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BACKGROUND: To improve lifestyle guidance within cardiac rehabilitation (CR), a comprehensive understanding of the motivation and lifestyle-supporting needs of patients with cardiovascular disease (CVD) is required. OBJECTIVES: This study's purpose is to evaluate patients' lifestyle and their motivation, self-efficacy and social support for change when starting CR. METHODS: 1782 CVD patients (69 % male, mean age 62 years) from 7 Dutch outpatient CR centers participated between 2020 and 2022. Modifiable risk factors were assessed with a survey and interviews by healthcare professionals during CR intake. RESULTS: Most patients exhibited an elevated risk in 3-4 domains. Elevated risks were most prominent in domains of (1) waist circumference and BMI (2) physical exercise (3) healthy foods intake and (4) sleep duration. Most patients chose to focus on increasing physical exercise, but about 20 % also wanted to focus on a healthy diet and/or decrease stress levels. Generally, motivation, self-efficacy and social support to reach new lifestyle goals were high. However, patients with an unfavorable risk profile had lower motivation and self-efficacy to work on lifestyle changes, while patients with lower social support had a higher chance to quit the program prematurely. CONCLUSIONS: Our results underscore the need to begin CR with a comprehensive lifestyle assessment and highlight the importance of offering lifestyle interventions tailored to patients' specific modifiable risk factors and lifestyle-supporting needs, targeting multiple lifestyle domains. Expanding the current scope of CR programs to address diverse patient needs and strengthening support may enhance motivation and adherence and lead to significant long-term benefits for cardiovascular health. CLINICAL TRIAL REGISTRATION NUMBER: Netherlands Trial Register; registration number NL8443.
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Purpose: Insecurities and social isolation resulting from the COVID-19 restrictions, may have elevated tensions at home, consequently increasing the risk of domestic violence. The present study aims to examine changes in the prevalence, nature, and type of reporter of domestic violence following the various restrictions implemented to control the spread of the COVID-19 virus in the Netherlands. Methods: All official domestic violence reports recorded by the 26 Dutch domestic violence agencies in 2019 and 2020 were collected and analyzed. Time-series forecasting analyses, using a SARIMAX model, were conducted to predict the trend of domestic violence reports during the first lockdown and to compare the predicted trend with the observed trend. Results: The observed trend of the registered prevalence of domestic violence did not substantially differ from the predicted trend based on pre-pandemic data. Similarly, findings regarding the nature of domestic violence suggest no clear divergence of pre-pandemic trends during the lockdown period. Nonetheless, a shift was found from professional reporters (e.g., the police) to non-professional reporters (e.g., neighbors). Conclusions: The prevalence of domestic violence reports in the Netherlands did not increase. However, the COVID-19 restrictions may have led citizens, especially neighbors, to detect domestic violence more often.