The Effects of Self-Efficacy Promoting Cardiac Rehabilitation Program on Self- Efficacy, Health Behavior, and Quality of Life

  • Song, Kyung Ja (Nursing Service Department Seoul National University Hospital)
  • Published : 2003.06.01

Abstract

Background. Ischemic heart disease results from athesclerotic changes of the coronary artery. These changes are aggravated by hypercholesterolemia, smoking, obesity, lack of exercise, coronary-prone personality, and stress. Because these risk factors affect not only the prevalence of the ischemic heart disease but also recurrence of the disease, cardiac rehabilitation programs were introduced to help patients with ischemic heart disease reduce risk factors. Diverse cardiac rehabilitation programs are needed to motivate participation in cardiac rehabilitation and to enhance patients' quality of life. Objectives. To examine the effect of a self-efficacy promoting cardiac rehabiltation program on self-efficacy, health behavior and quality of life of patients with ischemic heart disease. Methods. Data were collected from 45 hospitalized ischemic heart disease patients. Medical records were reviewed to obtain demographic and clinical characteristics. Data regarding self-efficacy, health behavior, and quality of life were obtained from interviews using structured questionnaires. The nonequivalent control group non-synchronized design was used to conduct this study. One session of conventional group education was given to patients in the control group while they were in the hospital. Patients in the experimental group participated in a newly developed cardiac rehabilitation program. It focused on strengthening self-efficacy with four self-efficacy sources-performance accomplishment, vicarious experiences, verbal persuasion and physical status using two individualized in-hospital education sessions and four weekly telephone counseling follow-up calls after discharge. Results. Four weeks after discharge, the increment of total self-efficacy score was significantly higher in the experimental group than in the control group (p<.0l). There was also a significant difference in the total quality of life scores increments between the two groups (p<.0l). However, no significant changes were noted in the increments of total health behavior scores between the two groups. Conclusion. A cardiac rehabilitation program focusing on promoting self-efficacy was effective in improving self-efficacy, and quality of life of patients with ischemic heart disease.

References

  1. Bandura, A. (1986). Socialfoundations of Thoughts and Action: A Social Cognitive Theory. NJ:Prentice-Hall
  2. Baxendale, N. M. (1992). Pathophysiology of Coronary Artery Disease. Nursing Clinics of North America.27(1), 143-151
  3. Becker, D. M., Levine, D. M. (1987). Risk Perception, Knowledge, and Lifestyles in Siblings of People with Premature Coronary Disease. American Journal of Preventive Medicine. 3(1), 45-50
  4. Bittner, V., Sanderson, B., Taylor, H. J., Green, D. (1997). Referral patterns to a university-based cardiac rehabilitation program: How well we following AHCPR guideline? Canadian Journal of Cardiology. 13(suppl. B), 188B
  5. Cho, H. S. (1999). The effect of Cardiac rehabilitation program for the ischemicheart disease patients. Doctoral thesis, Kyunghee University, Seoul, Korea
  6. Choo, J, A. (1997). The effects of aerobic exerciseprogramon the patients with acute myocardial infarction. Master thesis, Seoul National University, Seoul, Korea
  7. Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences. 2th edition, Lawrence Erlbaum associates, Publishers, Hillsdale, New Jersey, Hove and London
  8. Cornett, S., Watson, J. E. (1984). Cardiac Rehabilitation: An Interdisciplinary Team Approach. New York, John Wiley & Sons
  9. Flapan, A.D. (1994). Management of patients after their first myocardial infarction. British Medical Journal, 309, 1129-1134
  10. Franklin, B. A., Hall, L., & Timmis, G. C. (1997). Contemporary Cardiac Rehabilitation Services. American Journal of Cardiology, 79, 1075-1077 https://doi.org/10.1016/S0002-9149(97)00050-7
  11. Gillis, A. J. (1992). Determinants of a Health0promoting Lifestyle: An Integrated Review. Journal of Advanced Nursing, 18, 345-353 https://doi.org/10.1046/j.1365-2648.1993.18030345.x
  12. Gillis, C. L., Gortner, S. R., Hauck, W. W., & Shinn, J. A., Sparacino, P. A., & Tompkins, C. (1993). A Randomized Clinical Trials of Nursing Care for Recovery from Cardiac Surgery. Heart& Lung, 22(2), 125-133
  13. Gordon, N. F., Haskell, W. L. (1997). Comprehensive cardiovascular disease risk reduction In a cardiac rehabilitation setting. American Journal of Cardiology. 80(8B), 69H-73H https://doi.org/10.1016/S0002-9149(97)00825-4
  14. Gortner, S. R., Jenkins, L. S. (1990). Self-efficacy and Activity Level Following Cardiac Surgery. Journal of Advanced Nursing, 15, 1132-1138 https://doi.org/10.1111/j.1365-2648.1990.tb01704.x
  15. Grundy, S. M., Pasternak, R., Greenland, P., Smith, S., & Fuster, V. (1999). Assessment of cardiovascular Risk bu Use of Multiple-Risk-Factor'assessment Equation A Statement for Health care Professionals From the American Heart Association and the American College of Cardiology. Circulation, 100, 1482-1492
  16. Gulanick, M. (Gulanick, M. (1991). Is Phase 3 Cardiac Rehabilitation Necessary for Early Recovery of Patients with Cardiac Disease? A Randomized, Controlled study, Heart & Lung, 20, 9-15 ). Is Phase 3 Cardiac Rehabilitation Necessary for Early Recovery of Patients with Cardiac Disease? A Randomized, Controlled study, Heart & Lung, 20, 9-15
  17. Han, A. K. (1998). The effects of family involved patient education program on family support behavior and self-care performance-Among patients with coronary heart disease. Doctoral thesis, Yonsei University, Seoul, Korea
  18. Hong, K. H. (1996). Anxiety, health behavior and quality of life depending on the participation of the cardiac rehabilitation program. Master thesis, Kyunghee University, Seoul, Korea
  19. Kim, J. J. (1994). The effects of self-support group activity and aquarobic exercise program using self-efficacy enhancement on pain, physiologic index, and quality of life of the patients with rheumatoid arthritis. Doctoral thesis, Seoul National University, Seoul, Korea
  20. King, K. M., Teo, K. K. (1998). Cardiac rehabilitation referral & Attendance: Not one and the same. Rehabilitation Nursing. 23(5), 246-251
  21. Kinney, M. R., Packer, D. R., Dunbar, S. B. (1988). AACN's Clinical Reference for Critical-Care Nursing, Second edition. McGraw-HillBook Company
  22. Lee, Y. W. (1994). Effects of efficacy expectation improving program on self-efficacy and self care activity. Doctoral thesis, Yonsei University, Seoul, Korea
  23. Maeland, J., Havik, O. (1987). The effects of an in-hospital educational program for Marshall, J., Penckofer, S., Llewellyn, J. (1986). Structured postoperative teaching knowledge and compliance of patients who had coronary artery bypass surgery. Heart & Lung. 15, 76-82
  24. McAuley, E. (1992). The Role of Efficacy Recognition in the Prediction of Exercise Behavior in Middle-aged Adults. Journal of Behavioral Medicine, 5(1), 65-88
  25. McGirr, M., Rukholm, E., Salmoni, A., O'Sullivan, P., & Koren, J. (1990). Perceived Mood and Exercise Behaviors of Cardiac Rehabilitation Program Referrals. Canadian Journal of Cardiovascular Nursing, 1(4), 14-19
  26. Oh, B. J. (1994). Health promotion activity and quality of life prediction model among the patients with stomach cancer. Doctoral thesis, Seoul National University, Seoul, Korea
  27. Oldridge, N. B., Guyatt, G.H., Fischer, M., Rimm, A. (1988). Cardiac Rehabilitation after Myocardial Infarction: Combining data from Randomized Clinical Trials. Journal of American Medical Association, 260, 945-980 https://doi.org/10.1001/jama.260.7.945
  28. Oldridge, N. B., Rogowski, B. L. (1990). Self-efficacyand In-patient/cardiac Rehabilitation. American Journal of Cardiology, 66, 362-365 https://doi.org/10.1016/0002-9149(90)90850-Z
  29. Park, Y. I. (1994). The effect of self-control program for the improvement of the self care of the patients with essential hypertension. Doctoral thesis, Seoul National University, Seoul, Korea
  30. Pearson, T. A., Fuster, V. (1996). 27th Bethesda Conference. Executive Summary. Journal of American College of Cardiology, 21, 961-963
  31. Perkins, S., Jenkins, L. S. (1998). Self-efficacy Expectation, Behavior Performance, and Mood Status in Early Recovery from Percutaneoous Transluminal Coronary Angioplasty. Heart& Lung,27(1), 37-46 https://doi.org/10.1016/S0147-9563(98)90067-X
  32. Ruzicki, D. (1989). Realistically meeting the educational needs of hospitalized acute and short-stay patients. Nursing Clinic North America. 24, 629-236
  33. Shin, J. Y. (1999). The effect of self-efficacy data information program on perceived self-efficacy and self-care of the patients with coronary heart disease. Master thesis, Korea University, Seoul, Korea
  34. Shinn, H. C., Shim, J. Y., Lee, J, K., Kim, S. Y., Won, J, W., Sunwoo, S., & Park, H., K. (1999). Development of the Korean Health related Quality of Life Measuring Instrument-From the symptom sampling to pretest. Journal of Korean academy of Familial Medicine, 20(10), 1197-1208
  35. Song, M. R. (1999). The development and effects of the self-efficacy promoting program for the self care of the hemodialysis patients. Doctoral thesis, Seoul National University, Seoul, Korea