Effects of Exercise test Information on Self-Efficacy and Anxiety in Patients with Myocardial Infarction

Abstract

The primary purpose of this study was to examine the effects of preparatory information regarding the cycle ergometer exercise tolerance test on self-efficacy and anxiety of patients following a myocardial infarction (MI). The study also examined the effect self-efficacy on exercise test performance. A secondary purpose of the study was to investigate the effects of preparatory information and coping style on anxiety associated with the exercise test. Male cardiac patients ( N =30) ages 40-66 years (X=55 yrs.) who had documented MI based on at least two of the following: 1. a significant increase in cardiac enzyme levels 2. ECG diagnostic of HI or 3. chest pain and who were referred for a maximum performance exercise tolerance test two to six weeks post-infarction (X=4 weeks) were eligible for the study. Exclusion criteria consisted of unstable angina and/or uncontrolled dysrhythmias. All patients completed three self-report psychological questionnaires upon arrival at the laboratory: the A-state and A-trait portions of the Spielberger State-Trait Anxiety Inventory (STAI), the Miller Behavioral Style Scale (MBSS) and the physical self-efficacy assessment. Based on their pre-intervention cycling self-efficacy scores, patients were then randomly assigned to the experimental or control conditions. The experimental videotape included detailed procedural and sensory information about the exercise tolerance test as it was being performed by a cardiac patient. The control videotape included information about nutrition as it relates to coronary heart disease. Subsequent to viewing either the experimental or control videotapes, the A-state portion of the STAI and the self-efficacy assessment were re-administered. Patients then performed the exercise tolerance test on the cycle ergometer. Cycling self-efficacy of patients in the experimental condition (preparatory information) decreased whereas the cycling self-efficacy of patients in the control condition increased minimally resulting in a significant difference in self-efficacy between the two intervention groups ( p <.04). Anxiety of patients in the experimental intervention increased while there was virtually no change in anxiety in patients in the control condition ( p <.01). Patients with high pre-intervention cycling self-efficacy achieved higher mean maximum power output ( p <.001) than patients with low pre-intervention cycling self-efficacy. No interactions were found between coping style and preparatory information on the relative change in state anxiety. Anxiety in patients in the experimental group increased whereas anxiety in patients in the control group remained virtually unchanged, regardless of coping style ( p <.01). The data suggest that there is no basis for providing preparatory information regarding the exercise tolerance test to increase self-efficacy and to lower anxiety. The results indicate that self-efficacy is important in predicting exercise test performance. Preparatory information about the exercise tolerance test appears to increase anxiety regardless of coping style.