scholarly journals Exercise motivation in patients with heart failure

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L Klompstra ◽  
T Jaarsma ◽  
A Stromberg ◽  
M.H.L Van Der Wal
Keyword(s):  
Quality Of Life ◽  
Educational Level ◽  
Self Efficacy ◽  
Nyha Class ◽  
Social Motivation ◽  
Shortness Of Breath ◽  
Exercise Motivation ◽  
Physically Active ◽  
Patients With Heart Failure

Abstract Background Being physically active is important for patients with heart failure (HF) to improve clinical outcome, however, adherence to exercise is low (<50%). To tailor intervention that increase physical activity, it is important to know what motivates HF patients to exercise. Therefore, the aim of the study is to describe motivations of HF patients to exercise and describe variables that are related to their exercise motivation. Methods This is a cross-sectional analysis of baseline data of 605 patients with HF (mean age 67±12, 71% male, 60%NYHA I/II) who were included in the HF-Wii study. Stepwise regression modelling was used with exercise motivation as dependent variable. Exercise motivation was measured with the Exercise Motivation Index, including 15 statements with answers ranging from 0 (not important) to 4 (extremely important), with 3 subscales (physical, psychological and social motivation). Based on previous research the following predictors were included in the model: quality of life (MLwHFQ), self-efficacy (Exercise self-efficacy scale), cognition (MoCA), depression (HADs), sleeping difficulties (MISS), HF symptoms (fatigue, shortness of breath), age, gender, NYHA-class, comorbidity and educational level. Results Mean total motivation to exercise was 2.3±0.9 and physical and psychological motivation were rated as the more important (2.7±0.9 and 2.5±0.9) than social motivation (1.8±1.1). Motivation statements that were considered extremely important were being healthier (55% rated 4), slow down the ageing process (38% rated 4) and increasing well-being (31% rated 4). From the multiple linear regression model lower quality of life (β=−0.31, P<0.0001), lower self-efficacy (β=0.16, P<0.0001), experiencing shortness of breath (β=−0.28, P<0.0001), having COPD (β=−0.14, P=0.001) and low educational level (β=−0.09, P<0.028) were predictors related to lower motivation. This model explained 17% of the exercise motivation variability (p<0.0001). Cognition, sleeping difficulties, age, gender, NYHA-class and experiencing fatigue were not significantly related to motivation. Conclusion Lower quality of life, lower self-efficacy, experiencing shortness of breath, having COPD and lower educational level, decreases the motivation to exercise and may therefore be considered as barriers for exercise. These barriers should be assessed and considered when motivating patients to become more physically active. Funding Acknowledgement Type of funding source: None

Abstract 16304: Readiness for Physical Activity in Patients With Heart Failure

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Elena Marques-Sule ◽  
Luis Almenar ◽  
Pallav Deka ◽  
Dola Pathak ◽  
Raquel López-Vilella ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Heart Failure ◽  
Self Efficacy ◽  
Nyha Class ◽  
Analysis Of Covariance ◽  
Categorical Variables ◽  
Cross Sectional ◽  
Patients With Heart Failure

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.

Anxiety and Coping Based on Emotions may contribute to Reduced Quality of Life in Patients with Mild Systolic Heart Failure

2018 ◽  
pp. 1-6
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Self Efficacy ◽  
Sense Of Self ◽  
Coping Styles ◽  
Nyha Class ◽  
Systolic Heart Failure ◽  
Emotional Dimension ◽  
And Coping

Aims and Scope: Perception of health related quality of life (QoL) may result from the complex interplay between the severity of the disease and the patient’s psyche. It the present study we assumed that anxiety and coping based on emotions may contribute to reduced QoL in patients with mild systolic heart failure (HF). Methods: We examined mainly males with systolic HF (almost all with ischemic etiology of HF, all classified in the NYHA class II, receiving standard pharmacological treatment). Each patient underwent a physical examination, routine laboratory tests and standard transthoracic echocardiography and completed psychological questionnaires assessing: coping styles, sense of self efficacy, acceptance of illness, optimism and the level of anxiety and QoL (by Minnesota Living with Heart Failure Questionnaire). Results: Emotion-oriented coping was strongly positively related to an overall score reflecting QoL (r=0.37) as well as to both dimensions of QoL, with exceptionally high correlation with the emotional dimension (r=0.24 and r=0.62, respectively, all p<0.05). More reduced QoL (overall score as well as scores in both analysed dimensions) was significantly (all p<0.05) but weakly (r=-0.21, r=-0.20 and r=-0.26, respectively) related to lower acceptance of the illness. Higher level of anxiety was related to more reduced QoL (all p<0.05). Reduced QoL in emotional dimension was related to the tendency to avoidance-oriented coping (r=0.26, including also a sub style based on distraction, r=0.34) as well as to lower sense of self-efficacy (r=-0.20) and lower level of optimism (r=-0.20, all p<0.05). Conclusion: The results indicate that HF patients are psychologically diverse, which is not related to disease severity. However, QoL was related to emotion-oriented coping and anxiety. Psychological support for patients with HF should be focused on teaching adequate methods of coping and reducing anxiety.

scholarly journals The effect of graded activity and pain education (GAPE) - an early post-surgical rehabilitation programme after lumbar spinal fusion: study protocol for a randomized controlled trial

2020 ◽  
Author(s):  
Heidi Tegner ◽  
Bente Appel Esbensen ◽  
Marius Henriksen ◽  
Rachid Bech-Azeddine ◽  
Mari Lundberg ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Usual Care ◽  
Sedentary Behaviour ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Physically Active ◽  
Fear Of Movement ◽  
Post Surgery ◽  
Lumbar Spinal

Abstract BackgroundPatients with chronic low back pain undergoing lumbar spinal fusion (LSF) are physically inactive and thereby at risk of poor health. Barriers to being physically active need to be acknowledged in post-surgical rehabilitation. The primary objective of this randomized controlled trial (RCT) is to examine the effect of an early active intervention consisting of graded activity and pain education (GAPE) on sedentary behaviour in a population of patients undergoing LSF. The secondary objectives are to examine the effect of GAPE on, respectively, disability, pain, fear of movement, self-efficacy for exercise and health-related quality of life.MethodsThe study is an RCT planned to include 144 patients undergoing LSF at 1-2 levels for low back pain caused by degeneration of the lumbar spine. The patients will be randomly assigned to receive either usual care or usual care plus GAPE. GAPE consists of nine individual physiotherapist-guided sessions over a 10-week period. The overall purpose is to reduce sedentary behaviour, by educating the patient about pain and, based on a cognitive behavioural perspective, gradually strengthen the patient’s self-efficacy to be physically active and reduce fear of movement. The physiotherapist will plan the intervention in collaboration with the patient. Based on a semi-structured interview and observations of the patient in their home, they will set individually functional goals. The primary outcome will be reduction in sedentary behaviour, measured by an accelerometer at baseline (pre-surgery), and at three and 12 months post-surgery. Secondary outcomes will include disability, pain, fear of movement, self-efficacy for exercise, and quality of life. Secondary outcome data will be collected at baseline (pre-surgery), and at three, six, and 12 months post-surgery. DiscussionWe hypothesize that, compared with the “usual care group”, GAPE will primarily lead to a significantly reduction in sedentary behaviour, and secondarily a reduction in disability, pain intensity, and fear of movement; further, it will increase the patient’s self-efficacy for exercise and quality of life. Trial registration: www.clinicaltrials.gov (NCT04103970), 24 September 2019

scholarly journals The effect of graded activity and pain education (GAPE): an early post-surgical rehabilitation programme after lumbar spinal fusion—study protocol for a randomized controlled trial

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Heidi Tegner ◽  
Bente Appel Esbensen ◽  
Marius Henriksen ◽  
Rachid Bech-Azeddine ◽  
Mari Lundberg ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Usual Care ◽  
Sedentary Behaviour ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Physically Active ◽  
Fear Of Movement ◽  
Post Surgery ◽  
Lumbar Spinal

Abstract Background Patients with chronic low back pain undergoing lumbar spinal fusion (LSF) are physically inactive and thereby at risk of poor health. Barriers to being physically active need to be acknowledged in post-surgical rehabilitation. The primary objective of this randomized controlled trial (RCT) is to examine the effect of an early active intervention consisting of graded activity and pain education (GAPE) on sedentary behaviour in a population of patients undergoing LSF. The secondary objective is to examine the effect of GAPE on disability, pain, fear of movement, self-efficacy for exercise, and health-related quality of life. Methods The study is an RCT planned to include 144 patients undergoing LSF at 1–2 levels for low back pain caused by degeneration of the lumbar spine. The patients will be randomly assigned to receive either usual care or usual care plus GAPE. GAPE consists of nine individual physiotherapist-guided sessions over a 10-week period. The overall purpose is to reduce sedentary behaviour, by educating the patient about pain and, based on a cognitive behavioural perspective, gradually strengthen the patient’s self-efficacy to be physically active and reduce fear of movement. The physiotherapist will plan the intervention in collaboration with the patient. Based on a semi-structured interview and observations of the patient in their home, they will set individually functional goals. The primary outcome will be a reduction in sedentary behaviour, measured by an accelerometer at baseline (pre-surgery) and at 3 and 12 months post-surgery. Secondary outcomes will include disability, pain, fear of movement, self-efficacy for exercise, and quality of life. Secondary outcome data will be collected at baseline (pre-surgery) and at 3, 6 and 12 months post-surgery. Discussion We hypothesize that, compared with the “usual care group”, GAPE will primarily lead to a significant reduction in sedentary behaviour, and secondarily a reduction in disability, pain intensity, and fear of movement; further, it will increase the patient’s self-efficacy for exercise and quality of life. Trial registration www.clinicaltrials.gov NCT04103970, Registered on 24 September 2019

Associated factors and impacts of sedentary behaviour in patients with heart failure: A longitudinal study

2020 ◽  
Vol 19 (7) ◽  
pp. 609-618
Author(s):  
Mei-Fang Chen ◽  
Shin-Rong Ke ◽  
Chih-Ling Liu ◽  
Tao-Cheng Wu ◽  
Ya-Mei Yu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Heart Failure ◽  
Social Support ◽  
Sedentary Behaviour ◽  
Self Efficacy ◽  
Associated Factors ◽  
Heart Failure Patients ◽  
Patients With Heart Failure

Background: Sedentary behaviours may be related to factors such as self-efficacy, mood and social support. However, there is a paucity of longitudinal follow-up studies examining factors related to sedentary behaviour from physical-psychosocial perspectives in patients with heart failure. Aims: The purpose of this study was to explore the multidimensional associated factors and impacts of sedentary behaviour in heart failure patients. Methods: A longitudinal design was used. A convenience sample of 128 heart failure patients recruited from two large medical centres in northern Taiwan was obtained. Patients were interviewed with structured questionnaires to assess physical activity, symptom distress, exercise self-efficacy, anxiety and depression, social support, sleep quality and quality of life before discharge and at 3 and 6 months after discharge. Results: Heart failure patients reported low physical activity and tended to be sedentary. Sedentary behaviour was gradually reduced from hospitalization to 6 months after discharge. Sleep quality, quality of life, analgesic use, symptom distress and exercise self-efficacy were significant associated factors that explained 42.1–51% of the variance in sedentary behaviour. Patients with high sedentary behaviour had significantly greater depression and poorer sleep and quality of life than those with low sedentary behaviour at hospitalization and showed a significant improvement in depression at 3 and 6 months after discharge. Conclusion: Sedentary behaviour is common in heart failure patients and has impacts on depression and quality of life. An appropriate physical activity programme focusing on disease self-management and enhancing self-efficacy is needed for heart failure patients to improve their sedentary behaviour and quality of life.

scholarly journals The Relationship Between Quality of Life and Cardiovascular Self-Efficacy in Patients with Heart Failure: A Descriptive Correlation Study

2018 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Fereshte Baradaranfard ◽  
Sima Babaee ◽  
Saba Boroumand ◽  
Sorour Mosleh ◽  
Fahimeh Jafari ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Self Efficacy ◽  
Correlation Study ◽  
Patients With Heart Failure ◽  
The Relationship
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