As an adjunct to conventional medical and surgical treatment after an acute cardiovascular event, lifestyle exercise is optimally maintained after the patient finishes his/her cardiac rehabilitation program. There is, however, little empirical evidence of the behavioral benefits of lifestyle exercise adherence following the completion of a cardiac rehabilitation program. Thus, the purpose of this secondary analysis study is to identify the effect of lifestyle exercise on health beliefs regarding the benefits of and barriers to exercise, self-efficacy, and patients’ depressed mood in the year following the completion of a cardiac rehabilitation program.
This secondary analysis study consisted of a descriptive correlational, longitudinal design using the Pender Model of Health Promotion (Pender, 1996) as a conceptual framework to guide the selection of variables. The sample consisted of 203 patients (125 men, 78 women) who had a recent cardiac event. Data were collected using interviews near the end of CRP and 12 months following the completion of CRP. Standardized instruments were used to measure self-efficacy, depressed mood, and health beliefs. In the current study, lifestyle exercise consisted of the number of months in which participants continued to exercise after completion of the CRP (exercise maintenance), the number of hours exercised over 12 months (exercise amount), and the number of hours exercised in month 12 (amount of exercise in Month 12).
Results revealed that when controlling for the covariates of education, age, marital status, race and gender, only amount of exercise at Month 12 was a predictor of perceived benefits of and barriers to exercise at 12 months. None of the three lifestyle exercise dimensions were found to be a predictor of depressed mood. All three lifestyle exercise variables were predictors of adherence self-efficacy and barriers self-efficacy at 12 months. Gender was a significant moderator of the relationship between exercise amount and both adherence self-efficacy to exercise and the barriers self-efficacy to exercise. Similarly, gender was a significant moderator of the relationship between amount of exercise at Month 12 and both adherence self-efficacy to exercise and the barriers self-efficacy to exercise. Race was a significant moderator of the relationship between exercise amount and adherence self-efficacy to exercise. Similarly, race was a significant moderator of the relationship between amount of exercise at Month 12 and barriers self-efficacy to exercise.
Since exercise maintenance and exercise amount did not predict perceived benefits to and berries of exercise in this study and given the recent findings of the meta-analysis of Conn and colleagues (2002), nurses should not assume that exercise behavior is a predictor of health beliefs. Findings of this study revealed that lifestyle exercise does not predict depressed mood, which is inconsistent with previous studies findings. Nurses should not assume that exercise behavior is not a predictor of depressed mood. Despite the current study findings regarding depressed mood and given the findings of many studies nurses should keep monitoring the depressed mood level before, during, and after exercise to be able to capture and therefor intervene when needed.