Self-regulatory efficacy for exercise in cardiac rehabilitation: Review and recommendations for measurement.

PURPOSE: Self-regulatory efficacy (SRE) is a psychological resource necessary for cardiac rehabilitation (CR) exercise adoption and maintenance. A 2008 review of self-efficacy for CR exercise identified the need for more high-quality research on SRE. The present review had 4 purposes: (a) to review the characteristics of empirical SRE and CR exercise research since 2008; (b) to examine the quality of SRE measurement; (c) to determine whether varying quality of SRE measurement moderated the relationship between SRE, exercise, and CR social cognitions; and (d) to make recommendations for better measurement for future research. METHOD: An initial search of 766 possible studies identified 29 for review. These included individuals engaged in or completing CR where SRE for exercise and relevant outcomes was assessed. Meta-analysis examined whether SRE measurement quality was associated with the magnitude of effects observed and to determine potential moderation by quality. RESULTS: There were 11 unique operationalizations of SRE for exercise. Problematic factors included: non-SRE variables assessed as the construct, using global versus specific measures, and lack of a time frame over which SRE applied. Effect size was related to stronger relationships as level of study and measurement quality increased. CONCLUSION: Since 2008, an increase in studies examining SRE and CR exercise was observed. To advance SRE and CR exercise research, measurement and research quality improvements are recommended that have implications for future mediation and CR intervention assessment. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Perceiving Cardiac Rehabilitation Staff as Mainly Responsible for Exercise: A Dilemma for Future Self-Management.

BACKGROUND: Cardiac rehabilitation (CR) exercise therapy facilitates patient recovery and better health following a cardiovascular event. However, post-CR adherence to self-managed (SM)-exercise is suboptimal. Part of this problem may be participants' view of CR staff as mainly responsible for help and program structure. Does post-CR exercise adherence for those perceiving high CR staff responsibility suffer as a consequence? METHODS: Participants in this prospective, observational study were followed over 12 weeks of CR and one month afterward. High perceived staff responsibility individuals were examined for a decline in the strength of adherence-related social cognitions and exercise. Those high and low in perceived staff responsibility were also compared. RESULTS: High perceived staff responsibility individuals reported significant declines in anticipated exercise persistence (d = .58) and number of different SM-exercise options (d = .44). High versus low responsibility comparisons revealed a significant difference in one-month post-CR SM-exercise volume (d = .67). High perceived staff responsibility individuals exercised half of the amount of low responsibility counterparts at one month post-CR. Perceived staff responsibility and CR SRE significantly predicted SM-exercise volume, R2adj = .10, and persistence, R2adj = .18, one month post-CR. CONCLUSION: Viewing helpful well-trained CR staff as mainly responsible for participant behavior may be problematic for post-CR exercise maintenance among those more staff dependent.