Predictors of Exercise Maintenance 6 Months After Comprehensive Cardiac Rehabilitation.

PURPOSE: The objectives of this study were (1) to assess the effects of a comprehensive education intervention on maintenance of knowledge, exercise behavior, heart-healthy food intake, self-efficacy, and health literacy 6 mo after comprehensive cardiac rehabilitation (CR), and (2) to identify predictors of exercise maintenance 6 mo after comprehensive CR. METHODS: A prospective longitudinal study was conducted to test the effects of a structured educational curriculum in three CR programs in Canada. Participants completed surveys pre-, post-CR and 6 mo post-discharge to assess knowledge, heart-healthy food intake, self-efficacy, and health literacy. Exercise behavior was measured by number of steps/d using a pedometer. RESULTS: One hundred twenty participants completed the final survey. Increases in disease-related knowledge and self-efficacy, as well as behavior changes (increases in exercise and heart-healthy food intake), were achieved in comprehensive CR and sustained 6 mo post-program. Exercise maintenance was predicted by changes in heart-healthy food intake, self-efficacy, health literacy, and exercise-related knowledge. CONCLUSIONS: In this three-site study focusing on patient education for CR patients in Canada, the benefits of an education intervention in maintaining knowledge, exercise, healthy food intake, and self-efficacy were supported.

Effectiveness of an Education Intervention Among Cardiac Rehabilitation Patients in Canada: A Multi-Site Study.

BACKGROUND: Although patient education is considered a core component of cardiac rehabilitation (CR) programs, to our knowledge, no educational program designed for CR has been standardized in Canada. This absence of standardization may be due to a lack of reliable resources to educate these patients. The objective of this study was to assess the effectiveness of an education intervention in improving knowledge and health behaviours among CR patients in 3 sites in Canada. METHODS: CR patients were exposed to an evidence- and theoretically based comprehensive education intervention. Patients completed surveys assessing knowledge, physical activity, food intake, self-efficacy, and health literacy. All outcomes were assessed pre- and post-CR. Paired t tests were used to investigate variable changes between pre- and post-CR, Pearson correlation coefficients were used to determine the association between knowledge and behaviours, and linear regression models were computed to investigate differences in overall post-CR knowledge based on participant characteristics. RESULTS: A total of 252 patients consented to participate, of whom 158 (63.0%) completed post-CR assessments. There was a significant improvement in patients' overall knowledge pre- to post-CR, as well as in exercise, food intake, and self-efficacy (P < 0.05). Results showed a significant positive correlation between post-CR knowledge and food intake (r = 0.203; P = 0.01), self-efficacy (r = 0.201; P = 0.01), and health literacy (r = 0.241; P = 0.002). Education level (unstandardized beta = -2.511; P = 0.04) and pre-CR knowledge (unstandardized beta = 0.433; P < 0.001) were influential in changing post-CR knowledge. CONCLUSION: In this first-ever multi-site study focusing on patient education for CR patients in Canada, the benefits of an education intervention have been supported.

CONTEXTE: Bien que l'éducation du patient soit considérée comme un élément essentiel des programmes de réadaptation cardiaque (RC), il n'existe, à notre connaissance, aucun programme éducatif standardisé en RC au Canada. Cette absence de standardisation peut être attribuable à un manque de ressources fiables en matière d'éducation des patients. Cette étude visait à évaluer l'efficacité réelle d'une intervention éducative au regard de l'amélioration des connaissances et des comportements touchant la santé chez des patients en RC dans trois établissements au Canada. MÉTHODOLOGIE: Une intervention éducative globale fondée sur des données probantes et théoriques a été menée auprès de patients en RC. Les patients ont répondu à des questionnaires d'évaluation des connaissances, de l'activité physique, de l'apport alimentaire, de l'autoefficacité et de la littératie en matière de santé. Tous les résultats ont été évalués avant et après la RC. Des tests t pour échantillons appariés ont été utilisés pour étudier les changements touchant les variables évaluées avant et après la RC, des coefficients de corrélation de Pearson ont servi à déterminer l'association entre les connaissances et les comportements, et des modèles de régression linéaire ont été calculés pour étudier les différences dans les connaissances globales après la RC en fonction des caractéristiques des participants. RÉSULTATS: Au total, 252 patients ont accepté de participer; de ce nombre, 158 (63,0 %) ont pris part aux évaluations postérieures à la RC. Les connaissances globales des patients se sont améliorées de façon significative d'avant à après la RC, tout comme l'activité physique, l'apport alimentaire et l'autoefficacité (p < 0,05). Les résultats ont montré une corrélation positive significative entre les connaissances et l'apport alimentaire (r = 0,203; p = 0,01), l'autoefficacité (r = 0,201; p = 0,01) et la littératie en matière de santé (r = 0,241; p = 0,002) après la RC. Le niveau d'éducation (B = -2,511; p = 0,04) et les connaissances avant la RC (B = 0,433; p < 0,001) ont influé sur les changements touchant les connaissances après la RC. CONCLUSION: Cette toute première étude multicentrique axée sur l'éducation des patients en RC au Canada a permis de confirmer les avantages d'une intervention éducative.