RESUMEN
BACKGROUND: Nurses' suboptimal physical activity (PA) levels place them at high risk for cardiovascular diseases. Little is known about the motivational factors that influence their PA behavior. PURPOSE: This study drew on the Self-Determination Theory (SDT) to investigate whether associations between nurses' levels of mood disturbance, psychological need satisfaction (competence, autonomy, and relatedness), and self-determined motivation predict levels of objectively assessed PA. METHODS: A total of 363 nurses recruited from 14 hospitals in the Champlain region of Ontario, Canada, wore ActiGraph GT3X accelerometers and completed standardized questionnaires assessing sociodemographic and work characteristics, mood disturbance, and SDT variables. Levels of moderate-to-vigorous intensity PA (MVPA) were measured in minutes/week in bouts ≥10 min. Data were analyzed using path analysis and multiple mediational model. RESULTS: The model predicting MVPA showed good fit to the data, χâ2 (4, n = 363) = 7.82, p = .10; comparative fit index = .991; Tucker-Lewis Index = .967; root mean square error of approximation = .051. Higher mood disturbance was associated with lower perceived competence (ß = -.29, p = .002), autonomy (ß = -.29, p = .002), and relatedness (ß = -.19, p = .002). Lower perceived competence (ß = .46, p = .003) and autonomy (ß = .14, p = .011), as well as higher mood disturbance (ß = -.16, p = .016), were associated with less self-determined motivation for PA. Lower self-determined motivation was associated with lower levels of MVPA among nurses. CONCLUSIONS: Interventions targeting low mood, as well as perceived competence and autonomy in exercise, may promote MVPA among nurses and reduce cardiac risk.
Asunto(s)
Síntomas Afectivos/fisiopatología , Ejercicio Físico/psicología , Motivación/fisiología , Personal de Enfermería en Hospital/psicología , Actigrafía , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ontario , Autonomía Personal , Satisfacción PersonalRESUMEN
OBJECTIVE: To examine whether explaining causal links among endothelial pathophysiology, cardiac risk factors, symptoms and health behaviors (termed causal information) enhances patients' depth of knowledge about cardiovascular disease self-management and their perceptions of the cardiac rehabilitation and secondary prevention (CRSP) program. METHODS: Newly referred CRSP patients (N = 94) were cluster randomized to usual care (control; UC) or usual care with causal information (intervention; UC + CI). Depth of knowledge (factual vs. deep) was measured with an adapted cognitive-reasoning task. Patients' cardiovascular knowledge and beliefs about the efficacy of a CRSP program were assessed. RESULTS: After controlling for education level, patients in UC + CI demonstrated deeper knowledge about cardiovascular management than did those in UC. The UC + CI group showed higher factual knowledge than their counterparts after covarying education, occupation status and BMI. The UC + CI group also rated the CRSP program as more credible than those in UC, after controlling for age. Deep knowledge mediated the relationship between group conditions and perceived credibility of CRSP. CONCLUSION: Causal information can enhance the depth of patients' understanding of cardiovascular disease management and perceived treatment credibility of the CRSP program. PRACTICE IMPLICATIONS: Explaining causal links may help improve patient education delivery and enhance patient engagement in CRSP.
Asunto(s)
Rehabilitación Cardiaca , Causalidad , Endotelio Vascular/fisiopatología , Educación del Paciente como Asunto , Autocuidado , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Prevención SecundariaRESUMEN
OBJECTIVE: To determine whether explaining the causal links between illness management and symptom reduction would help younger and older adults learn and apply health information. METHOD: Ninety younger and 51 older adults read about a fictitious disease with or without explanations about the cause-and-effects (causal information) of illness management. A knowledge test (applied vs. factual items) was administered immediately and 1-week following the presentation of health booklets. Reading comprehension, working memory and health literacy were assessed as covariate variables. RESULTS: Younger adults outperformed older individuals on the applied and factual items at both time points. After controlling for covariates, causal information facilitated the comprehension and application of health information for younger but not older adults. Reading comprehension was the best predictor of test performance in the older sample. CONCLUSIONS: Providing an explanation of why illness management is effective for reducing symptomatology can help improve knowledge and application of health information for younger individuals. For older adults, lowering the verbal demands of patient education materials may be a better way to help them learn new health information. PRACTICE IMPLICATIONS: Use of causal information as a teaching strategy in patient education may enhance individuals' ability to learn about and implement self-care strategies.
Asunto(s)
Comprensión , Conocimientos, Actitudes y Práctica en Salud , Alfabetización en Salud , Educación del Paciente como Asunto , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Persona de Mediana Edad , Adulto JovenRESUMEN
OBJECTIVE: To describe the life goals of heart failure (HF) patients and to determine whether adherence is influenced by the extent to which these priorities are perceived as compatible with HF self-care regimens. METHOD: Forty HF outpatients identified their top-five life goals and indicated the compatibility of HF self-care regimens (diet, exercise, weighing) with these priorities. HF knowledge, self-efficacy and reported adherence were also assessed. RESULTS: Patients valued autonomy and social relationships as much as physical health. However, the rated importance of these domains did not predict adherence. Adherence positively correlated with the extent to which the regimen, specifically exercise, was considered compatible with life goals (r=.34, p<.05). Exercise adherence also correlated with illness severity and self-efficacy (rs=-.42 and .36, p<.05, respectively). The perceived compatibility of physical activity with personal goals predicted 11% of the variance in exercise adherence above and beyond that accounted for by illness severity and self-efficacy (FΔ (1, 36)=7.11, p<.05). CONCLUSIONS: Patients' goals outside of the illness management context influence self-care practices. PRACTICE IMPLICATIONS: Exploring patients' broad life goals may increase opportunities to resolve ambivalence and enhance motivation for self-care adherence.