Cardiac Exercise Self-efficacy Research Articles

Depression levels and cardiac exercise self-efficacy following 30 days discharge among acute coronary syndrome patients.

Depression levels and cardiac exercise self-efficacy following 30 days discharge among acute coronary syndrome patients.

Fatigue and physical activity in post-CABG patients: the parallel mediation model of kinesiophobia and self-efficacy : a prospective multicentre and cross-sectional study in China

ObjectivesThe objective of this study was to investigate how kinesiophobia and self-efficacy explain the relationship between fatigue and physical activity (PA) in post-coronary artery bypass grafting (post-CABG) patients over the...

Study of Factors Influencing Early Kinesiophobia in Older Patients after Coronary Artery Bypass Grafting in China

Background: Kinesiophobia is highly prevalent among postoperative cardiac patients. Early identification of kinesiophobia in patients who have undergone coronary artery bypass grafting (CABG) can improve their ability to participate in physical activities. However, there is limited research on the factors influencing kinesiophobia in older patients during the early stages after CABG. To investigate the factors influencing early kinesiophobia in older patients after coronary artery bypass grafting and to examine the correlation between these factors and social support and rehabilitation exercise self-efficacy. Methods: Using convenience sampling, 117 older patients who underwent coronary artery bypass grafting in the cardiac surgery ward of a tertiary grade A hospital in Bengbu City from October 2022 to September 2023 were analyzed. The survey was conducted on-site using a general information questionnaire, the Chinese version of the Tampa Scale for Kinesiophobia Heart (TSK-SV Heart), the Cardiac Exercise Self-Efficacy Instrument (CESEI), the Social Support Rating Scale (SSRS), and the pain assessment scale. Single-factor analysis, multifactor regression analysis, and Spearman's correlation analysis were employed. Results: Among the 117 older patients in the early postoperative phase following coronary artery bypass grafting, the incidence of kinesiophobia was 73.5%. Single-factor analysis revealed that education level, medical expense coverage, place of residence, and pain scores were significantly associated with kinesiophobia (p < 0.05). Multifactor regression analysis identified age and monthly income as factors influencing cardiac exercise self-efficacy (p < 0.05). Age, education level, medical expense coverage, and monthly income affected patient social support (p < 0.05). Spearman's correlation analysis revealed significant negative correlations among cardiac exercise self-efficacy, social support, and kinesiophobia level (p < 0.001). Conclusion: The incidence of early kinesiophobia is relatively high among older patients after coronary artery bypass grafting. Educational level, medical expense coverage, place of residence, and postoperative pain were influential factors. Both cardiac exercise self-efficacy and social support have a significant impact on kinesiophobia in patients. Therefore, clinical healthcare professionals should prioritize older patients undergoing postcoronary artery bypass grafting with lower educational levels and monthly incomes. Effective and evidence-based clinical interventions can be tailored based on these influencing factors and their correlations to promote active participation in rehabilitation exercises and improve patient outcomes in the early postoperative phase.

Mediating effect of kinesiophobia between self-efficacy and physical activity levels in post-CABG patients: protocol for a prospective, multicentre, cross-sectional study in China

IntroductionPhysical activity (PA) can improve cardiac function, exercise capacity, and quality of life, in addition to reducing mortality by 20%–30% and preventing the recurrence of adverse cardiovascular events in patients...

Effect of Digital Cardiac Rehabilitation Program on Self Efficacy of Patients with Coronary Artery Diseases

Background: Coronary artery disease is the umbrella term for a spectrum of diseases caused by myocardial ischemia decreasing blood supply to the heart muscle. Self-efficacy is a vital modifiable personal resource affecting rehabilitation adherence, and disease outcomes such as health-related quality of life among people with cardiovascular disease. Aim: To evaluate the effect of digital cardiac rehabilitation program on self efficacy of patients with coronary artery diseases. Subjects and method: Design: A quasi-experimental research design was used. Setting: The study was conducted at the cardiology unit and outpatients’ clinics at El Nasr Insurance Hospital in Hehwan city. Subjects: A Purposive sample of (100) adult patients diagnosed with coronary artery disease, was selected and equally divided into study & control groups, (50) patients for each one. Tools for data collection: It included 1) a structured interviewing questionnaire, 2) cardiac self-efficacy scale, and 3) cardiac exercise self-efficacy scale. Results: Majority of the patients in the study group had satisfactory knowledge level , had high cardiac self efficacy, and practice exercise self efficacy post rehabilitation program implementation. Conclusion: There was a statistically significant difference between the study and control groups concerning knowledge, cardiac self efficacy, and cardiac exercise self-efficacy post, and follow-up rehabilitation program implementation. The results of the current study supported the hypothesis that digital cardiac rehabilitation programs affect positively patients’ knowledge and cardiac self-efficacy. Recommendations: Future researches are required to develop and refine interventions to improve patient's compliance to treatment and prevent further deterioration of cardiac self-efficacy

Validity and reliability of the Iranian version of the Cardiac Exercise Self-Efficacy Scale.

BACKGROUNDThe assessment of exercise self-efficacy in patients with cardiovascular disease (CVD) is necessary to conduct tailored interventions. The aim of the current study was to validate the Iranian version of the Cardiac Exercise Self-efficacy Scale (CESE) for patients with CVD.METHODSTo develop the Iranian version of the CESE scale, a forward and back translation procedure was followed. Data were collected from 260 patients with CVD who were admitted to Imam Ali Cardiovascular Hospital, Iran, using convenience sampling. Psychometric properties of the scale including validity (face and content validity, discriminant, concurrent, convergent, divergent, and construct validity) and reliability (internal consistency, and test-retest reliability) were assessed. SPSS software was used for statistical analysis.RESULTSThe questionnaire had a good face and content validity and reliability, with Cronbach's alpha of 0.87 and intraclass correlation coefficient (ICC) of 0.42. The questionnaire discriminated well between subgroups according to their medical conditions and the “health transition” item in the Short-Form Health Survey (SF-36). There was a significant correlation between CESE and the physical components of the SF-36 (P < 0.001). In addition, a strong to moderate significant correlation was found between the CESE and the Exercise Self-efficacy Scale (ESES) (r = 0.77; P < 0.01) and between CESE and the Hospital Anxiety and Depression Scale (HADS) total (r = -0.45; P < 0.001). The exploratory factor analysis (EFA) identified a four-factor structure model, explaining 71.02% of the observed variance.CONCLUSIONThe Persian version of the CESE is a valid and reliable instrument for the evaluation of CVD patients’ exercise self-efficacy level in performing regular exercise behaviors.

Measuring exercise self-efficacy in Hong Kong Chinese adults with cardiovascular risk: Validation of a Chinese version of the Cardiac Exercise Self-efficacy Instrument.

About one-third of adults are physically inactive and thus prone to cardiovascular diseases. While self-efficacy mediates health behavior, its influences on exercise behavior among Chinese is yet to be explored by a validated instrument. This study aimed to examine the psychometric properties of the Hong Kong Chinese version of the Cardiac Exercise Self-efficacy Instrument (CESEI-C), which had been translated previously by these authors. The psychometric properties of the CESEI-C were tested with 160 Hong Kong Chinese with cardiovascular risk. Participants were asked to complete the CESEI-C, a physical activity assessment tool, and perform the exercise stress test. Exploratory factor analysis identified a unidimensional structure of the CESEI-C. Good internal consistency (Cronbach's alpha = 0.91) and good content validity (content validity indices: 0.93-1.00) had been reported previously. The convergent validity of the CESEI-C was supported by the significant positive correlations between the CESEI-C score and the amount of moderate-to-vigorous exercise (r = 0.18, p = 0.03), and exercise capacity (r = 0.30, p < 0.01). A comparison of CESEI-C scores by exercise capacities indicated that those with moderate-to-high exercise capacity had significantly higher CESEI scores than those with low exercise capacity (t = 2.105, p = 0.04). Thus, the CESEI-C is a valid and reliable instrument to measure exercise self-efficacy among Hong Kong Chinese.

Barriers to Intake Assessment in Women Referred for Cardiac Rehabilitation

Barriers to Intake Assessment in Women Referred for Cardiac Rehabilitation

Tai Chi Exercises Benefit Even Oldest Adults

Tai Chi Exercises Benefit Even Oldest Adults

Tai Chi Exercise in Patients With Chronic Heart Failure

Preliminary evidence suggests that meditative exercise may have benefits for patients with chronic systolic heart failure (HF); this has not been rigorously tested in a large clinical sample. We sought to investigate whether tai chi, as an adjunct to standard care, improves functional capacity and quality of life in patients with HF. A single-blind, multisite, parallel-group, randomized controlled trial evaluated 100 outpatients with systolic HF (New York Heart Association class I-III, left ventricular ejection fraction ≤40%) who were recruited between May 1, 2005, and September 30, 2008. A group-based 12-week tai chi exercise program (n = 50) or time-matched education (n = 50, control group) was conducted. Outcome measures included exercise capacity (6- minute walk test and peak oxygen uptake) and disease-specific quality of life (Minnesota Living With Heart Failure Questionnaire). Mean (SD) age of patients was 67 (11) years; baseline values were left ventricular ejection fraction, 29% (8%) and peak oxygen uptake, 13.5 mL/kg/min; the median New York Heart Association class of HF was class II. At completion of the study, there were no significant differences in change in 6-minute walk distance and peak oxygen uptake (median change [first quartile, third quartile], 35 [-2, 51] vs 2 [-7, 54] meters, P = .95; and 1.1 [-1.1, 1.5] vs -0.5 [-1.2, 1.8] mL/kg/min, P = .81) when comparing tai chi and control groups; however, patients in the tai chi group had greater improvements in quality of life (Minnesota Living With Heart Failure Questionnaire, -19 [-23, -3] vs 1 [-16, 3], P = .02). Improvements with tai chi were also seen in exercise self-efficacy (Cardiac Exercise Self-efficacy Instrument, 0.1 [0.1, 0.6] vs -0.3 [-0.5, 0.2], P < .001) and mood (Profile of Mood States total mood disturbance, -6 [-17, 1] vs -1 [-13, 10], P = .01). Tai chi exercise may improve quality of life, mood, and exercise self-efficacy in patients with HF. Trial Registration clinicaltrials.gov Identifier: NCT00110227.

Heart Failure Exercise And Training Camp: Effects of a multicomponent exercise training intervention in patients with heart failure

This study tested the effects of a multicomponent exercise training intervention called "Heart Failure Exercise And Training Camp" (HEART CAMP). The intervention was theoretically derived from Bandura's social cognitive theory. An experimental repeated-measures design was used. Participants were randomized to the HEART CAMP intervention group (n = 22) or the attention control group (n = 20). Participants were compared on self-efficacy for exercise, symptoms, physical function, and quality of life over 12 weeks. The intervention group had a 31% increase in cardiac exercise self-efficacy and significantly fewer symptoms compared with the attention control group. Quality of life increased significantly in both groups. A theory-based intervention improved self-efficacy for exercise and symptoms in patients with heart failure.

Pre-Coronary Artery Bypass Graft Measures and Enrollment in Cardiac Rehabilitation

The aim of this study was to examine the relationship between exercise tolerance, functional status, exercise behavior, and enrollment in cardiac rehabilitation (CR), preoperatively in individuals undergoing coronary artery bypass graft (CABG) surgery. Seventy-eight individuals undergoing CABG were evaluated 1 to 7 days preoperatively using the following measures: 2-minute walk test (2MWT), Duke Activity Status Index (DASI), Cardiac Exercise Self-Efficacy Instrument (CESEI), Stages of Change Questionnaire (SCQ), Short-Form 12 (SF-12), Hospital Anxiety Depression scale, location of residence, and education level. Participants were contacted via telephone 10 to 12 weeks postoperatively to determine if they were referred and enrolled in CR. Participants completed mailed questionnaires for follow-up. In subsequent telephone interviews, individuals who were not enrolled in CR were asked to provide reasons for nonenrollment. Overall enrollment in CR was 46%. No significant differences were found in 2MWT, CESEI, and DASI scores between enrolled and nonenrolled participants. Fifty-seven percent of urban-dwelling participants enrolled in CR compared to 29% of rural-dwelling participants (P < .01). Similarly, 65% of individuals with post-secondary education enrolled in CR compared to 38% of individuals without a post-secondary education (P = .05). The primary reasons for nonenrollment were behavioral intentions toward exercise and CR, accessibility, and healthcare team recommendation. Individuals who enrolled in CR demonstrated a larger postoperative improvement in CESEI score. Location of residence and education level predicted CR enrollment, whereas preoperative exercise tolerance, functional status, and exercise attitudes did not predict enrollment.

Relationship between illness representation and self‐efficacy

This paper reports a patient survey exploring the possible relationship between illness perception and self-efficacy following a cardiac event, and the implications this could have for nursing practice. Cardiac rehabilitation guidelines endorse the need to improve psychological care; suggesting that individualized support will improve the effectiveness of cardiac rehabilitation. Surveys, however, continue to identify that psychosocial factors are poorly assessed. Illness representation and self-efficacy are two prominent research approaches that have been developed as separate foci for the treatment of patients. A cross-sectional survey with patients diagnosed with either myocardial infarction or angina over an 8-month period in two hospitals. The Illness Perception Questionnaire, General Self-Efficacy Questionnaire, Cardiac Diet Self-efficacy Instrument and Cardiac Exercise Self-efficacy Instrument were used, alongside two specifically-designed scales: the Diet Outcome Expectation and Exercise Outcome Expectation Scales. The results indicate that there is a significant relationship between illness perception and self-efficacy. The greater patients' perceived consequences of the heart condition, the lower was the general self-efficacy available to cope with the condition. Further, the longer the perceived time the condition will affect the patient, the higher the specific self-efficacy to maintain a change of diet or exercise regime. The findings identify that, in the initial phase of recovery, nursing practice needs to focus on the key variables of "consequence" and "timeline" in order to increase patients' confidence in their ability to cope (self-efficacy).

Effects of TES program on exercise capacity, self-efficacy and patient compliance in patients with myocardial infarction

This study aimed to develop a TES program to improve exercise capacity to promote patient compliance to the prescribed exercise, and to test the feasibility of the program. The 8-week TES program consisted of three components : exercise training, self-efficacy enhancement and social support. Using the matching of gender, age, and the left ventricular ejection fraction, thirty one subjects were consecutively assigned to either TES group (n=15, 52+7 years) or Control group (n=16, 58+11 years) 3 weeks after MI. With the exception of exercise compliance (only after the TES program), the exercise capacity and exercise self-efficacy were both measured both before and after the 8-week TES program. The VO2peak (p=.043), anaerobic threshold (p=.023) and exercise duration (p=.015) improved in TES group compared to Control group after 8 weeks. The cardiac exercise self-efficacy (p=.036) was significantly higher in TES group than Control group. There was a significant increase of exercise compliance(p=.005) in TES group compared to Control group. The 8-week TES program improved the exercise capacity, exercise self-efficacy and exercise compliance. A appropriately implemented TES program in cardiovascular nursing practice may promote healthy behavioral modification and, therefore, contributing to reduce the risk of mortality and morbidity in MI patients.

Predictors of Referral to Cardiac Rehabilitation and Cardiac Exercise Self-Efficacy

Cardiac rehabilitation (CR) has known benefits after myocardial infarction (MI) or coronary artery bypass surgery (CABG). Yet, only a small percentage of patients are referred for outpatient CR after hospital discharge. This study investigates patient characteristics related to referral to CR and cardiac exercise self-efficacy, a salient predictor of health behavior change and maintenance. Two hundred nineteen patients enrolled in the study. Of the 185 patients who were CR candidates, 74 were referred to CR. Logistic regression analysis was used to identify variables related to CR referral. Results indicate that patient characteristics of having had fewer MIs or CABGs, having attended CR in the past, and being less physically active during leisure time are related to an increased likelihood of being referred to CR. Multiple regression analysis indicates that leisure physical activity is a predictor of cardiac exercise self-efficacy. Implications for nurses who recruit patients for CR are discussed.

Instrument Development

Self-efficacy has been documented as a strong predictor of health behaviors. Unfortunately, availability of reliable and valid measures of self-efficacy for a range of health behaviors is still limited. This study validated two measures of cardiac risk factor self-efficacy: the Cardiac Diet Self-Efficacy Instrument (CDSEI) and the Cardiac Exercise Self-Efficacy Instrument (CESEI). A sample of 370 cardiac rehabilitation participants provided data for principal factor analyses showing the unidimensionality of each instrument. Known groups construct validity was supported by a comparison of CDSEI and CESEI scores for cardiac rehabilitation participants and marathon runners. The value of CDSEI and CESEI scores in predicting subsequent exercise and diet performance was demonstrated with a third group of cardiac rehabilitation participants. Stability and internal consistency estimates in the .80s and .90s, respectively, support the scales' reliabilities.