Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria.
Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
PLoS One. 2024 May 16;19(5):e0302226. doi: 10.1371/journal.pone.0302226. eCollection 2024.
Cardiac rehabilitation (CR) patients often do not sustain physical activity (PA) behaviour in the long run, once they progress into a self-management stage of secondary prevention. This study aimed to explore former CR patients' PA preferences, determinants (i.e., influencing factors) and motivation for sustained PA engagement. We conducted a cross-sectional multi-centre survey using an original questionnaire based on prior qualitative interviews with cardiac patients. Five CR centres in Austria posted 500 questionnaires to former CR patients who had completed CR approximately three years prior, and 117 patients (23%) responded. Descriptive analysis was used to analyse closed-ended questions, and self-determination theory (SDT) was applied as a qualitative framework to analyse open-ended questions concerning motivation for PA engagement. Patients were generally physically active, but the majority (75.3%) did not fulfil the World Health Organisation's recommendations for aerobic PA and muscle strengthening. Most patients preferred being physically active outdoors (70%), engaging in aerobic-related (95%), individual and non-competitive exercises, with cycling (52%), walking (32%) and hiking (25%) among the most popular activities. Main determinants of PA were health, pain and motivation for 80%, 68%, 67% of patients, respectively. A subset of patients (77%) expanded on their motivations behind PA. According to SDT, most reasons (90%) were regulated by autonomous motivation (either extrinsically autonomously-regulated or intrinsic motivation) and stemmed mostly from health-related goals (e.g., fitness, general health, weight control), future quality-of-life aspirations (e.g., self-sufficiency in old age, presence for loved ones, preserving mobility) and enjoyment of PA. Patients' responses underscore the importance of promoting not only general PA, but also muscle strengthening training in CR interventions to maximise optimal health benefits. Our data further suggest that interventions which are aligned to patients' health goals and foster autonomous motivation may be particularly beneficial in increasing adherence to PA in the long-term.
心脏康复 (CR) 患者在进入二级预防的自我管理阶段后,往往无法长期维持身体活动 (PA) 行为。本研究旨在探讨前 CR 患者的 PA 偏好、决定因素(即影响因素)以及维持 PA 参与的动机。我们使用基于先前对心脏患者进行的定性访谈的原始问卷,进行了一项横断面多中心调查。奥地利的 5 个 CR 中心向大约三年前完成 CR 的前 CR 患者发送了 500 份问卷,有 117 名患者(23%)做出了回应。使用描述性分析来分析封闭式问题,并应用自我决定理论 (SDT) 作为分析与 PA 参与动机相关的开放式问题的定性框架。患者的身体活动总体上较为活跃,但大多数(75.3%)人没有达到世界卫生组织推荐的有氧 PA 和肌肉强化标准。大多数患者更喜欢在户外进行身体活动(70%),进行与有氧运动相关的(95%)、个体和非竞争性的运动,其中骑自行车(52%)、散步(32%)和徒步旅行(25%)是最受欢迎的活动。PA 的主要决定因素是健康、疼痛和动机,分别占 80%、68%和 67%的患者。有一部分患者(77%)进一步阐述了他们进行 PA 的动机。根据 SDT,大多数原因(90%)是由自主动机(外在自主调节或内在动机)调节的,主要源自与健康相关的目标(如健身、总体健康、体重控制)、未来的生活质量期望(如年老时的自给自足、亲人的陪伴、保持活动能力)和对 PA 的享受。患者的回答强调了在 CR 干预中不仅要促进一般的 PA,还要促进肌肉强化训练,以最大限度地提高最佳健康效益的重要性。我们的数据进一步表明,与患者的健康目标保持一致并培养自主动机的干预措施可能特别有助于长期提高 PA 的依从性。