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Modification of the Forms of Self-Determined Regulation and Quality of Life after a Cardiac Rehabilitation Programme: Tennis-Based vs. Bicycle Ergometer-Based. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179207. [PMID: 34501797 PMCID: PMC8430765 DOI: 10.3390/ijerph18179207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 08/27/2021] [Accepted: 08/29/2021] [Indexed: 11/24/2022]
Abstract
Background: The objective is to analyse and compare the effects of an adapted tennis cardiac rehabilitation programme and a classical bicycle ergometer-based programme on the type of motivation towards sports practice and quality of life in patients classified as low risk after suffering acute coronary syndrome. Methods: The Behavioural Regulation in Exercise Questionnaire (BREQ-2) and Velasco’s Qualityof Life Test were applied. The sample comprised 110 individuals (age = 55.05 ± 9.27) divided into two experimental groups (tennis and bicycle ergometer) and a control group. Results: The intra-group analysis showed a significant increase between pre- and post-test results in intrinsic regulation in the tennis group and in the control group. In identified regulation, the bicycle ergometer group presented significant differences from the control group. On the other hand, in the external regulation variable, only the tennis group showed significant differences, which decreased. Significant improvements in all quality-of-life factors when comparing the pre-test period with the post-test period were only found in the experimental groups. As per the inter-group analysis, significant differences were observed in favour of the tennis group with respect to the control group in the variables of health, social relations and leisure, and work time as well as in favour of the bicycle ergometer group compared with the control group in the variables of health, sleep and rest, future projects and mobility. No significant differences were found in any of the variables between the tennis group and the bicycle ergometer group. Conclusion: It is relevant to enhance the practice of physical exercise in infarcted patients classified as low risk as it improves the forms of more self-determined regulation towards sporting practice and their quality of life.
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A Motivational Telephone Intervention to Reduce Early Dropouts in Cardiac Rehabilitation: A FEASIBILITY PILOT STUDY. J Cardiopulm Rehabil Prev 2020; 39:318-324. [PMID: 31343582 DOI: 10.1097/hcr.0000000000000425] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE Cardiac rehabilitation (CR) improves outcomes, yet early dropout is common. The purpose of the study was to determine whether a motivational telephone intervention among patients at risk for nonadherence would reduce early dropouts. METHODS We performed a randomized double-blind pilot study with the intervention group receiving the telephone intervention 1 to 3 d after outpatient CR orientation. The control group received the standard of care, which did not routinely monitor attendance until 2 wk after orientation. The primary outcome was the percentage of patients who attended their second exercise session as scheduled. Secondary outcomes included attendance at the second CR session at any point and total number of sessions attended. Because not everyone randomized to the intervention was able to be contacted, we also conducted a per-protocol analysis. RESULTS One hundred patients were randomized to 2 groups (age 62 ± 15 yr, 46% male, 40% with myocardial infarction) with 49 in the intervention group. Patients who received the intervention were more likely to attend their second session as scheduled compared with the standard of care (80% vs 49%; relative risk = 1.62; 95% CI, 1.18-2.22). Although there was no difference in total number of sessions between groups, there was a statistically significant improvement in overall return rate among the per-protocol group (87% vs 66%; relative risk = 1.31; 95% CI, 1.05-1.63). CONCLUSIONS A nursing-based telephone intervention targeted to patients at risk for early dropout shortly after their CR orientation improved both on-time and eventual return rates. This straightforward strategy represents an attractive adjunct to improve adherence to outpatient CR.
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Thomson P, Angus NJ, Andreis F, Rushworth GF, Mohan AR, Chung ML, Leslie SJ. Longitudinal evaluation of the effects of illness perceptions and beliefs about cardiac rehabilitation on quality of life of patients with coronary artery disease and their caregivers. Health Qual Life Outcomes 2020; 18:158. [PMID: 32460825 PMCID: PMC7254753 DOI: 10.1186/s12955-020-01405-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 05/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients' negative illness perceptions and beliefs about cardiac rehabilitation (CR) can influence uptake and adherence to CR. Little is known about the interpartner influence of these antecedent variables on quality of life of patients with coronary artery disease (CAD) and their family caregivers. The aims of the study were: 1) to assess differences in illness perceptions, beliefs about CR and quality of life between patients with CAD and their family caregivers upon entry to a CR programme and at 6 months follow-up; and 2) to examine whether patients' and caregivers' perceptions of the patient's illness and beliefs about CR at baseline predict their own and their partner's quality of life at 6 months. METHODS In this longitudinal study of 40 patient-caregiver dyads from one CR service, patients completed the Brief Illness Perception Questionnaire and Beliefs about Cardiac Rehabilitation Questionnaire at baseline and 6 months; and caregivers completed these questionnaires based on their views about the patient's illness and CR. The Short-Form 12 Health Survey was used to assess patients' and caregivers' perceived health status. Dyadic data were analysed using the Actor-Partner Interdependence Model. RESULTS Most patients (70%) were men, mean age 62.45 years; and most caregivers (70%) were women, mean age 59.55 years. Caregivers were more concerned about the patient's illness than the patients themselves; although they had similar scores for beliefs about CR. Patients had poorer physical health than caregivers, but their level of mental health was similar. Caregivers' poorer mental health at 6 months was predicted by the patient's perceptions of timeline and illness concern (i.e. partner effects). Patient's and caregiver's illness perceptions and beliefs about CR were associated with their own physical and mental health at 6 months (i.e. actor effects). CONCLUSIONS Overall, the patients and caregivers had similar scores for illness perceptions and beliefs about CR. The actor and partner effect results indicate a need to focus on specific illness perceptions and beliefs about CR, targeting both the individual and the dyad, early in the rehabilitation process to help improve patients and caregivers physical and mental health (outcomes).
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Affiliation(s)
- Patricia Thomson
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK94LA, Scotland, UK.
| | - Neil J Angus
- School of Health, Social Care and Life Sciences, University of the Highlands and Islands, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, Scotland, UK
| | - Federico Andreis
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK94LA, Scotland, UK
| | - Gordon F Rushworth
- Highland Pharmacy Education & Research Centre, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, Scotland, UK
| | - Andrea R Mohan
- School of Nursing and Health Sciences, University of Dundee, Dundee, DD1 4HN, Scotland, UK
| | - Misook L Chung
- College of Nursing, University of Kentucky, Lexington, KY, 40506, USA
| | - Stephen J Leslie
- Cardiac Unit, Raigmore Hospital, NHS Highland, Old Perth Road, Inverness, IV2 3UJ, Scotland, UK
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Fernandes AC, McIntyre T, Coelho R, Prata J, Maciel MJ. Brief psychological intervention in phase I of cardiac rehabilitation after acute coronary syndrome. Rev Port Cardiol 2017; 36:641-649. [PMID: 28882655 DOI: 10.1016/j.repc.2017.01.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 01/22/2017] [Accepted: 01/28/2017] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Acute coronary syndrome (ACS) is an important cause of mortality and significant personal and financial costs. Cardiac rehabilitation (CR) programs have shown positive effects in reducing cardiovascular mortality and improving functional capacity. However, adherence is low and appears to be influenced by psychosocial factors, such as patients' cognitions and emotional state. The objective was to evaluate the efficacy of a brief in-hospital psychological intervention to promote cognitive and emotional adaptation after ACS. METHODS One hundred and twenty-one patients with ACS, admitted to a coronary care unit in a central hospital, were randomized to an experimental group (EG, n=65) and a control group (CG, n=56). Portuguese versions of the HADS and BIPQ were used to measure emotional well-being and illness cognitions. Two 1 h 15 min sessions were conducted 2-3 days after hospital admission, and a 20-minute follow-up session took place one month after discharge. Patients were assessed at four different time points: pre-test, post-test, and at 1- and 2-month follow-up. RESULTS The intervention had significant effects on anxiety, depression and illness cognitions. Anxiety and depression were significantly reduced and illness cognitions improved significantly in the EG compared to the control group. For the EG, these changes were maintained or enhanced at 1- and 2-month follow-up, whereas for the CG there was a deterioration in psychosocial adjustment. CONCLUSIONS These results indicate that a brief psychological intervention program delivered during hospitalization for ACS and combined with standard medical care can have positive effects in terms of psychosocial outcomes that have proven impact on cardiac rehabilitation and prognosis.
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Affiliation(s)
- Ana Cláudia Fernandes
- Faculdade de Filosofia e Ciências Sociais, Universidade Católica Portuguesa, Braga, Portugal
| | - Teresa McIntyre
- School of Education and Behavioral Sciences, Houston Baptist University, USA
| | - Rui Coelho
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal; Departamento de Neurociências Clínicas e Saúde Mental, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Joana Prata
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal; Departamento de Neurociências Clínicas e Saúde Mental, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
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Brief psychological intervention in phase I of cardiac rehabilitation after acute coronary syndrome. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2017. [DOI: 10.1016/j.repce.2017.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Herber OR, Smith K, White M, Jones MC. ‘Just not for me’ - contributing factors to nonattendance/noncompletion at phase III cardiac rehabilitation in acute coronary syndrome patients: a qualitative enquiry. J Clin Nurs 2017; 26:3529-3542. [DOI: 10.1111/jocn.13722] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2016] [Indexed: 01/14/2023]
Affiliation(s)
- Oliver Rudolf Herber
- School of Health and Population Sciences; University of Birmingham; Edgbaston Birmingham UK
- Institute of General Practice (ifam); Medical Faculty of the Heinrich Heine University Düsseldorf; Düsseldorf Germany
| | - Karen Smith
- Ninewells Hospital and Medical School; Dundee DD1 9SY and School of Nursing & Health Sciences; University of Dundee; Dundee Scotland
| | - Myra White
- Department of Ageing and Health; Ninewells Hospital and Medical School; Dundee UK
| | - Martyn C. Jones
- School of Nursing & Health Sciences; University of Dundee; Dundee UK
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Guo P, Harris R. The effectiveness and experience of self-management following acute coronary syndrome: A review of the literature. Int J Nurs Stud 2016; 61:29-51. [PMID: 27267181 DOI: 10.1016/j.ijnurstu.2016.05.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 04/26/2016] [Accepted: 05/13/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To evaluate the effectiveness of interventions used to support self-management, and to explore patients' experiences after acute coronary syndrome in relation to self-management. DESIGN Scoping review. DATA SOURCES Keyword search of CINAHL Plus, Medline, the Cochrane Library, and PsycINFO databases for studies conducted with adult population and published in English between 1993 and 2014. REVIEW METHODS From title and abstract review, duplicated articles and obviously irrelevant studies were removed. The full texts of the remaining articles were assessed against the selection criteria. Studies were included if they were original research on: (1) effectiveness of self-management interventions among individuals following acute coronary syndrome; or (2) patients' experience of self-managing recovery from acute coronary syndrome. RESULTS 44 articles (19 quantitative and 25 qualitative) were included. Most studies were conducted in western countries and quantitative studies were UK centric. Self-management interventions tended to be complex and include several components, including education and counselling, goal setting and problem solving skills which were mainly professional-led rather than patient-led. The review demonstrated variation in the effectiveness of self-management interventions in main outcomes assessed - anxiety and depression, quality of life and health behavioural outcomes. For most participants in the qualitative studies, acute coronary syndrome was unexpected and the recovery trajectory was a complex process. Experiences of making adjustment and adopting lifestyle changes following acute coronary syndrome were influenced by subjective life experiences and individual, sociocultural and environmental contexts. Participants' misunderstandings, misconceptions and confusion about disease processes and management were another influential factor. They emphasised a need for ongoing input and continued support from health professionals in their self-management of rehabilitation and recovery, particularly during the initial recovery period following hospital discharge. CONCLUSIONS Evidence of the effectiveness of self-management interventions among people with acute coronary syndrome remains inconclusive. Findings from the patients' experiences in relation to self-management following acute coronary syndrome provided important insights into what problems patients might have encountered during self-managing recovery and what support they might need, which can be used to inform the development of self-management interventions. Theoretical or conceptual frameworks have been minimally employed in these studies and should be incorporated in future development and evaluation of self-management interventions as a way of ensuring clarity and consistency related to how interventions are conceptualised, operationalised and empirically studied. Further research is needed to evaluate self-management interventions among people following acute coronary syndrome for sustained effect and within different health care contexts.
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Affiliation(s)
- Ping Guo
- Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, King's College London, Bessemer Road, SE5 9PJ, UK.
| | - Ruth Harris
- Florence Nightingale Faculty of Nursing & Midwifery, King's College London, UK; Faculty of Health, Social Care and Education, Kingston University and St George's, University of London, UK
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Fors A, Ulin K, Cliffordson C, Ekman I, Brink E. The Cardiac Self-Efficacy Scale, a useful tool with potential to evaluate person-centred care. Eur J Cardiovasc Nurs 2014; 14:536-43. [PMID: 25149667 DOI: 10.1177/1474515114548622] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Accepted: 08/04/2014] [Indexed: 12/30/2022]
Abstract
BACKGROUND Cardiac self-efficacy is a person's belief in his/her ability to manage the challenges posed by a coronary disease, and its role has been evaluated in several coronary populations using the Cardiac Self-Efficacy Scale (CSE Scale). Self-efficacy has an important role in person-centred care, however there is a lack of appropriate instruments that evaluate person-centred interventions. AIM The purpose of this study was to validate the CSE Scale by examining its psychometric properties as a first step in evaluating a person-centred care intervention in persons with acute coronary syndrome (ACS). METHODS The study sample consisted of 288 persons (72 women, 216 men) who completed the Swedish version of the CSE Scale two months after hospitalisation for an ACS event. Construct validity was psychometrically evaluated using confirmatory factor analysis. Additionally, convergent and discriminant validity were tested using correlation analyses. RESULTS The results revealed that the CSE Scale was represented by three dimensions (control symptoms, control illness and maintain functioning). The analyses also showed that the CSE Scale is suitable for providing a total summary score that represents a global cardiac self-efficacy dimension. Evaluation of convergent and discriminant validity showed the expected correlations. CONCLUSION The CSE Scale is a valid and reliable measure when evaluating self-efficacy in patients with ACS. It also seems to be a useful tool to promote person-centred care in clinical practice since it may offer useful guidance in the dialogue with the patient in the common creation of a personal health plan.
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Affiliation(s)
- Andreas Fors
- Institute of Health and Care Sciences, University of Gothenburg, Sweden Centre for Person-Centred Care (GPCC), University of Gothenburg, Sweden
| | - Kerstin Ulin
- Institute of Health and Care Sciences, University of Gothenburg, Sweden Centre for Person-Centred Care (GPCC), University of Gothenburg, Sweden
| | | | - Inger Ekman
- Institute of Health and Care Sciences, University of Gothenburg, Sweden Centre for Person-Centred Care (GPCC), University of Gothenburg, Sweden
| | - Eva Brink
- Institute of Health and Care Sciences, University of Gothenburg, Sweden Centre for Person-Centred Care (GPCC), University of Gothenburg, Sweden Department of Nursing, Health and Culture, University West, Trollhättan, Sweden
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Reges O, Vilchinsky N, Leibowitz M, Khaskia A, Mosseri M, Kark JD. Illness cognition as a predictor of exercise habits and participation in cardiac prevention and rehabilitation programs after acute coronary syndrome. BMC Public Health 2013; 13:956. [PMID: 24119027 PMCID: PMC3852800 DOI: 10.1186/1471-2458-13-956] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 10/08/2013] [Indexed: 12/21/2022] Open
Abstract
Background Despite well-established medical recommendations, many cardiac patients do not exercise regularly either independently or through formal cardiac prevention and rehabilitation programs (CPRP). This non-adherence is even more pronounced among minority ethnic groups. Illness cognition (IC), i.e. the way people perceive the situation they encounter, has been recognized as a crucial determinant of health-promoting behavior. Few studies have applied a cognitive perspective to explain the disparity in exercising and CPRP attendance between cardiac patients from different ethnic backgrounds. Based on the Health Belief Model (HBM) and the Common Sense Model (CSM), the objective was to assess the association of IC with exercising and with participation in CPRP among Jewish/majority and Arab/minority patients hospitalized with acute coronary syndrome. Methods Patients (N = 420) were interviewed during hospitalization (January-2009 until August- 2010) about IC, with 6-month follow-up interviews about exercise habits and participation in CPRP. Determinants that predict active lifestyle and participation in CPRP were assessed using backward stepwise logistic regression. Results Perceived susceptibility to heart disease and sense and personal control were independently associated with exercising 6 months after the acute event (OR = 0.58, 95% CI: 0.42-0.80 and OR = 1.09, 95% CI: 1.02-1.17, per unit on a 5-point scale). Perceived benefits of regular exercise and a sense of personal control were independently associated with participation in CPRP (OR = 1.56, 95% CI: 1.12-2.16 and OR = 1.08, 95% CI: 1.01-1.15, per unit on a 5-point scale). None of the IC variables assessed could explain the large differences in health promoting behaviors between the majority and minority ethnic groups. Conclusions IC should be taken into account in future interventions to promote physical activity and participation in CPRP for both ethnic groups. Yet, because IC failed to explain the gap between Arab and Jewish patients in those behaviors, other explanatory pathways such as psychological state or cultural views should be considered as potential areas for further research.
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Affiliation(s)
- Orna Reges
- Hebrew University-Hadassah School of Public Health and Community Medicine, Ein Kerem, Jerusalem, Israel.
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