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. 2001 Mar;85(3):290–294. doi: 10.1136/heart.85.3.290

Psychosocial components of cardiac recovery and rehabilitation attendance

K King 1, D Humen 1, H Smith 1, C Phan 1, K Teo 1
PMCID: PMC1729655  PMID: 11179268

Abstract

OBJECTIVE—To examine the relations between demographic factors, specific psychosocial factors, and cardiac rehabilitation attendance.
DESIGN—Cohort, repeated measures design.
SETTING—A large tertiary care centre in western Canada
PATIENTS—304 consecutive consenting patients discharged following acute myocardial infarction and/or coronary artery bypass graft surgery.
MAIN OUTCOME MEASURES—The Jenkins self-efficacy expectation scales and activity checklists of behaviour performance for maintaining health and role resumption, modified version of the self-motivation inventory, and the shortened social support scale.
RESULTS—Those who had higher role resumption behaviour performance scores at two weeks after discharge were significantly less likely to attend cardiac rehabilitation programmes. At six months after discharge, those who attended cardiac rehabilitation demonstrated higher health maintenance self-efficacy expectation and behaviour performance scores. Health maintenance self-efficacy expectation and behaviour performance improved over time. Women reported less social support but showed greater improvement in health maintenance self-efficacy expectation. Changes in self-efficacy scores were unrelated to—but changes in health maintenance behaviour performance scores were strongly associated with—cardiac rehabilitation attendance.
CONCLUSIONS—Cardiac patients and practitioners may have misconceptions about the mandate and potential benefits of rehabilitation programmes. Patients who resumed role related activities early and more completely apparently did not see the need to "rehabilitate" while those who attended cardiac rehabilitation programmes enhanced their secondary prevention behaviours.


Keywords: self-efficacy; motivation; social support; cardiac recovery; cardiac rehabilitation

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Selected References

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  1. Ades P. A., Waldmann M. L., Gillespie C. A controlled trial of exercise training in older coronary patients. J Gerontol A Biol Sci Med Sci. 1995 Jan;50A(1):M7–11. doi: 10.1093/gerona/50a.1.m7. [DOI] [PubMed] [Google Scholar]
  2. Ades P. A., Waldmann M. L., McCann W. J., Weaver S. O. Predictors of cardiac rehabilitation participation in older coronary patients. Arch Intern Med. 1992 May;152(5):1033–1035. [PubMed] [Google Scholar]
  3. Ades P. A., Waldmann M. L., Polk D. M., Coflesky J. T. Referral patterns and exercise response in the rehabilitation of female coronary patients aged greater than or equal to 62 years. Am J Cardiol. 1992 Jun 1;69(17):1422–1425. doi: 10.1016/0002-9149(92)90894-5. [DOI] [PubMed] [Google Scholar]
  4. Ashton K. C., Saccucci M. S. A follow-up study of ethnic and gender differences in cardiac rehabilitation. Rehabil Nurs. 1996 Jul-Aug;21(4):187-91, 195. doi: 10.1002/j.2048-7940.1996.tb01703.x. [DOI] [PubMed] [Google Scholar]
  5. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977 Mar;84(2):191–215. doi: 10.1037//0033-295x.84.2.191. [DOI] [PubMed] [Google Scholar]
  6. Bittner V., Sanderson B., Breland J., Green D. Referral patterns to a University-based cardiac rehabilitation program. Am J Cardiol. 1999 Jan 15;83(2):252-5, A5. doi: 10.1016/s0002-9149(98)00830-3. [DOI] [PubMed] [Google Scholar]
  7. Blumenthal J. A., Williams R. S., Wallace A. G., Williams R. B., Jr, Needles T. L. Physiological and psychological variables predict compliance to prescribed exercise therapy in patients recovering from myocardial infarction. Psychosom Med. 1982 Dec;44(6):519–527. doi: 10.1097/00006842-198212000-00003. [DOI] [PubMed] [Google Scholar]
  8. Carroll D. L. The importance of self-efficacy expectations in elderly patients recovering from coronary artery bypass surgery. Heart Lung. 1995 Jan-Feb;24(1):50–59. doi: 10.1016/s0147-9563(05)80095-0. [DOI] [PubMed] [Google Scholar]
  9. Cohen S. Psychosocial models of the role of social support in the etiology of physical disease. Health Psychol. 1988;7(3):269–297. doi: 10.1037//0278-6133.7.3.269. [DOI] [PubMed] [Google Scholar]
  10. Dafoe W., Huston P. Current trends in cardiac rehabilitation. CMAJ. 1997 Feb 15;156(4):527–532. [PMC free article] [PubMed] [Google Scholar]
  11. Dishman R. K., Ickes W. Self-motivation and adherence to therapeutic exercise. J Behav Med. 1981 Dec;4(4):421–438. doi: 10.1007/BF00846151. [DOI] [PubMed] [Google Scholar]
  12. Evenson K. R., Rosamond W. D., Luepker R. V. Predictors of outpatient cardiac rehabilitation utilization: the Minnesota Heart Surgery Registry. J Cardiopulm Rehabil. 1998 May-Jun;18(3):192–198. doi: 10.1097/00008483-199805000-00002. [DOI] [PubMed] [Google Scholar]
  13. Funch D. P., Marshall J. R., Gebhardt G. P. Assessment of a short scale to measure social support. Soc Sci Med. 1986;23(3):337–344. doi: 10.1016/0277-9536(86)90356-4. [DOI] [PubMed] [Google Scholar]
  14. Gortner S. R., Jenkins L. S. Self-efficacy and activity level following cardiac surgery. J Adv Nurs. 1990 Oct;15(10):1132–1138. doi: 10.1111/j.1365-2648.1990.tb01704.x. [DOI] [PubMed] [Google Scholar]
  15. Jeng C., Braun L. T. The influence of self-efficacy on exercise intensity, compliance rate and cardiac rehabilitation outcomes among coronary artery disease patients. Prog Cardiovasc Nurs. 1997 Winter;12(1):13–24. [PubMed] [Google Scholar]
  16. Johnson J. E., Weinert C., Richardson J. K. Rural residents' use of cardiac rehabilitation programs. Public Health Nurs. 1998 Aug;15(4):288–296. doi: 10.1111/j.1525-1446.1998.tb00352.x. [DOI] [PubMed] [Google Scholar]
  17. Kelly R. B., Zyzanski S. J., Alemagno S. A. Prediction of motivation and behavior change following health promotion: role of health beliefs, social support, and self-efficacy. Soc Sci Med. 1991;32(3):311–320. doi: 10.1016/0277-9536(91)90109-p. [DOI] [PubMed] [Google Scholar]
  18. King K. M. Gender and short-term recovery from cardiac surgery. Nurs Res. 2000 Jan-Feb;49(1):29–36. doi: 10.1097/00006199-200001000-00005. [DOI] [PubMed] [Google Scholar]
  19. King K. M., Humen D. P., Teo K. K. Cardiac rehabilitation: the forgotten intervention. Can J Cardiol. 1999 Sep;15(9):979–985. [PubMed] [Google Scholar]
  20. King K. M., Koop P. M. The influence of the cardiac surgery patient's sex and age on care-giving received. Soc Sci Med. 1999 Jun;48(12):1735–1742. doi: 10.1016/s0277-9536(99)00070-2. [DOI] [PubMed] [Google Scholar]
  21. King K. M., Teo K. K. Cardiac rehabilitation referral and attendance: not one and the same. Rehabil Nurs. 1998 Sep-Oct;23(5):246–251. doi: 10.1002/j.2048-7940.1998.tb01794.x. [DOI] [PubMed] [Google Scholar]
  22. Lavie C. J., Milani R. V. Effects of cardiac rehabilitation and exercise training on exercise capacity, coronary risk factors, behavioral characteristics, and quality of life in women. Am J Cardiol. 1995 Feb 15;75(5):340–343. doi: 10.1016/s0002-9149(99)80550-5. [DOI] [PubMed] [Google Scholar]
  23. Lavie C. J., Milani R. V. Effects of cardiac rehabilitation programs on exercise capacity, coronary risk factors, behavioral characteristics, and quality of life in a large elderly cohort. Am J Cardiol. 1995 Jul 15;76(3):177–179. doi: 10.1016/s0002-9149(99)80054-x. [DOI] [PubMed] [Google Scholar]
  24. McAuley E., Bane S. M., Mihalko S. L. Exercise in middle-aged adults: self-efficacy and self-presentational outcomes. Prev Med. 1995 Jul;24(4):319–328. doi: 10.1006/pmed.1995.1053. [DOI] [PubMed] [Google Scholar]
  25. Oldridge N. B., Rogowski B. L. Self-efficacy and in-patient cardiac rehabilitation. Am J Cardiol. 1990 Aug 1;66(3):362–365. doi: 10.1016/0002-9149(90)90850-z. [DOI] [PubMed] [Google Scholar]
  26. Oldridge N. B., Stoedefalke K. G. Compliance and motivation in cardiac exercise programs. Clin Sports Med. 1984 Apr;3(2):443–454. [PubMed] [Google Scholar]
  27. Pashkow F. J. Cardiac rehabilitation: not just exercise anymore. Cleve Clin J Med. 1996 Mar-Apr;63(2):116–123. doi: 10.3949/ccjm.63.2.116. [DOI] [PubMed] [Google Scholar]
  28. Perkins S., Jenkins L. S. Self-efficacy expectation, behavior performance, and mood status in early recovery from percutaneous transluminal coronary angioplasty. Heart Lung. 1998 Jan-Feb;27(1):37–46. doi: 10.1016/s0147-9563(98)90067-x. [DOI] [PubMed] [Google Scholar]
  29. Rhodes R., Morrissey M. J., Ward A. Self-motivation: a driving force for elders in cardiac rehabilitation. Geriatr Nurs. 1992 Mar-Apr;13(2):94–98. doi: 10.1016/s0197-4572(05)80116-8. [DOI] [PubMed] [Google Scholar]
  30. Sallis J. F., Hovell M. F., Hofstetter C. R. Predictors of adoption and maintenance of vigorous physical activity in men and women. Prev Med. 1992 Mar;21(2):237–251. doi: 10.1016/0091-7435(92)90022-a. [DOI] [PubMed] [Google Scholar]
  31. Thompson D. R., Bowman G. S. Evidence for the effectiveness of cardiac rehabilitation. Intensive Crit Care Nurs. 1998 Feb;14(1):38–48. doi: 10.1016/s0964-3397(98)80099-2. [DOI] [PubMed] [Google Scholar]

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