What are the experiences of people with heart failure regarding participation in physical activity? A systematic review, meta-aggregation and development of a logic model

OBJECTIVES: To (1) synthesise the experiences of people with heart failure and those who care for them concerning participation in physical activity (2) develop a logic model for a future intervention which will support people with heart failure to feel confident and safe in being physically active. DESIGN: A systematic review and meta-aggregation using Joanna Briggs Institute (JBI) methodology. DATA SOURCES: MEDLINE, Emcare and PsycINFO databases were searched through until June 2024 inclusively. ELIGIBILITY CRITERIA: Studies with a qualitative design, including qualitative components of mixed-methods studies, which describe experiences of participation in physical activity by adults with chronic heart failure. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers used standardised methods to search and screen studies. Data extraction included the PROGRESS-Plus items. The JBI checklist for qualitative studies was applied. Meta-aggregation guided by JBI methods was used to synthesise the data. This evidence, along with input from a patient and public involvement group, healthcare professionals and charity organisations, was used to develop a logic model. RESULTS: We included 28 papers (25 studies) comprising 14 qualitative studies and 11 mixed-method studies describing the perspectives of 483 people with heart failure, 64 carers and 12 healthcare professionals.The meta-aggregation produced seven synthesised findings describing the impact of physical symptoms, emotional factors, extrinsic factors, access to knowledge, self-motivation and peer/professional motivation and the positive impact of physical activity. The PROGRESS-PLUS tool identified significant inclusivity issues within the studies. The meta-aggregation with relevant contributor input informed behavioural determinants and potential intervention components of a logic model. CONCLUSIONS: This study identifies behavioural determinants that underlie the actions of people with heart failure in their relationship with physical activity and potential intervention components for a novel intervention design to support this population. There is a lack of studies exploring health professionals' and carers' perspectives on this topic. PROSPERO REGISTRATION NUMBER: CRD42022342883.