Table 2. List of emergent descriptive themes with subthemes illustrated with quotations and references reporting each subtheme.

Theme: reasons for attending with subthemes	Participant quotation	Theme: reasons for not attending with subthemes	Participant quotation	Theme: reasons for dropping out with subthemes	Participant quotation
Studies of PR programmes, n=9
(1) To help themselves to improve health statusa,34,35,38,40,41	“giving me the opportunity to help myself and do something positive instead of just taking this, taking that”34	(9) Perceived exercise would worsen health38,40,41	“…and when I got the letter and it said bring trainers and loose clothing I though oh it must be exercise so that’s really what made me not to go.”40	(22) Suffering an acute exacerbation of COPD/other conditions11,37,41	“Well when you’ve got osteoarthritis you’ve got bone on bone, and of course it’s painful”11
(2) Improvement in health was a priority against prior commitments and demandsa,35	“Even if you have to give up those things...you have to make choices. Do you want to grab a cup of coffee with someone or do you want to work on your health?”35	(10) Perception of health statusb,11,34,35,37,38,41	“My breathing on exertion would have to get better”11	(23) No change in health status after attending one/few sessions11,37	“You get people coming in [PR] just once and they really expect a miracle over night. And because nothing has happened they won’t bother coming back anymore”37
(3) Gain control of the conditiona,36,39	“I try to keep myself moving, and I’ll not give in…”39	(11) Lack of perceived benefit to participation in the programme or research studyb11,38,40,41	“I mean the thing is if someone goes to see you on this study thing, yeah? And you sit down there for half an hour and you talk and you tell and there must be something you can say “Well, here we are. Try that. That may help you.”38	(24) Social isolation can reduce confidencec,11,34,35	“being on my own there is no-one to give me a bit of a push or encouragement”34
(4) Last chance to cope and remain independent36,39	“I hope to be able to walk a bit better, to breathe better…just a wee bit more independence. I know it’s not going to be miracles, but I can only try and see if [PR] helps”39	(12) Lack of understanding of research study of the PR programme38	‘‘I just thought it was a... oh, what can I say... one of these test programmes, do you know what I mean? Like a guinea pig programme.’’38	(25) Intensity of the programmec,11,35,40	“…even though they’re told what to expect, they don’t know what to expect and if they have trouble like-um walk up stairs—Oh God, I can’t do this, I can’t do that here so what am I going to be doing there?”40
(5) Referrals by health-care professionals—with explanation for referrala,34,35,37,39,40	“The lung specialist said: … that he had seen patients who were able to take on some activities after participating in a rehabilitation programme. … Perhaps I’ll be able to walk one block then. And that was the doctor’s aim. They also told me: ‘We can’t cure you. But the intention is to get you some more [lung] volume.”35	(13) Negative view of the programme from experience and created by othersb,38,39	“I think you do panic…you think that it’s going to be the last time you’re going to breathe to be honest…Aye, if I was able to breathe better I’d be able to…do more”.39 ‘‘See, I’ve got a friend that’s got this... He’s got very bad breathing. And I said to him the other day. And he said ‘‘Ah, it’s a waste of time. I was down there,’’ he said. ‘‘Waste of time,’’ he said ‘‘Then we’s sitting there for half the day talking rubbish.’’ So that didn’t help me. I thought. ‘‘Yeah,’’ he said, ‘‘That’s all they done.’’...‘‘No,’’ he said, ‘‘I ain’t going back there no more.’’38	(26) No improvements seenc,35	“Look, if I didn’t notice any improvement _ I mean, after three weeks you can’t tell- but when I’m halfway through the programme and I can’t feel no difference, I would be wasting my time.”35
(6) Previous positive and negative experience of PR—social and emotional support from staff and other participantsa,35,39	“See, the good thing is you’re being supervised when you’re busy. And then they suddenly say: ‘You’d better see the speech therapist’. And that’s nice. It’s one integrated system. All these people are watching you”35 “I thought I was going to die off…but I don’t dwell on it, once it’s past it’s past. It doesn’t make me frightened to go anywhere or do anything you know”.39	(14) Prior commitments and competing demandsb,11,34,35,38	“when the dates came through we were going on holiday and that was more important”34	(27) Training with other participantsc,35	“Well, some are only there for the fun instead of to get better. That’s not what it’s meant for, of course. It can be a nuisance when they’re chattering for 5 or 10 min, sitting on a fitness machine, while in the mean time you could have used it. But you don’t wanna send them away, of course.”35
(7) To socialise34	“I don’t have many friends so I did use it as a bit of social time”34	(15) Burdensome journeyb,11,35,37,38,40	“I just can’t make it because I have no car and I have to walk all the way down to X Rd; that takes me about half an hour”11	(28) Burdensome journeyc,11,35	“Oh, one of the other things I do have a problem with is parking. It’s $X every time you go there. That’s very expensive when you’re on a pension.”11
(8) Personal benefits and peer supportd,34,36,41	“You are with people who understand, because they are walking the same walk”41	(16) Negative experience with health-care staff in the location of programmeb,38,39	“I went to [the specialist] and she said, “ Well, you needn’t bother coming back here, there’s nothing we can do for you.”39	(29) Feel secure at homec,11,35	“I feel much more secure at home than anywhere else”11
		(17) Location of the programmeb,38,41	Not exemplified with quote	(30) Competing demands11,40	“So I started going…the wife’s got Parkinson’s disease and she couldn’t cope on her own…I couldn’t leave her so I stopped going…”40
		(18) Seasonal weather38	Not exemplified with quote	(31) Timing of programme11,40	Not exemplified with quote
		(19) Referrals by health professionals—without explanationb,11,34,35,40	“this may or may not help you”34
		(20) Too old11	Not exemplified with quote
		(21) Timing of the programme mostlyb,11,40	Not exemplified with quote
Study of SM programme, n=112
(32) Altruism	“I tried to help, really. In myself, I’m all right…I said I’d go...because I’m interested…if it can help other people, and I think it probably did…”	(35) Physical limitations	“Well the main reason was I live in this corner…and sometimes if I have a good day I can make it and another time I’m fighting for breath halfway through and then I don’t attempt it...My friend when she comes up to take me, she takes me down in the wheelchair and I get in the car and when we come home she brings me back in the wheelchair”	(37) Psychological limitations	“I didn’t [want] to sit through too much because I tend to get a bit depressed and agitated and what have you…I don’t like getting in with a lot of people…”
(33) Wanted to learn about self-management	“...because I didn’t like the way I was going…I thought well the doctors don’t seem to be doing much although I’ve got the inhalers and I thought I wondered if there was anything I could do differently...”	(36) Prior commitments and demands	“...Wednesday morning is my hair dressing day, the hair dresser comes here (home) and we pay her here, then I get my hair done, I can’t wash it (hair) myself I can’t reach properly with these arms”	(38) Not ill enough	“…basically after 10 to 15 min I realized no I don’t belong here [at the course], ’cos the people there [at the course] are worse than me…these people couldn’t even walk up and down the street without having a...breather so I’m not like that...”
(34) Socialising and wanting to meet others with the same illness	“…from the social side of it as well ’cos when you’re stuck in doors like 24/7 virtually and just to be able to get out and meet other people that are in the same predicament…it’s not so embarrassing…”

Abbreviations: PR, pulmonary rehabilitation; SM, self-management.

^aIncludes potential reasons for wanting to attend the PR programme.

^bIncludes potential reasons for not wanting to attend the PR programme.

^cIncludes potential reasons that could result in dropping out of the PR programme.

^dReasons for continuing and completing the PR programme.