Exploring physical activity preferences and motivation in long-term cardiac prevention: An Austrian cross-sectional survey.

Cardiac rehabilitation (CR) patients often do not sustain physical activity (PA) behaviour in the long run, once they progress into a self-management stage of secondary prevention. This study aimed to explore former CR patients' PA preferences, determinants (i.e., influencing factors) and motivation for sustained PA engagement. We conducted a cross-sectional multi-centre survey using an original questionnaire based on prior qualitative interviews with cardiac patients. Five CR centres in Austria posted 500 questionnaires to former CR patients who had completed CR approximately three years prior, and 117 patients (23%) responded. Descriptive analysis was used to analyse closed-ended questions, and self-determination theory (SDT) was applied as a qualitative framework to analyse open-ended questions concerning motivation for PA engagement. Patients were generally physically active, but the majority (75.3%) did not fulfil the World Health Organisation's recommendations for aerobic PA and muscle strengthening. Most patients preferred being physically active outdoors (70%), engaging in aerobic-related (95%), individual and non-competitive exercises, with cycling (52%), walking (32%) and hiking (25%) among the most popular activities. Main determinants of PA were health, pain and motivation for 80%, 68%, 67% of patients, respectively. A subset of patients (77%) expanded on their motivations behind PA. According to SDT, most reasons (90%) were regulated by autonomous motivation (either extrinsically autonomously-regulated or intrinsic motivation) and stemmed mostly from health-related goals (e.g., fitness, general health, weight control), future quality-of-life aspirations (e.g., self-sufficiency in old age, presence for loved ones, preserving mobility) and enjoyment of PA. Patients' responses underscore the importance of promoting not only general PA, but also muscle strengthening training in CR interventions to maximise optimal health benefits. Our data further suggest that interventions which are aligned to patients' health goals and foster autonomous motivation may be particularly beneficial in increasing adherence to PA in the long-term.

Use and perceptions of digital technology for daily life, physical activity and health information among former cardiac rehabilitation patients in Austria: A cross-sectional survey.

Objective: Digital health technologies offer great potential to improve access and adherence to cardiovascular disease secondary prevention measures such as regular physical activity (PA). However, the use and perceptions of digital technology (DT) among cardiac rehabilitation (CR) patients are not well understood. The aim of this study was therefore to explore the use of DT in former CR patients' daily lives, for PA and for health information; and to gain insight into patient perceptions of DT for PA, including barriers, facilitators and requested features. Methods: A cross-sectional postal survey was conducted between May 2022 and January 2023. Five Austrian CR centres contacted 500 former patients who had completed a phase 2 CR programme from January 2019 onwards. One-hundred seventeen patients (mean [SD] age, 69 ± 10 years, 22% female) responded. Descriptive and thematic analyses were conducted for closed and open-ended questions, respectively. Results: Results indicated high DT usage for communication and informational aspects, and to a large extent also for PA and health information seeking. Main facilitators of DT use for PA were attributed to health and behavioural monitoring. Main barriers were lack of perceived need, lack of interest and poor usability. Most frequently requested features included pulse and blood pressure measurement, step count and compatibility to other devices. Conclusions: Patients generally used and perceived DT as beneficial in daily life and for secondary prevention purposes such as PA. The survey identified facilitators, barriers and feature requests, which may inform the design and implementation of digital health interventions for CR patients.

General and Disease-Specific Health Indicator Changes Associated with Inpatient Rehabilitation.

OBJECTIVES: Rehabilitation plays a vital role in the mitigation and improvement of functional limitations associated with aging and chronic conditions. Moderating factors such as sex, age, the medical diagnosis, and rehabilitation timing for admission status, as well as the expected change related to inpatient rehabilitation, are examined to provide a valid basis for the routine assessment of the quality of medical outcomes. DESIGN: An observational study was carried out, placing a focus on general and disease-specific health measurements, to assess representative results of multidisciplinary inpatient rehabilitation. Aspects that were possibly confounding and introduced bias were controlled based on data from a quasi-experimental (waiting) control group. MEASURES: Existing data or general health indicators were extracted from medical records. The indicators included blood pressure, resting heart rate, self-assessed health, and pain, as well as more disease-specific indicators of physical function and performance (eg, activities of daily living, walking tests, blood lipids). These are used to identify moderating factors related to health outcomes. SETTING AND PARTICIPANTS: A standardized collection of routine data from 16,966 patients [61.5 ± 12.5 years; 7871 (46%) women, 9095 (54%) men] with different medical diagnoses before and after rehabilitation were summarized using a descriptive evaluation in terms of a content and factor analysis. RESULTS: Without rehabilitation, general health indicators did not improve independently and remained stable at best [odds ratio (OR) = 0.74], whereas disease-specific indicators improved noticeably after surgery (OR = 3.20). Inpatient rehabilitation was shown to reduce the risk factors associated with certain lifestyles, optimize organ function, and improve well-being in most patients (>70%; cutoff: z-difference >0.20), with a standardized mean difference (SMD) seen in overall medical quality outcome of -0.48 ± 0.37 [pre- vs post-rehabilitation: ηp2 = 0.622; dCohen = -1.22; 95% confidence interval (95% CI) -1.24 to -1.19]. The baseline medical values obtained at the beginning of rehabilitation were influenced by indication, age, and sex (all P < .001); however, these factors have less significant effects on improvements in general health indicators (ηp2 < 0.01). According to the disease-specific results, the greatest improvements were found in older patients (SMD for patients >60 vs ≤60 years: 95% CI 0.08-0.11) and during the early rehabilitation stage (ηp2 = 0.063). CONCLUSIONS AND IMPLICATIONS: Compared with those who received no inpatient rehabilitation, patients who received rehabilitation showed greater improvements in 2 independent areas, general and disease-specific health measures, regardless of their diagnosis, age, and sex. Due to the study design and the use of a nonrandomized waiting group, causal conclusions must be drawn with caution. However, the comparability and stability of the presented results strongly support the validity of the observed improvements associated with inpatient rehabilitation.

Intravenous injection of metallic mercury: case report and course of mercury during chelation therapy with DMPS.

INTRODUCTION: Although several cases of i.v. injection of metallic mercury have been reported, it still remains an uncommon event. CASE REPORT: A 34-year-old male came to hospital because complaining of pleuritic chest pain. X-ray showed radio dense punctate lesions in both lung fields, as well as around both elbows. Mercury concentration in blood (140 microg/L) and urine (320 microg/L) from the patient were significantly elevated, compared with the reference concentrations of < or = 2.0 mug/L mercury in blood and urine. The course of renal elimination of mercury and the mercury concentration in whole blood during 5 months of chelation therapy with sodium 2,3-dimercapto-1-propanesulfonate (Dimaval) were monitored. Furthermore, the time-course of mercury in scalp hair from the patient was determined. CONCLUSION: We report a case of probable consecutive i.v. administration of metallic mercury.