SOCIAL EFFICACY BELIEFS AND EXERCISE BEHAVIOUR IN CARDIAC REHABILITATION

Abstract

<p>Participation in exercise-based cardiac rehabilitation is a fundamental component for recovery and secondary prevention efforts following a cardiac event (Smith et aI., 2006). However, despite the known benefits of regular exercise for cardiac patients (Jolliffe et aI., 2001) and the ever-increasing availability of cardiac rehabilitation and related programs, individuals affected by cardiovascular disease continue to demonstrate poor attendance and follow-up adherence to exercise programming; this is particularly true for female participants (Daly et aI., 2002; Halm et al., 1999, Woodgate & Brawley, 2008). Previous research has shown self-efficacy to be a reliable and strong predictor of exercise adherence in both the general and cardiac rehabilitation populations. Using social cognitive theory (Bandura, 1986, 1997,2001), the present study investigated several socially-mediated perceptions that were theorized to predict self-efficacy, and in tum, its relationship to adherence to cardiac rehabilitation programming. In particular, this study was designed to investigate proxy efficacy and a newly- proposed socially-mediated efficacy construct (instructor support efficacy) and the relations between those variables, self-efficacy and exercise adherence within the cardiac rehabilitation setting. It was hypothesized that proxy efficacy for self-regulation and instructor support efficacy measured during the third week of cardiac rehabilitation would independently predict self-efficacy for self-regulation at week 9 of cardiac rehabilitation. It was also hypothesized that instructor support efficacy at week 3 of cardiac rehabilitation would be a stronger predictor of self-efficacy for self-regulation at week 9 of cardiac rehabilitation among women compared to men. Lastly, the study aimed to investigate proxy efficacy, instructor support efficacy and self-efficacy as predictors of exercise class attendance and adherence during participation in the cardiac rehabilitation program. Sixty cardiac rehabilitation participants (of which approximately 73% were male) who were enrolled in a hospital-based cardiac rehabilitation program completed assessments for self-efficacy for self-regulation, proxy efficacy for selfregulation, proxy efficacy for in-class exercise and instructor support efficacy at weeks 3 and 9 of program participation. Exercise attendance and exercise prescription adherence records were collected (at week 15 of program participation) using attendance records and exercise logbooks from the cardiac rehabilitation centre. In general, scores for all variables of interest were relatively high. Consistent with the first hypothesis, proxy efficacy for self-regulation and instructor support efficacy measured during the third week of cardiac rehabilitation independently predicted self-efficacy for self-regulation at week 9 of participation in the cardiac rehabilitation program. However, contrary to the hypotheses, when sex was investigated as a moderator of the instructor support efficacy - self-efficacy relationship, instructor support efficacy at week 3 did not predict self-efficacy for self-regulation at week 9 for either women or men. Finally, self-efficacy for self-regulation and proxy efficacy for in-class exercise independently predicted exercise class attendance between weeks 3-9, but no other significant predictors were found for exercise class attendance or program adherence throughout the remainder of the program. The findings from the present study provide a promising starting point in the development and assessment of instructor Support efficacy within the cardiac rehabiliation population.</p>