Horwood Hayley, Williams Michael J A, Mandic Sandra
Active Living Laboratory, School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand.
Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; Dunedin Hospital, Dunedin, New Zealand.
Heart Lung Circ. 2015 Oct;24(10):980-7. doi: 10.1016/j.hlc.2015.03.023. Epub 2015 Apr 21.
Reasons for low attendance at maintenance cardiac rehabilitation (CR) programs remain largely unknown. Using the Health Belief Model as a theoretical framework, this study compared the motivations and barriers for attending a community-based CR maintenance program in high attenders (HA), low attenders (LA) and non-attenders (NA) with coronary artery disease (CAD).
Forty-four older adults with CAD (70.5% males; age: 72.7±6.9 years; 11 HA, 16 LA and 17 NA) completed questionnaires examining reasons for attending CR: perceived threat (symptoms of CAD; the Revised Illness Perception Questionnaire), perceived benefits (Multi-dimensional Outcomes Expectations for Exercise Scale), perceived barriers (Cardiac Rehabilitation Barriers Scale) and cues to action questionnaire.
Sociodemographic characteristics and perceived threat were not different between the groups. Compared to LA and NA, HA perceived greater social and physical (vs NA only) benefits of participation in maintenance CR and had fewer barriers to attending (all p<0.05). The CR program newsletter, personal health concerns and others having heart problems were stronger cues to action for HA versus NA (all p<0.05).
Participants perceived greater benefits from attending CR, had fewer barriers and perceived stronger cues to action compared to non-attenders. Promoting CR maintenance programs should emphasise physical and social benefits and provide encouragement.
心脏康复维持项目参与率低的原因在很大程度上仍不明确。本研究以健康信念模型为理论框架，比较了冠心病患者中高参与度者（HA）、低参与度者（LA）和未参与者（NA）参加社区心脏康复维持项目的动机和障碍。
44名患有冠心病的老年人（男性占70.5%；年龄：72.7±6.9岁；11名高参与度者、16名低参与度者和17名未参与者）完成了关于参加心脏康复原因的问卷调查：感知威胁（冠心病症状；修订后的疾病认知问卷）、感知益处（运动量表的多维结果期望）、感知障碍（心脏康复障碍量表）和行动线索问卷。
各组间社会人口学特征和感知威胁无差异。与低参与度者和未参与者相比，高参与度者感知到参与心脏康复维持项目有更大的社会和身体（仅与未参与者相比）益处，且参加的障碍更少（所有p<0.05）。与未参与者相比，心脏康复项目通讯、个人健康担忧以及其他人患有心脏病对高参与度者来说是更强的行动线索（所有p<0.05）。
与未参与者相比，参与者认为参加心脏康复有更大益处，障碍更少，且行动线索更强。推广心脏康复维持项目应强调身体和社会效益并给予鼓励。
