxiety and fear regarding the upcoming surgery, other treatments, and results from surgery (pathology, etc.) made it Lithocholic Acid challeng-ing for participants to engage in the walking program. In addition to preoperative anxiety, stress-related to completing preoperative tasks and chores were overwhelming for patients and FCGs. Worries about
Exemplars: facilitators to adherence.
Theme Patient Caregiver
Physical activity “He walks 5–7 × week for 60–80 min in the morning and 45 min in the afternoon. “Wife does Pilates twice a week and goes to the gym once a week.”
as part of Also goes to the gym 2 × week for 90 min doing treadmill, weights and pilates. “Husband is her primary caregiver and he hikes 2× a week in the
routine Patient likes to ski, walk, go to the gym, do his yard work.” mountains.”
“Active and goes to gym 2 × week and works out with a trainer with body weight “Patient's husband is her caregiver and he is also active and likes to
resistance training and Pilates exercises.” golf for 3–4 h a day.”
“Patient is very active and walks 2–3 miles every day with her husband - about 45
“She is active throughout the week engaging in tennis weekly and yoga, aerobics,
walking and weight lifting an additional 3–4 times per week.”
“Spends his day doing yard work and general maintenance on his home and other
properties.”
“Normally, she enjoys walking around her block with her friends.”
Coping “She states that she copes by praying and putting her problems in the hands of God.” “She has been coping by relying on her faith, a prayer group.”
strategies “Faith is what grounds them through these experiences and that this actually turned “She is actively engaged in charity work and socializes daily.”
out easier than they thought.” “Cleans her home when she feels stressed.”
“Sits on the board for the local YMCA which involves meetings and events throughout “Caregiver states that she has been incorporating exercise
the week.” consistently based on previous recommendation to utilize this as a
“Socializing with family and friends.” coping strategy for stress.”
“He also values keeping a clean home which includes mopping/vacuuming and
washing dishes.”
“Attempts to ‘control’ an activity indoors, such as cleaning out the drawers.”
“Her primary coping strategy is meditation.”
“Patient normally manages her stress by performing labor intensive activities
Setting goals for “Patient stated three goals for after surgery: Returning to the mountains, skiing and
motivation teaching skiing.”
“Goal of increasing steps by 1000 in the next two days.”
“Reported cooking, returning to his job as a mechanic, painting, playing his musical
instrument, and walking/jogging and important activities to continue or return to
after surgery, rating each of 10/10 importance.”
“His goal is to recover from surgery so he can get back to his routine of travelling and
enjoying life.”
“Patient stated that she is motivated to recover quickly as she has her children and
grandchildren visiting for the holidays.”
Social/family “Pt states she has good support from friends who are contacting her throughout her “Caregiver is extremely helpful in providing support and
support hospital stay.” encouragement for her. Caregiver states that she will provide
“His daughter and son are living with him on a temporary basis. He has multiple consistent encouragement for patient to walk daily.”
children and grandchildren, and described himself as being ‘lucky’ on having a good “Husband very supportive and present; has been walking with the
social support system.” patient.”
“Patient reported that grandchild has purchased several books for him to read.” “Husband has been walking consistently and motivating her to join
“Daughters prepare his meals and maintain the home to make Cold-sensitive more convenient for