Centre for Sports and Exercise Medicine, Queen Mary University of London, Mile End Hospital, Bancroft Road, London, E1 4DG, UK.
BMC Cardiovasc Disord. 2021 Feb 18;21(1):105. doi: 10.1186/s12872-021-01898-7.
Outcomes following myocardial infarction (MI) are improved by uptake and maintenance of physical activity (PA), but little is understood regarding patients experience of maintaining an active lifestyle once immediate support, such as cardiac-rehabilitation (CR), has ended.
The purpose of this study was to investigate MI survivors' attitude and appraisal towards PA and the perceived barriers, motivators and facilitators for maintaining PA long-term.
Semi-structured interviews were carried out with 18 adults (mean age 60.5, range 37-73 years) from England and Scotland, who were a minimum of 5 months post-MI (mean 29 months, range 5-122 months). There were comparatively more male participants (n = 13, 72 %) than female (n = 5, 28 %). Overall 12 (67 %) participants had attended CR. The interviews were transcribed verbatim and thematic analysis was performed using qualitative data analysis software NVivo.
Data analysis indicated that the following four core themes influenced MI survivors' behaviour and attitude towards PA: (1) MI as a teachable moment for behaviour change, (2) affective response to MI: enjoyment versus fear, (3) cognitive response to MI: self-perception, attitude and self-efficacy, and (4) access to support and resources, including PA facilities and social support. Participants highlighted a lack of available guidance on maintaining PA behaviour change following CR and that advice on the frequency and intensity of exercise to follow was often unclear and confusing. Feelings of vulnerability and fear of overexertion were apparent, affecting participants self-efficacy to exercise.
Current CR programmes fail to address PA belief systems and perceptions of self-efficacy to exercise. Interventions that address feelings of vulnerability and fear of overexertion may be beneficial. Providing ongoing PA advice and access to social support may facilitate patients to maintain changes in PA.
心肌梗死 (MI) 患者通过接受并保持身体活动 (PA)，其预后得到改善，但对于即时支持（如心脏康复 (CR)）结束后患者如何保持积极的生活方式，人们知之甚少。
本研究旨在探讨 MI 幸存者对 PA 的态度和评价，以及他们对长期保持 PA 的障碍、动机和促进因素的看法。
对来自英格兰和苏格兰的 18 名成年人（平均年龄 60.5 岁，范围 37-73 岁）进行了半结构化访谈，他们在 MI 后至少 5 个月（平均 29 个月，范围 5-122 个月）。参与者中男性（n=13，72%）明显多于女性（n=5，28%）。总体而言，有 12 名（67%）参与者参加过 CR。访谈内容逐字转录，使用定性数据分析软件 NVivo 进行主题分析。
数据分析表明，以下四个核心主题影响了 MI 幸存者对 PA 的行为和态度：(1) MI 是行为改变的一个可教时刻，(2) 对 MI 的情感反应：享受与恐惧，(3) 对 MI 的认知反应：自我认知、态度和自我效能，以及 (4) 获得支持和资源，包括 PA 设施和社会支持。参与者强调，CR 后缺乏关于维持 PA 行为改变的指导，而且关于后续运动频率和强度的建议往往不明确和令人困惑。脆弱感和过度劳累的恐惧显而易见，影响了参与者的运动自我效能感。
目前的 CR 计划未能解决 PA 信念体系和对运动自我效能的看法。针对脆弱感和过度劳累恐惧的干预措施可能是有益的。提供持续的 PA 建议和获得社会支持可能有助于患者维持 PA 方面的改变。
