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Understanding cardiac outpatients’ experience of starting and maintaining physical activity
Author
Lew, Henry Yuen Foong
Supervisor
Tan, Soo Yin
Abstract
Cardiovascular diseases (CVD) contribute to about 32% of all death in Singapore in 2008 and mental health co-morbidities like depression (Singapore Heart Foundation [SHF], 2008; Kirsi, Arja & Hannele, 2007). Although cardiac outpatient rehabilitation exercise programs demonstrated effectiveness in improving mental and physical health, participation rates are low (Kirsi et al., 2007). Furthermore little is known about how psychological counselling interventions like Cognitive-Behavioural Therapy (CBT) and group therapy could be tailored to include psychosocial variables to improve participation in cardiac rehabilitation exercise programs (Bennett & Boothby, 2007). Hence the purpose of this study is to understand the experience of cardiac outpatients when they exercise and to explore what helped them to start and what helped them to maintain their physical activity. This is so that counselling interventions can be better informed to increase participation of cardiac outpatients in rehabilitation programs.
Using Concurrent Nested Design, the main qualitative research used Interpretative Phenomenology Analysis (IPA) to understand the exercise experience of six cardiac outpatient participants in starting and maintaining physical activities through semi-structured interviews. The complementary quantitative research of the Concurrent Nested Design used a quantitative exploratory research to shed light on trends and distributions of 30 cardiac outpatient respondents’ exercise behaviours through a questionnaire. Participants highlighted that there were two sets of different factors that helped them to start and maintained their exercise. Anticipated health benefits and assistance from healthcare professionals and family members, helped participants to gain confidence to exercise, overcome initial difficulties of exercises and initiate exercise. Actual benefits of exercise and assistance from peers, helped participants to gain confidence to manage recurring difficulties from exercise, view heart disease as more manageable and assisted them to continue to exercise.
Quantitative exploratory research highlighted that respondents generally expected exercise to benefit their health, were relatively confident to perform exercise tasks and overcome difficulties faced when they exercised, had a good amount of social support to exercise and viewed their illness as chronic and within their control.
These findings helped to suggest possible factors and processes that facilitated cardiac outpatients’ self management of heart disease via exercise. Exercise task efficacy, outcome expectations, social support from healthcare professionals and family, and exercise self regulatory efficacy for initial difficulties of exercise, were suggested to be possible factors in exercise initiation. While benefits of exercise, illness perception, social support from peers and exercise self regulatory efficacy for recurring difficulties of exercise, were suggested to be possible factors in exercise maintenance. As such this study highlighted specific areas for clinicians to target in counselling to promote initiation and maintenance of regular exercise and provided support to the psychosocial variables in Social Cognitive Theory (SCT). It also emphasized the complementary roles played by different parties and the need to work collaboratively with respective parties to promote exercise in cardiac outpatients.
Using Concurrent Nested Design, the main qualitative research used Interpretative Phenomenology Analysis (IPA) to understand the exercise experience of six cardiac outpatient participants in starting and maintaining physical activities through semi-structured interviews. The complementary quantitative research of the Concurrent Nested Design used a quantitative exploratory research to shed light on trends and distributions of 30 cardiac outpatient respondents’ exercise behaviours through a questionnaire. Participants highlighted that there were two sets of different factors that helped them to start and maintained their exercise. Anticipated health benefits and assistance from healthcare professionals and family members, helped participants to gain confidence to exercise, overcome initial difficulties of exercises and initiate exercise. Actual benefits of exercise and assistance from peers, helped participants to gain confidence to manage recurring difficulties from exercise, view heart disease as more manageable and assisted them to continue to exercise.
Quantitative exploratory research highlighted that respondents generally expected exercise to benefit their health, were relatively confident to perform exercise tasks and overcome difficulties faced when they exercised, had a good amount of social support to exercise and viewed their illness as chronic and within their control.
These findings helped to suggest possible factors and processes that facilitated cardiac outpatients’ self management of heart disease via exercise. Exercise task efficacy, outcome expectations, social support from healthcare professionals and family, and exercise self regulatory efficacy for initial difficulties of exercise, were suggested to be possible factors in exercise initiation. While benefits of exercise, illness perception, social support from peers and exercise self regulatory efficacy for recurring difficulties of exercise, were suggested to be possible factors in exercise maintenance. As such this study highlighted specific areas for clinicians to target in counselling to promote initiation and maintenance of regular exercise and provided support to the psychosocial variables in Social Cognitive Theory (SCT). It also emphasized the complementary roles played by different parties and the need to work collaboratively with respective parties to promote exercise in cardiac outpatients.
Date Issued
2010
Call Number
RC684.E9 Lew
Date Submitted
2010