Introduction:
Despite the impressive gains achieved by those who attend cardiac rehabilitation, many patients fail to maintain the gains in physical capacity in the longer term. There are likely psychosocial characteristics that can be leveraged to sustain behavior change.
Hypothesis:
Patients with higher perceived cardiac control, social support, and exercise self-efficacy, without depression, and those who received motivational interviewing (MI) sessions, adjunctive to cardiac rehabilitation, will have a significantly higher physical capacity.
Methods:
This is a secondary analysis of the data from a randomized controlled trial of MI as a tool to enhance secondary prevention strategies in cardiovascular disease (MICIS study) conducted at three hospitals in Sydney, Australia who attended 6-week phase II cardiac rehabilitation. Two, 1-hour sessions of a nurse-delivered motivational interview focused on increasing physical capacity was implemented and the participants were followed at 6-weeks and 12-months. The outcome for the study was physical capacity measured by distance walked on the six-minute walk test (6MWT). Multiple imputations were used to handle missing data. Descriptive statistics, t-tests, chi-square tests and linear regression for cluster data were used for data analysis.
Results:
The mean (SD) age of participants (n=110) at baseline was 60.1 (10.57) years and the majority were male (71.8%). (Table). In the adjusted analysis, motivational interviewing (p =0.57), perceived cardiac control (p=0.30), self-efficacy for exercise (p = 0.06) and level of depressive symptoms were not related to 6MWT. With every unit increase in perceived social support score, there was a decrease in distance walked in 6MWT by 1.30 meters (b = -1.30; p= 0.007).
Conclusion:
In this sample, psychosocial predictors, except social support, were not likely to influence physical capacity. Investigating barriers and facilitators to sustaining the effects of cardiac rehabilitation are needed.
The Association Between Self Efficacy, Perceived Social Support and Adherence to Treatment in Patients with Heart Failure
