'Doing it together?' A dyadic qualitative study of perceptions, facilitators, barriers and expectations for physical...

Persons with dementia and their caregivers are more physically inactive than cognitively healthy peers or non-caregivers, yet little is known about their views on dyadic physical activities. This study explored the perceptions, facilitators, barriers and expectations related to dyadic physical activity among persons with dementia and their caregivers.

An exploratory dyadic qualitative study was conducted with 24 community-dwelling dyads in Hong Kong SAR, China. Semi-structured dyadic interviews were analysed using inductive thematic analysis.

Four themes comprising 22 subthemes were identified. Dyads recognised mutual physical, psychological and relational benefits and valued activities that fostered shared enjoyment and relational resonance, though some questioned dyadic activity's relevance. Engagement was facilitated by clear rewards, established habits, everyday collaborative activities, culturally meaningful incentives and strong social and professional support in a facilitative environment. Participation was hindered by limited shared understanding of physical activity, negative emotions in partner, mismatched fitness levels and activity rhythms, social withdrawal by the person with dementia, time pressures and conflicting family attitudes. Dyads expected interventions to yield tangible health and fitness gains, be tailored to both partners' capacities and interests, provide appropriate challenge and ensure safety through explicit risk management strategies.

Dyadic physical activity is not simply 'doing it together'. Instead, interventions should be tailored, health-oriented and relationally attuned, with explicit consideration of the practical and emotional challenges faced by both dyad members. Psychoeducation regarding the significance of physical activity may need to extend beyond the dyadic members to the wider family to promote 'doing it together'.