Experiences of training-adherence in a 12 weeks home-based IMT program for individuals with COPD

Although inspiratory muscle training (IMT) is effective in improving inspiratory muscle strength, endurance, and physical activity in individuals with COPD; training-adherence remains a challenge. The participants9 inability to maintain effective training levels is well-known in pulmonary rehabilitation. In order to optimise home-based IMT, it is paramount to gain knowledge about the participants9 experiences with home-based training. This knowledge may contribute to development of home-based IMT interventions. This study aims to explore experiences of training-adherence in a 12 weeks home-based IMT program for individuals with COPD. We used a grounded theory design, in which data collection and a constant comparative analysis were conducted in a concurrent process till theoretical saturation was reached. Thirty-six individuals with COPD were recruited from a pulmonary rehabilitation program. Data were collected by semi-structured face-to-face and telephone interviews with participants after completion of the 12 weeks IMT program. Maintaining self-esteem resulted from the participants9 behavioural patterns, through which they resolved their main concern: avoiding to disappoint themselves through three changeable behavioural modes: the Regretting Mode, referring to discouraging, denying, and renouncing behaviour; the Misgiving Mode, referring to respecting, reserving, and extenuating behaviour; and the Involving Mode, including determining, committing, and accepting behaviour. The Theory of Maintaining Self-esteem provides knowledge of participant9s variation in their need for professional support, and should be targeted specifically at participants in the Misgiving Mode.