The goal of this research was to gain greater understanding about the management of heart
failure patients. A particular focus was to evaluate exercise tolerance and behavior. The major findings of the first study included: (1) evidence that few heart failure patients receive adequate information regarding physical activity; (2) performance on a six-minute walk test were ~42% lower, and SF-36 scores were also lower in heart failure patients compared to controls; (3)
stability in hemodynamic measures and distance walked on the 6-minute walk test were adequate, and (4) home exercise resulted in 19% improvement in maximum walking distance and 30% improvement in physical function score on the SF-36. The second study showed the feasibility to implement a care-managed program for heart failure patients in a family practice setting. However, a significant barrier was recruitment. Despite this failure, patients improved ~24% on the maximum walking distance and 29%, 46%, and 13% on the physical function, vitality, and mental health scores on the SF-36. The third study examined the motivation and readiness of heart failure patients to engage in planned physical activity. The findings revealed 22 patients in precontemplation, 33 in contemplation, 41 in preparation, 23 in action, and 29 in maintenance. In regards to the Transtheoretical model constructs (self-efficacy, pros and cons of
decisional balance, and experiential processes) the data revealed that self-efficacy scores were
lowest in the precontemplation and increased in linear fashion to maintenance. Decisional
balance changed from greater perceived cons and lower perceived pros in precontemplation and
contemplation to lower perceived cons and higher perceived pros in action and maintenance.
Experiential processes were used predominantly in precontemplation and contemplation, whereas behavioral processes were more prominently used in action and maintenance. The most important predictors of physical activity stages of change were the behavioral processes (r2= .78)followed by perceived self-efficacy (r2= .66). Finally, this study indicated that patients in preaction
stages of readiness to exercise have significant lower exercise tolerance then those in action and maintenance. These data suggest greater clinical emphasis should be placed on strategies to move patients toward the preparation and action stages of readiness.
| Identifer | oai:union.ndltd.org:LSU/oai:etd.lsu.edu:etd-12162005-090458 |
| Date | 16 December 2005 |
| Creators | Parish, Tracie Rena |
| Contributors | Maria Kosma, Michael Welsch, Gary Gintner, Dennis Landin, Michael Lefevre |
| Publisher | LSU |
| Source Sets | Louisiana State University |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.lsu.edu/docs/available/etd-12162005-090458/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached herein a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to LSU or its agents the non-exclusive license to archive and make accessible, under the conditions specified below and in appropriate University policies, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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