<p> Exercise programs designed for cardiac patients frequently report high dropout rates. Little is known about the reasons for this high rate of dropout; further, little is known about health behavior patterns including physical activity subsequent to graduation or dropout from exercise programs. Identification of reasons for dropout and the pattern of physical activity after participation in formal exercise rehabilitation would provide information regarding achievement and maintenance of treatment goals.</p> <p> Entry characteristics were determined for 84 male cardiac patients (45 compliers and 39 dropouts) from the McMaster Cardiac Rehabilitation Exercise Program. Follow-up information pertaining to areas of: a) health; b) employment, smoking, activity, and dietary status; c) reasons for joining the program; d) perceived benefits achieved; and e) factors contributing to compliance with or dropout from the exercise program was obtained from 63 subjects (41 compliers and 22 dropouts) who responded to a questionnaire by mail.</p> <p> The dropout rate at the end of the 6 month program was 46.4% (39 of 84 subjects) with one-half of all dropout occurring within the first 2 months of the 6 month program. Upon entry into the exercise program, a significantly greater proportion of dropouts (43.6%, n=17) than compliers (8.9%, n=4) were found to be regular smokers. Likewise, a significantly greater proportion of dropouts (82.1%, n=32) than compliers (55.6%, n=25) were found to be inactive in their leisure habits upon entry. Dropouts were also more likely to be blue collar workers (71.8%, n=28), and younger in age (x̅ age = 48.4 years) when compared to compliers (37.8%, n=17; x̅ age = 54.3 years) upon entry into the exercise program. Upon follow-up, compliers were significantly more likely to report active leisure habits (85.4%, n=35) than were responding dropouts (45.5%, n=10). Compliers were also significantly more likely to report moderate work activity levels upon follow-up (54.8%, n=17) compared to dropouts (22.2%, n=4). Reasons for compliance to and withdrawal from the exercise program provided by respondents centred around psychosocial and personal convenience categories.</p> <p> Although statistically significant, the greater follow-up activity levels noted among compliers in this study appear to be only temporary, short-term patterns which tend to diminish with time. It is suggested that compliance-improving strategies be developed through further study with the aim of encouraging the long-term maintenance of desired behavior change.</p> / Thesis / Master of Science (MSc)

<p>Despite the known benefits of regular exercise for cardiac patients (Jolliffe et al., 2001) and the delivery of cardiac rehabilitation programs to facilitate exercise participation in this population, exercise adherence remains a challenge for these individuals as evidenced by the reported decline in exercise participation over time (e.g., Moore et al., 2006). Investigating cardiac patients' motivation or willingness to engage in exercise may provide a better understanding of why some patients are better maintainers of exercise and others are not. Using self-determination theory (Deci & Ryan, 1985; 2002), the present study investigated changes in need satisfaction and selfdetermined motivation, as well as the role of perceived autonomy support relative to patient motivation, in the early months of participation in cardiac rehabilitation. It was hypothesized that need satisfaction and autonomous forms of behavioural regulation would increase over time, and that perceived autonomy support (ratings of exercise leaders' tendencies to acknowledge patients' perspectives, provide choices and contingent feedback, etc.) would positively predict changes in behavioural regulation, mediated by changes in psychological need satisfaction. Another aim of the study was to examine how autonomous forms of behavioural regulation related to cardiac patients' exercise intentions and self-managed exercise behaviour, and it was hypothesized that this relationship would be positive for both exercise intentions and behaviour. Fifty-three male participants (Mage= 62.83 ± 10.78) who were enrolled in a hospital-based cardiac rehabilitation program completed assessments of perceived autonomy support, need satisfaction and behavioural regulation at weeks 4, 8, and 12 of program participation. At week 14, participants' self-managed exercise behaviour and their exercise intentions to engage in independent exercise for the next 4 weeks were assessed. In general, participants' scores for all variables of interest were relatively high. Consistent with hypotheses, autonomy and relatedness need satisfaction, along with integrated and intrinsic regulation increased from week 4 to week 12 during cardiac rehabilitation. However, perceived autonomy support was not related to changes in need satisfaction or behavioural regulation, and thus, support for mediation was not obtained. Nonetheless, the high ratings of perceived autonomy support reflect the exercise leaders' natural tendency to use an autonomy supportive teaching style with patients. In addition, a positive relationship was found between autonomous forms of behavioural regulation (i.e., integrated and intrinsic) and exercise intentions, lending support to the SDT framework. The positive findings for need satisfaction, autonomous regulation, exercise intentions, and behaviour reflect a highly self-determined group of cardiac patients who are choosing to engage in self-managed exercise while still participating in the supervised cardiac rehabilitation program. These findings are promising in terms of regular exercise adoption in this population.</p> / Thesis / Master of Science (MSc)