Master of Science (Hons.)
Department of Psychology
Ljubic, Mary Angela, Motivation, psychological distress and exercise adherence following myocardial infarction, Master of Science (Hons.) thesis, Department of Psychology, University of Wollongong, 2001. http://ro.uow.edu.au/theses/2863
Patient adherence to post coronary exercise therapy is relatively poor with at least 50% discontinuing within 6 to 12 months of starting their cardiac rehabilitation programme (Dishman, 1988; Oldridge, 1988). The relationship between exercise motivation, psychological distress and adherence to exercise therapy following myocardial infarction (Ml) was examined. The extent to which myocardial infarction patients adhered to their cardiac rehabilitation programme was also explored. Researchers have found that the factors that influence participation in cardiac rehabilitation include intrinsic motivation, extrinsic motivation and psychological distress (Blumenthal, Williams, Wallace, Williams, & Needles, 1982; Oman & McAuley, 1991; Mullan, Markland & Ingledew 1997). Fifty myocardial infarction patients were recruited from the Cardiac Education and Assessment Programme (CEAP) at Westmead Hospital. Demographic information, the Exercise Motivation lnventory-2 (EMI-2) and the Depression, Anxiety and Stress Scale (DASS) were administered prior to the programme. The DASS and EMI-2 were re-administered by telephone interview at 5 month follow-up. Four exercise adherence measures were included in the present study: attendance, exercise stress test, self-report ratings and 7 day activity recall interview. There was a 46% adherence rate for Ml patients during the hospital programme. Of those individuals who completed CEAP, 91% obtained functional improvement on the exercise stress test. For the 38 patients who were followed-up by telephone interview at 5 months, 71% were exercising according to CEAP prescription. Results indicated that multiple measures of exercise adherence provided a more comprehensive picture. The results did not support the utility of Cognitive Evaluation Theory in explaining the links between intrinsic and extrinsic motivation and adherence to exercise therapy. However, higher levels of anxiety were associated with lower levels of self reported exercise adherence. The three strongest motivations for exercise in this group of Ml patients were all health related; wanting to be free from illness, maintaining good health and recovering from the effects of coronary heart disease. Recommendations for programme development are presented. It is also suggested that there is a need to generate guidelines for measuring exercise adherence and these need to be empirically driven.