PhD, RN, Assistant Professor, Faculty of Nursing, Applied Science Private University, Amman, Jordan.
PhD, Professor, Health and Rehabilitation Sciences, School of Health Sciences, University of Salford, Manchester, UK.
J Nurs Res. 2020 Nov 2;29(1):e131. doi: 10.1097/JNR.0000000000000408.
Regular physical activity is important for patients with established coronary heart disease as it favorably influences their coronary risk profile. General self-efficacy is a powerful predictor of health behavior change that involves increases in physical activity levels. Few studies have simultaneously measured physical activity and self-efficacy during early recovery after a first acute myocardial infarction (AMI).
The aims of this study were to assess changes in objectively measured physical activity levels at 2 weeks (T2) and 6 weeks (T3) and self-reported cardiac self-efficacy at hospital discharge (T1) and at T2 and T3 in patients recovering from AMI.
A repeated-measures design was used to recruit a purposive sample of patients from a single center in Jordan who were diagnosed with first AMI and who did not have access to cardiac rehabilitation. A body-worn activity monitor (activPAL) was used to objectively measure free-living physical activity levels for 7 consecutive days at two time points (T2 and T3). An Arabic version of the cardiac self-efficacy scale was administered at T1, T2, and T3. Paired t tests and analysis of variance were used to examine differences in physical activity levels and cardiac self-efficacy scores, respectively.
A sample of 100 participants was recruited, of which 62% were male. The mean age of the sample was 54.5 ± 9.9 years. No statistically significant difference in physical activity levels was measured at 2 weeks (T2) and 6 weeks (T3). Cardiac self-efficacy scores improved significantly between T1, T2, and T3 across subscales and global cardiac self-efficacy.
CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Participants recovering from AMI in Jordan did not increase their physical activity levels during the early recovery phase, although cardiac self-efficacy scores improved. This may be because the increase in cardiac self-efficacy was not matched by the practical skills and knowledge required to translate this positive psychological construct into behavioral change. This study provides a first step toward understanding the complex relationship between cardiac self-efficacy and physical activity in this population. The authors hope that these findings support the design of culturally appropriate interventions to increase physical activity levels in this population.
对于已确诊冠心病的患者来说，定期进行身体活动非常重要，因为这有利于改善其冠心病风险状况。一般自我效能感是健康行为改变的有力预测因素，它涉及到身体活动水平的提高。很少有研究同时测量首次急性心肌梗死（AMI）后早期康复期间的身体活动水平和自我效能感。
本研究旨在评估 AMI 康复患者在出院时（T1）以及在 T2 和 T3 时的自我报告的心脏自我效能感，以及在 T2 和 T3 时客观测量的身体活动水平的变化。
采用重复测量设计，从约旦的一家单中心招募了一个有目的的 AMI 患者样本，这些患者没有接受过心脏康复。使用可穿戴活动监测器（activPAL）在两个时间点（T2 和 T3）连续 7 天客观测量自由活动身体活动水平。在 T1、T2 和 T3 时，使用阿拉伯语版的心脏自我效能量表进行测量。采用配对 t 检验和方差分析分别检查身体活动水平和心脏自我效能感评分的差异。
共招募了 100 名参与者，其中 62%为男性。样本的平均年龄为 54.5 ± 9.9 岁。在 T2 和 T3 时，身体活动水平没有统计学上的显著差异。在 T1、T2 和 T3 时，心脏自我效能感评分在各子量表和整体心脏自我效能感上均有显著改善。
结论/对实践的意义：在约旦，AMI 康复患者在早期康复阶段并没有增加身体活动水平，尽管心脏自我效能感评分有所提高。这可能是因为心脏自我效能感的提高与将这种积极的心理结构转化为行为改变所需的实际技能和知识不匹配。本研究为理解该人群中心脏自我效能感与身体活动之间的复杂关系迈出了第一步。作者希望这些发现支持设计文化上合适的干预措施，以提高该人群的身体活动水平。
