J Cardiovasc Nurs. 2021;36(4):E11-E19. doi: 10.1097/JCN.0000000000000810.
Increasing patient adherence to regular exercise post acute myocardial infarction (AMI) is a major goal after hospitalization. It is therefore essential to identify perceived benefits and barriers to exercise and its association with exercise self-efficacy among patients post AMI.
The purpose of this study was to identify the perceived benefits and barriers to exercise and the predictors of exercise self-efficacy among patients after AMI.
A cross-sectional study design was used with a convenience sample of 254 patients, recruited from the 3 main hospitals in Jordan. Instruments included the Exercise Benefits and Barriers Scale and the Exercise Self-Efficacy Scale. Mean scores were computed to determine the perceived benefits and barriers responses. Multiple linear regression was conducted to explore the predictors of exercise self-efficacy. Data were collected over 5 months.
The greatest perceived benefits were related to personal factors, for example, "I enjoy exercise" (2.45 [0.98]), and physical performance, for example, "My muscle tone is improved with exercise" (2.44 [0.86]) and "Exercise increases my stamina" (2.43 [0.86]). The greatest perceived barriers were related to environmental barriers, for example, "Lack of exercise places" (2.67 [0.82]), and internal factors related to physical exertion itself, for example, "Concerned about getting tired during exercise participation" (2.65 [0.72]). The Exercise Self-Efficacy Scale showed that patients post ST-elevation AMI had higher exercise self-efficacy than those with other treatment modalities (AMI, 44.71 [19.07] vs 36.59 [17.34]; P = .001). Patients treated by primary percutaneous coronary intervention had higher exercise self-efficacy, 49.2 (18.61), than patients treated by thrombolysis and percutaneous coronary intervention, 39.28 (18.3), and patients treated by medications other than thrombolytic therapy, 36.59 (17.4) (F2,251 = 11.612, P = .001). The multiple linear regression model explained approximately 29% of the variance in exercise self-efficacy (F11,242 = 7.914, P < .001). Five variables contributed significantly to the prediction of self-efficacy: type of AMI (standardized β = -0.173, t = -3.311, P = .01), perceived exercise benefits (standardized β = 0.322, t = 4.912, P = .01), perceived exercise barriers (standardized β = -0.291, t = -4.521, P = .01), being Argela smokers (water pipe smoking) (standardized β = -0.132, t = -2.617, P = .029), and cholesterol level (standardized β = -0.158, t = -2.174, P = .003).
Primary perceived benefits of exercise reported were in the areas of personal factors and improved physical performance. The main perceived barriers to exercise were in the areas of environmental factors and physical exertion. Identification of benefits and barriers to exercise, type of AMI, and treatment modalities of AMI as predictors of exercise self-efficacy is a significant step for developing appropriate interventions that effectively improve exercise self-efficacy and exercise among post-AMI patients.
提高急性心肌梗死（AMI）后患者定期锻炼的依从性是住院后的主要目标。因此，识别患者对运动的感知益处和障碍及其与 AMI 后运动自我效能的关系至关重要。
本研究旨在确定 AMI 后患者对运动的感知益处和障碍及其运动自我效能的预测因素。
采用横断面研究设计，便利抽样 254 名患者，来自约旦的 3 家主要医院。研究工具包括运动益处和障碍量表以及运动自我效能量表。计算平均得分以确定感知益处和障碍的反应。采用多元线性回归分析探索运动自我效能的预测因素。数据收集持续了 5 个月。
最大的感知益处与个人因素有关，例如“我喜欢运动”（2.45 [0.98]），与身体表现有关，例如“运动改善了我的肌肉张力”（2.44 [0.86]）和“运动增加了我的耐力”（2.43 [0.86]）。最大的感知障碍与环境障碍有关，例如“缺乏运动场所”（2.67 [0.82]），以及与体力消耗本身有关的内部因素，例如“担心在运动参与期间感到疲倦”（2.65 [0.72]）。运动自我效能量表显示，ST 段抬高 AMI 患者的运动自我效能高于其他治疗方式的患者（AMI，44.71 [19.07] vs 36.59 [17.34]；P =.001）。接受经皮冠状动脉介入治疗的患者的运动自我效能更高，为 49.2（18.61），而接受溶栓和经皮冠状动脉介入治疗的患者为 39.28（18.3），接受溶栓治疗以外的药物治疗的患者为 36.59（17.4）（F2,251 = 11.612，P =.001）。多元线性回归模型解释了运动自我效能的约 29%的方差（F11,242 = 7.914，P <.001）。五个变量对自我效能的预测有显著贡献：AMI 类型（标准化β=-0.173，t=-3.311，P =.01），感知运动益处（标准化β=0.322，t=4.912，P =.01），感知运动障碍（标准化β=-0.291，t=-4.521，P =.01），Argela 吸烟者（水烟）（标准化β=-0.132，t=-2.617，P =.029）和胆固醇水平（标准化β=-0.158，t=-2.174，P =.003）。
报告的运动的主要感知益处是在个人因素和改善身体表现方面。运动的主要感知障碍是在环境因素和体力消耗方面。识别运动的益处和障碍、AMI 类型和 AMI 的治疗方式是预测运动自我效能的重要步骤，这对于制定有效的干预措施以有效提高 AMI 后患者的运动自我效能和运动能力至关重要。
