Candelaria Dion, Kirkness Ann, Bruntsch Christine, Gullick Janice, Randall Sue, Ladak Laila Akbar, Gallagher Robyn
Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia (Mr Candelaria and Drs Gullick, Randall, Ladak, and Gallagher); Charles Perkins Centre, The University of Sydney, Sydney, Australia (Mr Candelaria and Dr Gallagher); Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, Australia (Mss Kirkness and Bruntsch); and The Aga Khan University, Karachi, Pakistan (Dr Ladak).
J Cardiopulm Rehabil Prev. 2023 May 1;43(3):179-185. doi: 10.1097/HCR.0000000000000742. Epub 2022 Nov 14.
The objective of this study was to determine exercise self-efficacy improvements during cardiac rehabilitation (CR) and identify predictors of exercise self-efficacy change in CR participants.
Patients with coronary heart disease at four metropolitan CR sites completed the Exercise Self-efficacy Scale at entry and completion. A general linear model identified independent predictors of change in exercise self-efficacy.
The mean age of patients (n = 194) was 65.9 ± 10.5 yr, and 81% were males. The majority (80%) were married or partnered, 76% were White, and 24% were from an ethnic minority background. Patients received CR in-person (n = 91, 47%) or remote-delivered (n = 103, 54%). Exercise self-efficacy mean scores improved significantly from 25.2 ± 5.8 at CR entry to 26.2 ± 6.3 points at completion ( P = .025). The majority of patients (59%) improved their self-efficacy scores, 34% worsened, and 7% had no change. Predictors of reduced exercise self-efficacy change were being from an ethnic minority (B =-2.96), not having a spouse/partner (B =-2.42), attending in-person CR (B =1.75), and having higher exercise self-efficacy at entry (B =-0.37) (adjusted R2 = 0.247).
Confidence for self-directed exercise improves in most, but not all, patients during CR. Those at risk for poor improvement (ethnic minorities, single patients) may need extra or tailored support, and screening for exercise self-efficacy at CR entry and completion is recommended. Differences identified from CR delivery mode need exploration using robust methods to account for complex factors.
本研究的目的是确定心脏康复（CR）期间运动自我效能的改善情况，并识别CR参与者运动自我效能变化的预测因素。
四个大城市CR站点的冠心病患者在入组时和结束时完成运动自我效能量表。一个一般线性模型确定了运动自我效能变化的独立预测因素。
患者（n = 194）的平均年龄为65.9±10.5岁，81%为男性。大多数（80%）已婚或有伴侣，76%为白人，24%来自少数民族背景。患者接受面对面CR（n = 91，47%）或远程CR（n = 103，54%）。运动自我效能平均得分从CR入组时的25.2±5.8显著提高到结束时的26.2±6.3分（P = 0.025）。大多数患者（59%）提高了自我效能得分，34%恶化，7%无变化。运动自我效能变化降低的预测因素包括来自少数民族（B = -2.96）、没有配偶/伴侣（B = -2.42）、参加面对面CR（B = 1.75）以及入组时运动自我效能较高（B = -0.37）（调整后R2 = 0.247）。
在CR期间，大多数但并非所有患者的自主运动信心都有所提高。改善不佳风险较高的人群（少数民族、单身患者）可能需要额外或量身定制的支持，建议在CR入组时和结束时筛查运动自我效能。需要使用稳健的方法探索CR实施方式的差异，以考虑复杂因素。
