Introduction:
Little attention has been given to assessing the physical readiness and psychological readiness (motivation & self-efficacy) in patients with heart failure (HF). The aim of this study is to explore the readiness for PA (physical and psychological) in patients with HF and factors related.
Method:
A cross-sectional study with 163 patients included (mean age 66±16, 50% female, 63% NYHA I, 37% NYHA II) assessing background and clinical data, physical activity (IPAQ-s), depression and anxiety (HADs), quality of life (SF36). Readiness for PA was assessed with physical readiness based on the PA Readiness Questionnaire (PAR-Q) and psychological readiness was measured with the Exercise Self-efficacy Scale (ESES) and motivation with the Motivation for PA and Exercise/ Working Out questionnaire (RM 4-FM). Correlational analyses were done to explore the relationship between physical readiness and psychological readiness and factors related. A multivariate analysis of covariance was done to test the effect of categorical variables on readiness for PA.
Results:
Of the patients, 64% were not physically ready in becoming more physically active (n=105), 80% of the patients reported low self-efficacy (n=129), 45% (n=74) were extrinsically motivated for change and 55% (n=89) had primarily internal factors that motivated. Physical readiness and psychological readiness were highly correlated with each other. There was a statistically significant higher readiness for PA based on lower age (p < 0.01), male gender (p < 0.01), lower time since diagnose (p < 0.01), being married (p < 0.01), higher educational level (p < 0.01), lower NYHA-class (p = 0.04), lower BMI (p < 0.01), not having COPD (p < 0.01), higher quality of life (p < 0.01) and lower experience of anxiety symptoms (p = 0.03).
Conclusions:
A prudent first step in fitness assessments and exercise prescription process is the determination of readiness for PA. Along with screening for any physical limitations, it is also important to screen for psychological readiness for engaging in PA. Our findings may assist healthcare providers who are dealing with patients with HF to modify current and develop new practices related to risk reduction as screening readiness for PA before entering PA programs.
Does improvement in self-management skills predict improvement in quality of life and depressive symptoms? A prospective study in patients with heart failure up to one year after self-management education
