Anderson Derek R, Emery Charles F
Department of Psychology.
Health Psychol. 2014 Dec;33(12):1614-7. doi: 10.1037/hea0000017. Epub 2014 Feb 3.
Cardiac rehabilitation (CR) is routinely prescribed for patients with cardiovascular disease (CVD), but data indicate that 20% to 50% of patients do not adhere to CR. Studies have focused on the impact of depression on CR adherence, but results have been equivocal. Irrational health beliefs are related to adherence among diabetes patients, but have not been examined among cardiac patients. This study examined depression and irrational health beliefs as predictors of CR adherence.
Sixty-one participants (30% female; mean age = 59.9 ± 11.8; 72% Caucasian), recruited at the outset of an outpatient CR program, completed a baseline questionnaire including measures of depression and irrational health beliefs. CR adherence was defined as the percentage of CR exercise sessions completed. Pearson correlations and analysis of variance determined demographic factors related to adherence. Hierarchical regression analyses examined irrational health beliefs and depression as predictors of CR adherence.
Older age (p < .05) and higher income (p < .05) were associated with better CR adherence, but CR adherence was lower among African Americans than Caucasians (p < .01). Depression was not related to adherence (p = .78), but irrational health beliefs predicted CR adherence, after controlling for race/ethnicity, income, and age (β = -.290, ΔR² = .074, ΔF[1,55] = 5.50, p < .05).
Irrational health beliefs predicted CR adherence but depression did not. Thus, poorer adherence to CR was associated with endorsing beliefs that are not based in medical evidence.
心脏康复(CR)通常被开给心血管疾病(CVD)患者,但数据表明20%至50%的患者不坚持心脏康复。研究聚焦于抑郁对心脏康复依从性的影响,但结果并不明确。不合理的健康信念与糖尿病患者的依从性有关,但尚未在心脏病患者中进行研究。本研究考察了抑郁和不合理的健康信念作为心脏康复依从性的预测因素。
在一个门诊心脏康复项目开始时招募了61名参与者(30%为女性;平均年龄 = 59.9 ± 11.8;72%为白种人),他们完成了一份基线问卷,包括抑郁和不合理健康信念的测量。心脏康复依从性定义为完成的心脏康复锻炼课程的百分比。Pearson相关性分析和方差分析确定了与依从性相关的人口统计学因素。分层回归分析考察了不合理的健康信念和抑郁作为心脏康复依从性的预测因素。
年龄较大(p < .05)和收入较高(p < .05)与更好的心脏康复依从性相关,但非裔美国人的心脏康复依从性低于白种人(p < .01)。抑郁与依从性无关(p = .78),但在控制了种族/民族、收入和年龄后,不合理的健康信念预测了心脏康复依从性(β = -.290,ΔR² = .074,ΔF[1,55] = 5.50,p < .05)。
不合理的健康信念预测了心脏康复依从性,而抑郁则没有。因此,较差的心脏康复依从性与认可缺乏医学证据的信念有关。