TotalCardiology Rehabilitation, Calgary, Canada; Department of Physical Therapy, University of Illinois at Chicago, Chicago, USA; Department of Psychology, University of Calgary, Calgary, Canada.
Nursing and Community Health Sciences, University of Calgary, Calgary, Canada.
Patient Educ Couns. 2018 Nov;101(11):1914-1923. doi: 10.1016/j.pec.2018.06.015. Epub 2018 Jun 26.
Cardiac rehabilitation (CR) is an effective treatment for cardiovascular disease, yet many referred patients do not participate. Motivational interviewing could be beneficial in this context, but efficacy with prospective CR patients has not been examined. This study investigated the impact of motivational interviewing on intention to participate in CR.
Individuals recovering from acute coronary syndrome (n = 96) were randomized to motivational interviewing or usual care, following CR referral but before CR enrollment. The primary outcome was intention to attend CR. Secondary outcomes included CR beliefs, barriers, self-efficacy, illness perception, social support, intervention acceptability, and CR participation.
Compared to those in usual care, patients who received the motivational intervention reported higher intention to attend CR (p = .001), viewed CR as more necessary (p = .036), had fewer concerns about exercise (p = .011), and attended more exercise sessions (p = .008). There was an indirect effect of the intervention on CR enrollment (b = 0.45, 95% CI 0.04-1.18) and CR adherence (b = 2.59, 95% CI 0.95-5.03) via higher levels of intention. Overall, patients reported high intention to attend CR (M = 6.20/7.00, SD = 1.67), most (85%) enrolled, and they attended an average of 65% of scheduled CR sessions.
A single collaborative conversation about CR can increase both intention to attend CR and actual program adherence.
The findings will inform future efforts to optimize behavioral interventions to enhance CR participation.
心脏康复（CR）是治疗心血管疾病的有效方法，但许多被推荐的患者并未参与。在这种情况下，动机性访谈可能会有所帮助，但尚未对预期的 CR 患者进行疗效评估。本研究调查了动机性访谈对 CR 参与意向的影响。
急性冠状动脉综合征（n=96）患者在接受 CR 转介但尚未参加 CR 前，随机分为动机性访谈组或常规护理组。主要结局是参加 CR 的意向。次要结局包括 CR 信念、障碍、自我效能感、疾病感知、社会支持、干预可接受性和 CR 参与度。
与常规护理组相比，接受动机干预的患者报告了更高的参加 CR 的意向（p=0.001），认为 CR 更有必要（p=0.036），对运动的担忧更少（p=0.011），并参加了更多的运动课程（p=0.008）。干预对 CR 登记（b=0.45，95%CI 0.04-1.18）和 CR 依从性（b=2.59，95%CI 0.95-5.03）的间接影响是通过更高的意向水平实现的。总体而言，患者报告了很高的参加 CR 的意向（M=6.20/7.00，SD=1.67），大多数（85%）登记，并且他们平均参加了计划 CR 课程的 65%。
一次关于 CR 的协作性讨论可以提高参加 CR 的意向和实际项目依从性。
研究结果将为未来优化行为干预以增强 CR 参与度的努力提供信息。
