Exercise Self-efficacy Improvements During Cardiac Rehabilitation: IMPACT OF SOCIAL DISPARITIES.

Area of Science:

• Cardiology
• Rehabilitation Medicine
• Behavioral Science

Background:

• Cardiac rehabilitation (CR) is crucial for patients with coronary heart disease (CHD).
• Exercise self-efficacy is a key factor influencing adherence to exercise programs.
• Understanding factors affecting exercise self-efficacy is vital for optimizing CR outcomes.

Purpose of the Study:

• To assess changes in exercise self-efficacy among patients undergoing cardiac rehabilitation.
• To identify predictors associated with improvements or declines in exercise self-efficacy during CR.

Main Methods:

• A cohort of 194 patients with CHD from four CR sites completed the Exercise Self-efficacy Scale at CR entry and completion.
• A general linear model was employed to identify independent predictors of change in exercise self-efficacy.

Main Results:

• Mean exercise self-efficacy scores significantly improved from CR entry (25.2 ± 5.8) to completion (26.2 ± 6.3) (P = .025).
• 59% of patients showed improved self-efficacy, while 34% experienced a decline.
• Predictors of reduced exercise self-efficacy included belonging to an ethnic minority, lacking a spouse/partner, and higher baseline self-efficacy.

Conclusions:

• Exercise self-efficacy generally increases during CR, but not universally.
• Ethnic minorities and single patients are at higher risk for poorer self-efficacy gains and may require targeted interventions.
• Screening exercise self-efficacy at CR entry and completion is recommended; further research into CR delivery modes is warranted.