The self-regulation of exercise for the purposes of disease prevention and rehabilitation is a complex process that includes temporary lapses from exercise adherence. Research is lacking in the understanding of the cognitive experiences associated with lapsing and the impact of possible negative thoughts, emotions, and self-evaluations on future exercise self-regulation. Using a Social Cognitive Theory (SCT) framework, the primary purpose of the present experimental study was to examine the impact of potential negative reactions to exercise lapse experiences on exercise self-regulatory cognitions (i.e., decisional struggle, exercise self-regulatory efficacy, action planning, and willingness to self-regulate) using an experimental message designed to induce negative thoughts and affect about exercise lapsing. A secondary purpose of the study was to examine the potential moderating influences of the relatively unexplored construct of emotional self-efficacy on possible negative reactions. Forty-four adult participants were recruited from two exercise therapy programs run by the local health region to participate in this study. Participants filled out baseline measures of demographics, exercise self-regulatory efficacy (exercise SRE), and emotional self-efficacy at the first meeting. At the second meeting, participants were randomly assigned to read either an information control message or a negative lapse message. After reading the message, participants responded to affect measures and recorded their acute exercise thoughts. Next, self-regulatory cognitions were measured including decisional struggle, exercise SRE, action planning, and willingness to self-regulate. There were no significant differences between experimental groups on any of the measures, F(9, 34) = .80, Wilks ë = .825, p = .619. Possible explanations for these nonsignificant results are discussed. Given the opportunity to compare the present results to past research on acute positive and negative exercise thoughts by Gyurcsik and colleagues, and to potentially extend these findings to a population of exercise therapy maintainers, post hoc analysis of related research questions was carried out. Groups of positive and negative thinkers were formed based on the measure of acute thoughts. The omnibus MANOVA comparing positive and negative thinkers on social-cognitive measures was significant, F(8, 31) = 2.72, Wilks ë = .588, p = .021. As hypothesized, positive thinkers were found to have higher positive affect (p = .03), lower decisional struggle (p = .006), higher exercise SRE (p = .013), and higher willingness to self-regulate (p = .003). Positive thinkers also exercised more frequently than negative thinkers both at the program, F(1, 36) = 9.5, p = .004, and independently, F(1, 36) = 5.4, p = .026. Results are discussed in relation to SCT and past research on acute exercise thoughts. Limitations of the original experiment are discussed in terms of the negative lapse message. Future research is discussed both for the study of negative reactions to lapsing and for positive and negative thinking related to exercise.

This preliminary investigation utilized both a top-down theory (Banduras Self-Efficacy Theory: SET, 1997) and a bottom-up theory (Leventhals Common Sense Model: CSM, 1980) to examine the cognitions and exercise behavior of novice cardiac rehabilitation (CR) participants engaged in 3 months of standard CR treatment. The primary purpose of this study was to investigate if the Illness Perception Questionnaire (IPQ,) as a reflection of the CSM, could classify CR novices relative to the strength of their illness perceptions. A further objective was to detect differences at baseline between the illness perception groups when evaluating SET variables and health-related outcomes that have been identified as important correlates of CR adherence. Additionally, the study proposed to determine differences between illness perception groups on adherence to recommended exercise therapy in CR. Lastly, differences between the groups on the assessed variables over the 3 month-rehabilitation period was examined. Forty-nine CR initiates were recruited. Participants were measured at 4 different time points over the 3-month initiation phase of CR. The IPQ, SF-36 (assessing health-related quality of life; HRQL,) and other social cognitive measures, including self-regulatory efficacy and positive and negative outcome expectations, were used to examine individuals. Participants completed measures at initiation of CR, after 2 weeks in CR, 6 weeks in CR and at the end of the 3-month initiate phase of CR. At onset of the program, cluster analysis successfully classified participants to weaker and stronger symptom-identity groups (i.e., illness perception groups). These groups were shown to be significantly different on the illness perceptions of identity, consequences and emotion. Upon initiation of CR, the classified groups were also significantly different on likelihood and value of negative outcome expectations, as well as physical and mental HRQL. At baseline, the group with stronger identity, consequences and emotion had higher negative outcome expectations and lower HRQL. In regards to adherence at the end of 3-months of CR, significant differences were found between the groups such that the group with stronger identity, consequences and emotion were less adherent to CR. This study was an initial exploration of the effectiveness of using the CSM along with SET. The findings offer insight into complementary use of top-down and bottom-up theoretical constructs to study psychological beliefs and adherence to exercise therapy in this rehabilitation setting.

Bakgrund: Forskning har visat att träning förbättrar den fysiska förmågan och höjer livskvaliteten hos personer med hjärtsvikt. Trots detta är det många personer med hjärtsvikt som inte deltar i gruppträning. Syfte: Syftet med denna studie var att beskriva vilka faktorer som personer med hjärtsvikt, som inte deltar i hjärtsviktsgrupp, upplever som hinder respektive möjligheter när de ska ta beslut om att delta i gruppträning. Design: Studien var en kvalitativ studie med deskriptiv design som utfördes genom semistrukturerade intervjuer med fem informanter. Resultat och slutsats: Resultaten, som tolkades utifrån beteendeförändringsmodellen Health Action Process Approach (HAPA), av denna studie visade att informanterna upplever olika hinder för träningen som har med prioritet, otrygghet, psykisk ohälsa, transportproblem och bristande information att göra. I vissa fall väljs träningen också bort på grund av att informanterna istället tränar i hemmet. Det största hindret enligt studiens resultat var bristen på information. Framförallt har informanterna bristande kunskap om träning som en del av behandlingen vid hjärtsvikt, NYHA II-III, och de effekter som träningen ger. Detta medför att informanterna inte uppfattar vilka möjligheter som träning i hjärtsviktsgrupp ger. De faktorer som uppfattas som positiva med träning har att göra med att informanterna uppskattar träningen, att de känner samhörighet med andra i träningsgruppen och att de upplever en förbättrad hälsa. / Background: Research has shown that exercise improves the physical ability and improves the quality of life for people with heart failure. Despite this, many people with heart failure does not participate in group training. Aim: The purpose of this study was to describe what factors that people with heart failure, who do not participate in heart failure group, perceived as barriers and opportunities when they will take the decision to participate in training in heart failure group. Design: The study was a qualitative study with descriptive design and was done by semi-structured interviews with five informants. Results and conclusion: The results of this study, which were interpreted by the behavior change model, Health Action Process Approach (HAPA), showed that the informants perceive different barriers to training which are about priority, insecurity, mental illness, transportation problems and inadequate information. In some cases the informants choose home training instead of group training. The biggest barrier according to the results of this study was lack of information. In particular, informants lack of knowledge about exercise as a part of treatment for heart failure, NYHA II-III, and the effects of the training. This means that the informants do not perceive the opportunities that training in heart failure group can give. The factors that are perceived as positive with training have to do with informants appreciate the training, that they feel connected with others in the training group and that they experience a health improvement.

Thesis (Ph. D.)--University of Missouri--Columbia, 2003. / "December 2003." Typescript. Vita. Includes bibliographical references (leaves 162-175). Also available on the Internet.

Thesis (Ph. D.)--University of Missouri--Columbia, 2000. / "May 2000." Typescript. Vita. Includes bibliographical references (leaves 152-178). Also available on the Internet.

Thesis (Ph. D.)--University of Washington, 2003. / Vita. Includes bibliographical references (leaves 86-97).

Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 2003. / Vita. Includes bibliographical references (leaves 98-111).

Objective: To examine the effect of exercise-based cardiac rehabilitation program for secondary prevention of coronary heart disease on cardiac-related mortality, recurrent cardiovascular event and quality of life. Methods: All studies published between 1990 and 2013 in PubMed, and from 1980 to 2013 in EMBASE, which evaluated the effectiveness of exercise-based cardiac rehabilitation program for coronary heart disease. Using the specific keywords “Cardiac rehabilitation”, “Coronary heart disease” OR “Ischemic heart disease” [MeSH], “Exercise” OR “Physical activities” AND “Quality of life” OR “Mortality” AND Cardiovascular events” were searched. A total of 7randomized controlled trials out of 5,051articles from PubMed and 117 articles from EMBASE were included in this systematic review. The primary outcome measures used in the included seven studies were HRQOL, restenosis, cardiac event, cardiac related mortality. Similar demographic and clinical characteristics of the subjects between the intervention and the control groups were recorded. The studies were from five countries. The average age of the subjects in the seven studies was 61years, the average half of them have history of myocardial infarction. Though there were discrepancies among the results generated in the included studies, the potential benefits of exercise-based cardiac rehabilitation could be seen. Results: Compared with the non-exercise-based cardiac rehabilitation, patients allocated to the exercise-based cardiac rehabilitation program had greater improvement in HRQOL and reduction of cardiac events. The result of reducing restenosis was inconsistent. The cardiac related mortality is not significant difference between exercise-based and non-exercise-based cardiac rehabilitation. / published_or_final_version / Public Health / Master / Master of Public Health

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

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