Attitudes and behavioral intentions of aortic dissection survivors towards exercise: an application of the health action process approach framework

Abstract

Background: Exercise can help patients with aortic dissection (AD) control blood pressure, prevent further progression of AD, promote mental health, improve the prognosis of cardiovascular disease, and improve their overall quality of life. However, it is not clear what the attitudes and behavioral intentions of AD survivors are towards exercise. Methods: This exploratory qualitative research was based on the Health Action Process Approach (HAPA) theory to explore the cognition, attitude, motivational factors, behavior intention, barriers and facilitators of exercise in patients with AD. Face-to-face and telephone semi-structured interviews were conducted in 24 AD patients from the Department of Cardio-Vascular Surgery of third-grade Class A hospitals in Wuhan, China from April 2021 to June 2021. The patient's current stage of behavior was evaluated according to the Patient-Centered Assessment and Counseling for Exercise (PACE) questionnaire. Results: Among the 24 participants interviewed, 9 (37.5%) were in the pre-intention stage, 8 (33.3%) were in the intention stage, and 7 (29.2%) were in the action stage. The three groups were significantly different in terms of their history of previous cardiac surgery (Fisher's exact test, p = 0.043) and in the type of interview conducted (Fisher's exact test, p < 0.001). In-patients with a history of cardiac surgery were more likely to be in the pre-intention stage (post-hoc test, p < 0.05). Patients from different stages had different structures. AD patients in the pre-intention stage were more likely to express risk perception and negative results for exercise. The self-efficacy of this group was often low, and lacked exercise intention and clear action plans (post-hoc test, p < 0.05). Conclusions: More attention should be paid to in-patients with a history of cardiac surgery, including health advice on exercise after discharge and promotion of changes in their health behavior. Guidelines based on the available exercise data in AD patients should be established to provide recommendations for individualized exercise programs. This should provide a basis for promoting patient rehabilitation and improving postoperative quality of life.

Developing an Exercise Attitudes and Behavior Intentions Questionnaire for Survivors of Aortic Dissection: An Exploratory Factor Analysis

“…The results of EFA showed that action planning and coping planning were in the same dimension, so we combined the two into one dimension (implementation intention). In addition, in contrast from the HAPA theory, we found that social support was a very important factor for the persistence of exercise behavior in the interview process [ 19 ], so we added the dimension of social support to measure EABIQ. The modified questionnaire items were clear and easy to understand following a pilot study and formal investigation.…”

“…Twenty-four AD patients in Wuhan, China were invited to participate in semi-structured interviews from April 2021 to June 2021 [ 19 ]. In addition, we added a dimension of perceived social support according to the semi-structured interviews.…”

“…Competitive sports and isometric heavy weightlifting should be discouraged [ 18 ]. However, patients with AD may not exercise because of pain, fear of accidents during exercise, worries about disease recurrence, and other reasons [ 19 ]. Thus, it is very important to understand the attitudes and intentions of AD survivors before the formation of specific exercise programs and guidelines.…”

Attitudes and Motivations Towards Implantation of Intention Towards Exercise among Entrepreneurs: A Brain Freshness Activity

“…The emotional aspects significantly contribute to exercise intentions [1]. Scholars like [25] and [26] exert attitudes and behavioural intentions as robust predictors of dissection survivors towards exercise. In the perception of [27], teachers' self-efficacy, attitudes, and intentions regarding implementing a new physical education curriculum had affected students' exercise intentions.…”

Linking Exercise Intention to Exercise Action: The Moderating Role of Self-Efficacy

“…Especially, as pointed out by Luszczynska et al ( 2011 ), action planning is unable to promote physical activity among those without strong self-efficacy. Indeed, people with low self-efficacy often lack clear action plans, thus exhibiting less exercise intention (Feng et al, 2022 ). Accordingly, high self-efficacy is positively related to planning, which further promotes health-promoting intention.…”