Exercise Self-efficacy, Perceived Benefits, and Barriers to Exercise Among Patients Following Acute Myocardial Infarction

Abstract

BackgroundIncreasing patient adherence to regular exercise post acute myocardial infarction (AMI) is a major goal after hospitalization. It is therefore essential to identify perceived benefits and barriers to exercise and its association with exercise self-efficacy among patients post AMI.AimsThe purpose of this study was to identify the perceived benefits and barriers to exercise and the predictors of exercise self-efficacy among patients after AMI.MethodsA cross-sectional study design was used with a convenience sample of 254 patients, recruited from the 3 main hospitals in Jordan. Instruments included the Exercise Benefits and Barriers Scale and the Exercise Self-Efficacy Scale. Mean scores were computed to determine the perceived benefits and barriers responses. Multiple linear regression was conducted to explore the predictors of exercise self-efficacy. Data were collected over 5 months.ResultsThe greatest perceived benefits were related to personal factors, for example, “I enjoy exercise” (2.45 [0.98]), and physical performance, for example, “My muscle tone is improved with exercise” (2.44 [0.86]) and “Exercise increases my stamina” (2.43 [0.86]). The greatest perceived barriers were related to environmental barriers, for example, “Lack of exercise places” (2.67 [0.82]), and internal factors related to physical exertion itself, for example, “Concerned about getting tired during exercise participation” (2.65 [0.72]). The Exercise Self-Efficacy Scale showed that patients post ST-elevation AMI had higher exercise self-efficacy than those with other treatment modalities (AMI, 44.71 [19.07] vs 36.59 [17.34]; P = .001). Patients treated by primary percutaneous coronary intervention had higher exercise self-efficacy, 49.2 (18.61), than patients treated by thrombolysis and percutaneous coronary intervention, 39.28 (18.3), and patients treated by medications other than thrombolytic therapy, 36.59 (17.4) (F2,251 = 11.612, P = .001). The multiple linear regression model explained approximately 29% of the variance in exercise self-efficacy (F11,242 = 7.914, P < .001). Five variables contributed significantly to the prediction of self-efficacy: type of AMI (standardized β = −0.173, t = −3.311, P = .01), perceived exercise benefits (standardized β = 0.322, t = 4.912, P = .01), perceived exercise barriers (standardized β = −0.291, t = −4.521, P = .01), being Argela smokers (water pipe smoking) (standardized β = −0.132, t = −2.617, P = .029), and cholesterol level (standardized β = −0.158, t = −2.174, P = .003).ConclusionsPrimary perceived benefits of exercise reported were in the areas of personal factors and improved physical performance. The main perceived barriers to exercise were in the areas of environmental factors and physical exertion. Identification of benefits and barriers to exercise, type of AMI, and treatment modalities of AMI as predictors of exercise self-efficacy is a significant step for developing appropriate interventions that effectively improve exercise self-efficacy and exercise among post-AMI patients.

Gender Differences in Perceived Barriers and Benefitsof Whole-Body Electromyostimulation Users: A Pilot Study

“…The main finding of this study shows us the perceived benefits of PE practice with WB-EMS, among which are: enjoyment, increased physical fitness, personal accomplishment, overall body improvement and increased muscle strength, as other 215 authors have shown in their studies, with a healthy population [24,25,37,38]. In relation to personal achievements, there is another study that supports our finding, in which Shajraw and colleagues [39] state that in the greatest perceived benefits in patients with myocardial infarction, 218 were related to personal factors, such as: I like to exercise, and also my physical performance, e.g., my muscle tone improves with exercise and exercising increases my endurance. There is little evidence from specific studies with WB-EMS on perceived benefits, hence our research.…”

“…Other authors, in addition to lack of time, include social influence and "lack of skills" as prevalent barriers in people with obesity [45]. Another study included as a barrier the lack of places to exercise and internal factors related to the effort itself, such as concern about fatigue during exercise participation in patients with myocardial infarction [39].…”

Psychological factors associated with exercise self-efficacy in the recipients of an implantable cardioverter defibrillator

“…Research has shown that these personal facilitators and barriers influence the nature of physical activities performed by patients with heart failure, as they impact the individual’s confidence in their ability to succeed in those activities [ 22 ]. Another study revealed that a positive relationship between physical activity situations performed and physical activity self-efficacy in middle-aged and older adults who perceive exercise benefits, coupled with a negative relationship with perceived exercise barriers[ 23 ]. Furthermore, self-care efficacy is strongly linked to patients’ capacity to perform daily activities, return to work, and self-care behaviours, and is a crucial factor in adjusting to illness [ 24 ].…”

Exercise Adherence in Older and Middle-Aged Adults With Coronary Artery Disease Before and During COVID-19

“…17 Common barriers to exercise adherence reported include work commitments, lack of exercise equipment, pain, injuries, age, and chronic health conditions. 18,19 Recently, the COVID-19 pandemic presented unique challenges to exercise, particularly for older adults. 20,21 As community centers and gyms closed because of COVID-19, maintaining exercise became more difficult.…”

“…After a major cardiac event, a downward trend in exercise adherence has been observed, with 78% not adhering to exercise guidelines after discharge 17 . Common barriers to exercise adherence reported include work commitments, lack of exercise equipment, pain, injuries, age, and chronic health conditions 18,19 . Recently, the COVID-19 pandemic presented unique challenges to exercise, particularly for older adults 20,21 .…”