从需求到行动：解读动机在慢性心力衰竭患者坚持家庭心脏康复运动中的作用
From need to action: decoding the role of motivation in adherence to home-based cardiac rehabilitation exercise in chronic heart failure patients.
作者信息
Yang Zhen, Huang Hao, Xu Linyu, Gao Yu, Zhang Chunqi, Wang Aiping
机构信息
The First Affiliated Hospital of China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, Liaoning Province, China.
West China Hospital, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan Province, China.
出版信息
BMC Nurs. 2024 Dec 18;23(1):913. doi: 10.1186/s12912-024-02617-1.
BACKGROUND
Adherence to home-based cardiac rehabilitation exercise remains suboptimal, and motivation may be the intrinsic driving force. This study aimed to explore the role of exercise regulatory motivation in mediating the relationship between psychological needs and exercise adherence among chronic heart failure patients, and to develop a mechanism model.
METHODS
This study adopted an explanatory sequential mixed-methods design. A hypothesized model of adherence behavior was developed. A survey was used to test the theory-driven model. A semi-structured interview delved deeper into chronic heart failure patients' experiences with HBCR exercise, identifying reasons behind significant mediation effects and refining the mechanism model.
RESULTS
A total of 248 eligible chronic heart failure patients participated in the quantitative study. Exercise regulatory motivation partially mediated the relationship between psychological needs and exercise adherence. In the qualitative study, 18 chronic heart failure patients from the quantitative sample were purposefully selected. Five sub-themes emerged from the textual data, which were distilled into two overarching themes: "Specific Functions of Pathway Variables" and "Reasons for Mediation Path Significance." Integrating the qualitative and quantitative results, it was found that satisfying patients' psychological needs for exercise activates regulatory motivation, which in turn triggers sustained exercise behavior. As motivation becomes increasingly internalized, patients are able to set clear goals and maintain or adjust their home-based cardiac rehabilitation exercise over the long term.
CONCLUSION
From a health psychology perspective, this study is the first to reveal the role of exercise regulatory motivation in linking psychological needs and exercise adherence among chronic heart failure patients, ultimately developing a mechanism model.
CLINICAL TRIAL NUMBER
Not applicable.
背景
家庭心脏康复运动的依从性仍然不理想，而动机可能是内在驱动力。本研究旨在探讨运动调节动机在慢性心力衰竭患者心理需求与运动依从性之间关系的中介作用，并构建一个机制模型。
方法
本研究采用解释性序列混合方法设计。构建了一个依从行为的假设模型。通过一项调查来检验理论驱动模型。一项半结构化访谈更深入地探究了慢性心力衰竭患者进行家庭心脏康复运动的经历，确定显著中介效应背后的原因并完善机制模型。
结果
共有248名符合条件的慢性心力衰竭患者参与了定量研究。运动调节动机部分中介了心理需求与运动依从性之间的关系。在定性研究中，从定量样本中有目的地选取了18名慢性心力衰竭患者。文本数据中出现了五个子主题，这些子主题被提炼为两个总体主题：“路径变量的特定功能”和“中介路径意义的原因”。综合定性和定量结果发现，满足患者对运动的心理需求会激活调节动机，进而引发持续的运动行为。随着动机越来越内化，患者能够设定明确的目标，并长期维持或调整其家庭心脏康复运动。
结论
从健康心理学角度来看，本研究首次揭示了运动调节动机在慢性心力衰竭患者心理需求与运动依从性之间的联系中的作用，最终构建了一个机制模型。
临床试验编号
不适用。
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