STAGES OF CHANGE IN EXERCISE ADHERENCE AMONG OLDER CARDIAC CLIENTS (ELDERLY).
Contributors: University of Nebraska Medical Center.
Published: 1994
Number of pages: 224
Subjects: Health Sciences, Nursing.; Psychology, Behavioral.; Gerontology.
Description: Objective. Further understanding of exercise adherence by investigating five stages of exercise adherence and determinants.

Design. Descriptive correlational cross-sectional.

Respondents. 352 community-dwelling older cardiac clients, including 57 in Precontemplation, 54 in Contemplation, 77 in Preparation, 81 in Action and 83 in Maintenance Stages of Exercise Adherence. Inclusion criteria: aged 65 or older, cardiac rehabilitation Phase I (CR) participant within 18 months and ambulatory without assist or with cane.

Methods. Computer-assisted telephone interview (mean completion time = 32.3 minutes, response rate = 79%). Demographic information, blood pressure (BP) and heart rate (HR) at rest and while exercising from CR chart audit.

Measures and variables from integrated health promotion and transtheoretical models. Gender, income, education, rate pressure product (HR x systolic $\rm BP\sp-□10)□$, perceived health status, prior related exercise behavior, interpersonal support for exercise, situational influences on exercise, Stage of Exercise Adherence Questionnaire, Modified 7-Day Activity Interview, Exercise Benefits/Barriers Scale, Self-efficacy for Exercise Questionnaire and Processes of Change (PC) in Exercise Adherence.

Main Results. 12 months following CR, 48.9% exercised regularly; at 12-18 months, 30.3% exercised. Discriminant Analysis determinants accounted for 50% of variance. Significant contributors were: self-efficacy, behavioral PC, interpersonal support, benefits, barriers and health status. Theoretical ordering of stages was strongly confirmed by equal distances between group centroids (Precontemplation = $-$1.72, Contemplation = $-$0.67, Preparation = $-$0.10, Action = 0.52, Maintenance = 1.21). Differences were found between determinants in all adjacent stages of exercise adherence using MANOVA and follow-up analysis (p $<$.05). The data fit the integrated exercise adherence model following modifications using LISREL. Exercise was influenced as follows: directly (barriers and behavioral PC), directly and indirectly (gender, prior related exercise behavior, interpersonal support and self-efficacy), indirectly (income and health status). Benefits and experiential PC had no influence on exercise.

Conclusions. Integrated model provided clarification of exercise adherence process and strongly implies which determinants to target for interventions with older cardiac clients in each stage of exercise adherence.
Notes: Source: Dissertation Abstracts International, Volume: 56-01, Section: B, page: 0172.

Thesis (PH.D.)--UNIVERSITY OF NEBRASKA MEDICAL CENTER, 1994.

School code: 0367.