Managing lapses in cardiac rehabilitation exercise therapy: examination of the problem-solving process

Poor adherence to cardiac rehabilitation (CR) exercise therapy is an ongoing problem. Problem-solving (PS) is an identified cognitive-behavioral strategy to promote exercise adherence. However, PS process has not been examined, and how PS promotes adherence is not known. Using Social Cognitive Theory and Ewart's Social Problem-Solving Model as guiding frameworks, we examined proposed theoretical links between persistence, an indicator of adherence, and (a) PS effectiveness and (b) self-regulatory efficacy. Based on the Model of Social Problem-Solving, 2 distinct components of the PS process (problem-solving and solution implementation), were examined.

Older adult participants (N = 52; 32 men) representing a typical CR sample (mean age = 65.6 years; SD = 10.8) participated in this correlational, observational study.

Two hierarchical multiple regressions indicated that PS effectiveness and self-regulatory efficacy were significant predictors of anticipated persistence. Relative to PS process, both predictors accounted for: (a) 41% of the variance in anticipated persistence with PS; and (b) 49% of the variance in anticipated persistence with solution implementation.

Proposed theoretical relationships were supported, and both PS effectiveness and self-regulatory efficacy accounted for a greater amount of the variance in anticipated persistence than either alone. Future efforts to improve adherence to rehabilitative exercise could include the use of PS. The 2 distinct components of the PS process may be important for successful adjustment to problems.