Cardiac rehabilitation is profoundly effective at improving physical activity and reducing morbidity and mortality of heart patients. Despite its effectiveness, it is highly underutilized. Research indicates proxy-efficacy and self efficacy positively correlate and predict exercise adherence after Phase II cardiac rehabilitation (Bray & Cowan, 2004; Bray, Brawley, & Millen, 2006). The purpose of the current study aims to investigate the relationship of Phase I patients' proxy-efficacy and self efficacy and their intention to enroll in Phase II cardiac rehabilitation. Thirty participants completed measurements of self-efficacy and proxy-efficacy, a demographic questionnaire, and asked to indicate intent to enroll. Results revealed proxy-efficacy does not predict intention to enroll into Phase II cardiac rehabilitation. Even though patients generally had high confidence in their cardiac rehabilitation specialists, proxy-efficacy was an insufficient predictor of intention to enroll in subsequent cardiac rehabilitation services. Moreover, results indicate proxy-efficacy and self efficacy for exercise are not related. / School of Physical Education, Sport, and Exercise Science

Thesis (D. Th. (Praktiese Teologie))--Universiteit van Suid-Afrika, 2002.

published_or_final_version / Nursing Studies / Master / Master of Nursing

The purpose of this study was to describe the relationship between health expectations and compliance in persons who were attending a cardiac rehabilitation program. Three subscales of the Olivas Health Motivation Scale were administered to a convenience sample of 23 subjects at two points in time: at the beginning and at the completion of the prescribed sessions. A significant relationship was found between Stimulus Outcome Expectations and the duration of exercise at the beginning of the cardiac rehabilitation sessions (r = -.51, p =.02). The relationship between Regimen Efficacy Expectations and the duration of exercise was also found to be significant at the beginning of the sessions (r = -.40, p =.05). There was no significant relationship between health expectations and compliance at the completion of the sessions. One measure of health expectations, Stimulus Outcome Expectations (F = 10.11, p =.01), and two measures of compliance, duration of exercise (F = 406.45, p =.00) and metabolic equivalents (F = 74.14, p =.00), were significantly different between the beginning and the completion of cardiac rehabilitation.

The purpose of the study was to determine the effects of either a programmed instruction booklet or group lecture on knowledge of post myocardial infarction patients. A convenience sample of 30 post myocardial infarction patients enrolled in Cardiac Rehabilitation at a midwestern hospital were asked to participate.Subjects were assigned either to the experimental group or the lecture group. The pretest was administered to both groups. The experimental group received the self instruction booklet and the lecture group received a posttest was immediately completed by the participants. A nonequivalent pretest-posttest repeated measure design was utilized in the study.The results of the study showed a mean improvement in knowledge scores for both the booklet group and lecture group, with the booklet group having the larger gain in knowledge scores. The knowledge gain however, was not significant at the 0.05 level. / School of Nursing

While many short-term physical activity (PA) interventions in cardiac rehabilitation (CR) patients have proven to be successful at increasing PA levels, little is known about the long-term impact these interventions have. The purpose of the current study was to determine if the Increased Physical Activity in Cardiac Patients (IPAC) study utilizing pedometer feedback, motivational messages, and a combination of both were successful at increasing PA levels and improving cardiovascular disease (CVD) risk factors after 12 months. The results of the study indicated that none of the IPAC interventions were successful at increasing PA levels after 12 months compared to the usual care group and all groups reverted back to baseline levels. Additionally, no significant differences were seen across time or between groups in most CVD risk factors. Further research is needed to develop PA interventions in CR patients that foster long-term PA maintenance. / School of Physical Education, Sport, and Exercise Science

Abdominal obesity is a part of insulin resistance syndrome that is closely linked to increased risk of coronary artery disease (CAD). Because fat tissue acts as an endocrine target and source of hormone production, increased metabolism or production of chemical messengers in fat tissue may result in metabolic perturbations that contribute to occurrence and recurrence of coronary events. This dissertation research entails two separate approaches. The first study, a cross-sectional analysis, sought to determine whether serum cortisol responses to oral glucose loading are associated with abdominal obesity, non-esterified fatty acid (NEFA) suppression, and self-reported symptoms of depression in 26 non-diabetic coronary patients. We conclude that lower cortisol responses to oral glucose loading are associated with abdominal obesity, reduced NEFA suppression, and fewer symptoms of depression (P���0.028). Future prospective studies should determine whether psychosocial risk factors, such as depression and anxiety, increase cortisol production, whether increases in cortisol production act synergistically with a positive energy balance in the development of abdominal obesity, and whether increases in abdominal obesity lead to increases in cortisol metabolism and insulin resistance. C-reactive protein (CRP) is a marker of low-grade inflammation that is associated with increased risk for recurrent events in coronary patients. Fat tissue also secretes proinflammatory cytokines that stimulate hepatic production of CRP. Thus, the second study, an intervention study, sought to determine whether the first three months of cardiac rehabilitation could reduce serum concentrations of CRP and the proinflammatory cytokine, tumor necrosis factor-�� (TNF-��), in our non-diabetic coronary patients (N=26). Results from the intervention study showed significant reductions in serum CRP levels (P=0.012) that were associated with reductions in waist circumferences after cardiac rehabilitation (r=0.39, P=0.049). However, changes in serum TNF-�� levels after cardiac rehabilitation were nonsignificant (P=0.869). Thus, we conclude that cardiac rehabilitation may reduce the severity of low-grade inflammatory conditions, in part, through reductions in waist circumference in non-diabetic coronary patients. / Graduation date: 2001

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

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