Attitudes and behavioral intentions of aortic dissection survivors towards exercise: an application of the health action process approach framework.

Danni Feng,Sufang Huang,Xiaorong Lang

doi:10.31083/j.rcm2302064

Abstract

Exercise can help patients with aortic dissection (AD) control blood pressure, prevent further progression of AD, promote mental health, improve the prognosis of cardiovascular disease, and improve their overall quality of life. However, it is not clear what the attitudes and behavioral intentions of AD survivors are towards exercise. This exploratory qualitative research was based on the Health Action Process Approach (HAPA) theory to explore the cognition, attitude, motivational factors, behavior intention, barriers and facilitators of exercise in patients with AD. Face-to-face and telephone semi-structured interviews were conducted in 24 AD patients from the Department of Cardio-Vascular Surgery of third-grade Class A hospitals in Wuhan, China from April 2021 to June 2021. The patient's current stage of behavior was evaluated according to the Patient-Centered Assessment and Counseling for Exercise (PACE) questionnaire. Among the 24 participants interviewed, 9 (37.5%) were in the pre-intention stage, 8 (33.3%) were in the intention stage, and 7 (29.2%) were in the action stage. The three groups were significantly different in terms of their history of previous cardiac surgery (Fisher's exact test, p = 0.043) and in the type of interview conducted (Fisher's exact test, p < 0.001). In-patients with a history of cardiac surgery were more likely to be in the pre-intention stage (post-hoc test, p < 0.05). Patients from different stages had different structures. AD patients in the pre-intention stage were more likely to express risk perception and negative results for exercise. The self-efficacy of this group was often low, and lacked exercise intention and clear action plans (post-hoc test, p < 0.05). More attention should be paid to in-patients with a history of cardiac surgery, including health advice on exercise after discharge and promotion of changes in their health behavior. Guidelines based on the available exercise data in AD patients should be established to provide recommendations for individualized exercise programs. This should provide a basis for promoting patient rehabilitation and improving postoperative quality of life.

Highlights

Aortic dissection (AD) is a pathological change where the blood in the aortic cavity enters the aortic media from the aortic intima tear and expands along the long axis of the aorta, resulting in separation of the true and false aortic cavities [1]
The patients were further divided into four groups according to whether they were in-patients or discharged, and whether or not they had a history of previous cardiac surgery
Significant differences were found between these groups (Fisher’s exact test, p < 0.001): inpatients without a history of cardiac surgery showed a preference for the intention stage, in-patients with a history of cardiac surgery showed a preference for the pre-intention stage, while discharged patients without a history of cardiac surgery showed a preference for the action stage

Summary

Introduction

Aortic dissection (AD) is a pathological change where the blood in the aortic cavity enters the aortic media from the aortic intima tear and expands along the long axis of the aorta, resulting in separation of the true and false aortic cavities [1]. Exercise can help patients with aortic dissection (AD) control blood pressure, prevent further progression of AD, promote mental health, improve the prognosis of cardiovascular disease, and improve their overall quality of life. It is not clear what the attitudes and behavioral intentions of AD survivors are towards exercise. In-patients with a history of cardiac surgery were more likely to be in the pre-intention stage (post-hoc test, p < 0.05). This should provide a basis for promoting patient rehabilitation and improving postoperative quality of life

Results

Discussion

Conclusion