Sense of Coherence Predicts Physical Activity Maintenance and Health-Related Quality of Life: A 3-Year Longitudinal Study on Cardiovascular Patients

Abstract

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally. A physically active lifestyle can improve the health-related quality of life (HRQoL) of people with CVD. Nevertheless, adherence to a physically active lifestyle is poor. This study examined the longitudinal (pre-event, 6-, 12-, 24-, and 36-month follow-ups) physical activity profiles in 275 patients (mean age = 57.1 years; SD = 7.87; 84% men) after the first acute coronary event. Moreover, it investigated the associations among physical activity, sense of coherence (SOC), and HRQoL. Physical activity profiles were identified through latent class growth analysis, and linear regressions were then performed to explore the association between physical activity, SOC, and HRQoL. After the cardiovascular event, 62% of patients reached adequate physical activity levels and maintained them over time (virtuous profile). The remaining 38% could not implement (23%) or maintain (15%) a healthy behavior. A strong SOC at baseline (standardized β = 0.19, p = 0.002) predicted the probability of belonging to the virtuous profile. Moreover, a strong SOC at baseline (standardized β = 0.27, p < 0.001), together with the probability of belonging to the virtuous profile (standardized β = 0.16, p = 0.031), predicted a better HRQoL at the final follow-up. Findings showed a strong relationship between SOC, the ability to adopt a physically active lifestyle stably over time, and HRQoL in patients with CVD. They suggest the importance of tailoring physical activity interventions by promoting resilience resources such as SOC to improve patients’ quality of life after an acute coronary event.

Predicting physical activity and quality of life in coronary heart disease patients: An 18-month path analysis of motivational and emotional factors.

“…The last finding regards the significant direct association observed between physical activity behavior and HRQoL, both evaluated at final follow-up. This result is consistent with prior research that already showed a significant impact of being regularly physically active on patients’ cardiovascular health (Adorni et al, 2022; Arija et al, 2018; Hawkes et al, 2013; Montayre et al, 2022). Notably, the present study adds complexity to this association by estimating significant indirect effects of baseline HRQoL and cardiac self-efficacy evaluated 18 months before.…”

“…Moreover, as described by prior works (Castillo-Mayén, Luque, Rubio, et al, 2021; Modica et al, 2019; Sandberg et al, 2015), functional coping strategies, affective balance, and stronger intention to adopt healthier behaviors were found determinant in achieving better cardiovascular health. Overall, this finding extends the current body of knowledge that already established strong relationships between positive psychological profiles and the adoption of healthier behaviors, and how these relations are longitudinally associated with better perceived cardiovascular health (Adorni et al, 2022; Castillo-Mayén, Luque, Rubio, et al, 2021; Roshanaei-Moghaddam et al, 2009). In addition to this, the present work not only sheds light on the indirect role of psychological and behavioral factors in the longitudinal improvement of HRQoL, but it may also provide future preventive intervention programs with crucial components to be targeted in order to enhance patients’ self-management skills following a cardiac event.…”

“…Particularly among patients with CVDs, significant relationships were evidenced between perceived HRQoL and the adoption of health behaviors. Prior studies revealed that adopting and maintaining adequate physical activity levels contributed to obtaining both short- and long-term positive effects (up to 3 years after the coronary event) on perceived cardiovascular health (Adorni et al, 2022; Arija et al, 2018; Montayre et al, 2022). Similarly, findings from another longitudinal research revealed that more frequent sedentary behaviors predicted lower levels of both physical and mental HRQoL over 6 months (Hawkes et al, 2013).…”

Usage of Complementary and Alternative Methods, Lifestyle, and Psychological Variables in Cancer Care

“…Daily physical activity. In other studies, engagement in PA after a cardiovascular event was correlated to coherence (42). In a recent study from 2020 on patients with multiple sclerosis, as in our survey, no associations were visible (43).…”

El sentido de coherencia y las habilidades para la vida como factores protectores en personas con prediabetes

“…Además, se observa que las personas que realizan actividad física suficiente obtienen puntuaciones mayores en el SOC. Un estudio reciente ha identificado los factores que influyen en la adherencia en la actividad física sugiriendo el SOC como uno de estos factores (29).…”