| Summary: | 碩士 === 長榮大學 === 護理學系碩士班 === 106 === Background: Cardiovascular rehabilitation exercise greatly enhanced health promotion of patients with coronary artery disease. Patients usually do not practice cardiovascular rehabilitation exercise after discharge. However, it is lack of studies focusing on patient adherence to cardiovascular exercise and its associated factors.
Purpose: The aim of the study is to examine the influencing factors of patient adherence to a cardiovascular rehabilitation exercise after discharge.
Method: This is a cross-sectional study. The study is convenience sampling and conducted in cardiovascular outpatient department of a medical center in Southern Taiwan. Inclusion criteria included: (1) diagnosed of coronary artery disease via cardiac catherization; (2) cardiovascular rehabilitation exercise guided by rehabilitation therapist during hospitalization; (3) 20 years old; (4) consciousness clear; (5) able to communicate orally; (6) without psychiatric history and cognitive impairment. Exclusion criteria included patients who attend cardiovascular rehabilitation program at the Rehabilitation Department, patients who had received coronary artery bypass operation, and terminal cancer patients. The structured questionnaire will be used for data collection. The questionnaire includes 5 sections, exercise adherence, self-efficacy of rehabilitation exercise, social support, knowledge, and demographic data. The sample size is 100. The statistical software is SPSS version 20.0. Data analyses use t test, correlation, ANOVA test, and multiple regression model.
Results: The study results indicate that patients with no signs of fatigue and shortness of breath show better adherence to a cardiovascular rehabilitation exercise than patients with signs of fatigue and shortness of breath (t=2.44, p<.05). Patients who exercised regularly before the disease show better adherence to a cardiovascular rehabilitation exercise than patients who did not exercise regularly (t=2.53, p<.05). Patients that rate their health status as good show better adherence to a cardiovascular than patients that rate their health status as normal or bad (F=6.52, p<.01). The mentioned three variables show significant differences. Moreover, self-efficacy of rehabilitation exercise (r = .580, p < .01), support from family (r = .341, p <.01) and support from friends (r = .323, p <.01) have positive relations with patient adherence to a cardiovascular rehabilitation exercise after discharge. The analysis results of multiple regression models are shown as follows. The significant factors include self-rated health status as normal (β = .26, p<.05), higher self-efficacy of rehabilitation exercise (β = .49, p < .01) and better support from friends (β= .22, p < .01).
Conclusion: Among patients with coronary artery disease, those who exercised regularly before the disease and rated their health status as good, those with better self-efficacy of rehabilitation exercise, those with better support by family and those with better support by friends show better adherence to a cardiovascular rehabilitation exercise after discharge. The results can be used as a reference for the medical teams to improve patients' self-efficacy of rehabilitation exercise. By improving the patient adherence to a cardiovascular rehabilitation exercise after discharge, the coronary artery disease can thus be prevented and controlled.
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