Nursing Support for Exercise Adherence in Chronic Disease Management: A Qualitative Descriptive Study of Patient and Nurse Perceptions.

Background: Physical inactivity is common among people living with chronic non-communicable disease, and nurses are frequently the professionals with the most sustained patient contact. How nursing support for physical activity is experienced by patients, and how nurses understand their own role in providing it, remain poorly described. Objective: To explore how patients with chronic diseases and nursing professionals describe nursing support for physical activity and exercise adherence, and where their accounts converge or diverge. Methods: A qualitative descriptive study using individual semi-structured interviews and reflexive thematic analysis. Seventeen participants (nine patients with chronic diseases and eight nursing professionals) were purposively recruited from five healthcare institutions in the Riyadh region of Saudi Arabia. Interviews lasted 30 to 60 min (mean 45 min) and were conducted between December 2025 and February 2026. No quantitative measures of exercise frequency, intensity, duration, or session regularity were collected, so the study reports perceptions and experiences rather than measured adherence, and no causal relationships were examined. Rigor was addressed through researcher reflexivity, member checking, peer debriefing, and an audit trail; reporting follows COREQ. Results: Five themes were constructed: (1) Nursing-Facilitated Empowerment Through Education and Guidance; (2) Personalized Support and Accountability Mechanisms; (3) Barriers and Facilitators to Exercise Adherence; (4) Perceived Health Benefits and Motivation Enhancement; and (5) Gaps in Current Nursing Practice and Opportunities for Enhancement. Participants identified individualized explanation, graduated goal-setting, correction of fear-based misconceptions, scheduled exercise-specific review, and family involvement as the components of support they valued most, and lapsed follow-up, generic advice, limited interdisciplinary coordination, and scarce patient resources as the principal shortfalls. Conclusions: Patients and nurses in this setting described sustained, individualized nursing support as central to how patients engage with exercise, while both groups identified structural constraints that limit it. These accounts indicate targets that intervention studies with objective activity measurement could test; they do not establish that nursing support changes exercise behavior.