Health, Medical, and Neuropsychology Unit, Leiden University, the Netherlands.
Department of Methodology and Statistics, Tilburg University, the Netherlands.
Heart Lung. 2025 Jan-Feb;69:31-39. doi: 10.1016/j.hrtlng.2024.09.008. Epub 2024 Sep 17.
To improve lifestyle guidance within cardiac rehabilitation (CR), a comprehensive understanding of the motivation and lifestyle-supporting needs of patients with cardiovascular disease (CVD) is required.
This study's purpose is to evaluate patients' lifestyle and their motivation, self-efficacy and social support for change when starting CR.
1782 CVD patients (69 % male, mean age 62 years) from 7 Dutch outpatient CR centers participated between 2020 and 2022. Modifiable risk factors were assessed with a survey and interviews by healthcare professionals during CR intake.
Most patients exhibited an elevated risk in 3-4 domains. Elevated risks were most prominent in domains of (1) waist circumference and BMI (2) physical exercise (3) healthy foods intake and (4) sleep duration. Most patients chose to focus on increasing physical exercise, but about 20 % also wanted to focus on a healthy diet and/or decrease stress levels. Generally, motivation, self-efficacy and social support to reach new lifestyle goals were high. However, patients with an unfavorable risk profile had lower motivation and self-efficacy to work on lifestyle changes, while patients with lower social support had a higher chance to quit the program prematurely.
Our results underscore the need to begin CR with a comprehensive lifestyle assessment and highlight the importance of offering lifestyle interventions tailored to patients' specific modifiable risk factors and lifestyle-supporting needs, targeting multiple lifestyle domains. Expanding the current scope of CR programs to address diverse patient needs and strengthening support may enhance motivation and adherence and lead to significant long-term benefits for cardiovascular health.
Netherlands Trial Register; registration number NL8443.
为了改善心脏康复（CR）中的生活方式指导，需要全面了解心血管疾病（CVD）患者的动机和支持生活方式的需求。
本研究旨在评估患者在开始 CR 时的生活方式以及改变的动机、自我效能和社会支持。
2020 年至 2022 年期间，来自 7 家荷兰门诊 CR 中心的 1782 名 CVD 患者（69%为男性，平均年龄 62 岁）参与了该研究。在 CR 摄入期间，医疗保健专业人员通过调查和访谈评估可改变的风险因素。
大多数患者在 3-4 个领域存在升高的风险。升高的风险在以下领域最为突出：（1）腰围和 BMI；（2）身体活动；（3）健康食物摄入；（4）睡眠时间。大多数患者选择专注于增加身体活动，但约 20%的患者还希望专注于健康饮食和/或降低压力水平。总体而言，达到新的生活方式目标的动机、自我效能和社会支持很高。然而，风险状况不利的患者改变生活方式的动机和自我效能较低，而社会支持较低的患者提前退出计划的可能性较高。
我们的研究结果强调了在开始 CR 时需要进行全面的生活方式评估，并强调了提供针对患者特定可改变风险因素和支持生活方式需求的生活方式干预措施的重要性，针对多个生活方式领域。扩大当前 CR 计划的范围以满足不同患者的需求并加强支持，可能会提高动机和依从性，并为心血管健康带来显著的长期益处。
荷兰试验注册处；注册号 NL8443。
