The physiological and psychosocial benefits of sustained exercise adherence among individuals with coronary artery disease (CAD) have been well-documented (e.g., Blumenthal et al., 1997; Rozanski et al., 1999; Wenger et al., 1995). Despite these known benefits, approximately 80% of patients who enter the maintenance phase of cardiac rehabilitation drop out after one year (Balady et al., 1994; Hedback, Perk, Wodlin, 1993 ). Among this 80%, less than 25% continue to exercise at levels that will maintain or improve cardiorespiratory fitness (Daltroy, 1985; Radtke, 1989). Self-efficacy has been identified as a significant predictor of adherence to exercise beyond the initial 6 months of participation. In addition to self-efficacy, outcome satisfaction has been suggested as a potentially significant predictor of adherence to exercise beyond the initiation phase (i.e., beyond the first 6 months). Unfortunately, most research examining these predictors of adherence has been conducted among asymptomatic populations. Thus, little is known about the predictive utility of self-efficacy and outcome satisfaction in relation to sustained exercise adherence among the CAD population. The purpose of the present study was to examine self-efficacy (Bandura, 1986) and outcome satisfaction (Rothman, 2000) in the prediction of adherence to maintenance cardiac rehabilitation in 101 men (M age= 68.15 ± 8.03) with coronary artery disease (CAD). A series of three hierarchical multiple regression analyses were conducted to predict onsite, offsite and total adherence to the maintenance cardiac rehabilitation exercise prescription. Interestingly, Exercise Beliefs (i.e., days of aerobic exercise per week believed necessary to maintain cardiovascular health), one of the study covariates, emerged as an important predictor of both offsite and total exercise adherence and explained a significant amount of variance in these variables (R2 = .25 [offsite], .23 [total],ps < .01). As predicted, self-regulatory efficacy was a significant predictor and explained a significant amount of variance in onsite exercise adherence (R2 = .17 [scheduling],p < .001). Task self-efficacy was not a significant predictor and did not account for a significant amount of variance in onsite exercise adherence. Also as predicted, task self-efficacy was a significant predictor and explained a significant amount of variance in offsite exercise adherence (R2= .10,p < .05). Self-regulatory efficacy was not a significant predictor and did not account for a significant amount of variance in offsite exercise adherence. In addition, consistent with hypothesis, both task self-efficacy and self-regulatory efficacy were significant predictors of total exercise adherence and explained a significant amount of the variance in this variable (R2 = .12 [task], .07 [scheduling],ps < .05). Contrary to hypothesis, outcome satisfaction did not explain a significant amount of variance in exercise adherence (onsite, offsite, and total) beyond that explained by self-efficacy (task and self-regulatory) alone. Taken together, this research has enhanced our knowledge of the psychosocial predictors of adherence to the maintenance cardiac rehabilitation exercise prescription among men with CAD. These findings also have important implications for health care professionals working in the area of cardiac rehabilitation. Specifically, it is up to health care professionals to ensure that patient beliefs regarding the maintenance cardiac rehabilitation exercise prescription are accurate, and that patients are efficacious in their ability to engage in the elemental physical aspects of exercise and to effectively schedule exercise into their daily lives. / Thesis / Master of Science (MS)
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/24535 |
| Date | 05 1900 |
| Creators | Lichtenberger, Catherine |
| Contributors | Ginis, Kathleen, Human Biodynamics |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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