Self-regulation Strategies Related to Exercise adherence in Patients with Heart Failure

1. Self-regulation Strategies Related to Exercise adherence in Patients with Heart Failure By: Fatemeh Rajati Assistant Professor, Ph.D in Health Education & Promotion Kermanshah University of Medical Sciences

2. Background: • Chronic heart failure (CHF) is one of the most common and debilitating conditions in older patients, frequently resulting from coronary artery disease or chronic hypertension.

3. Patients commonly experience a decline in their health-related quality of life (QoL), due to severe impairments in physical and social functioning, as well as associated psychological disorder such as depression

4. Cardiac rehabilitation (CR) program is a part of outpatient secondary prevention in patients with HF. • CR is aimed at promoting QoL, functional capacity, exercise tolerance, reducing mortality, and the need for frequent hospitalizations.

5. Exercise is affected by factors including demographic variables and potentially psychosocial variables such as self-regulation. • However, less is known on the theoretical framework, depicting how educational intervention on psychological and cognitive variables affect exercise adherence.

6. Aim The purpose of this study is to assess the effectiveness of a Social-cognitive theory-based intervention to improve exercise in patients with HF.

7. Design A Randomized Clinical Trial (RCT) was conducted in the case (n=30) & control group (n=30).

9. (Usual care + 3 times a week CR ) + A theoretical-based exercise intervention Baseline 1 month 2 months 3 months 4 months 5 months Measurements After intervention Follow up Follow up

10. Patients eligibility Patients were accepted into the study if they are diagnosed with HF.

11. Inclusion criteria: (a)aged 30 years or over (b) having been treated medically (c) being able to speak and read Persian (d) having a LVEF of ≤40, (e) being assessed as (NYHA) II and III by the cardiac function classification method of New York Heart Association

12. Participants were excluded from the study if they meet the following criteria, as determined by the study’s cardiologist:

13. (a) presence of unstable angina pectoris, (b) participation in another aerobic exercise program more than three times a week within the past 12 months, (d) having symptoms of acute decompensated CHF, (e) having suffered from severe mental illnesses, (g) having prior orthopedic or neuromuscular conditions, preventing participation in exercise and strength/resistance training, and (f) currently being a participant in a similar study.

14. It was mainly established the intervention model based on the principal SCT components.

15. What Action Planning Where When Planning How Coping Plan Self-regulation Awareness of standards (type , frequency,& duration) Heart rate monitoring Action control Self-monitoring Symptom Awareness exercise (Borg Rating of Perceived Exertion) Behavior observation Self-regulatory effort Feedback & judgment Response (problem solving)

16. Results

18. The results of this study demonstrate an advantage of SCT-based exercise intervention in patients with heart failure participating in cardiac rehabilitation over three months follow-up.

19. These results suggest that the incorporating theory-based educational intervention into exercise bridge the gap of the usually limited and incoherent provision of educational care in cardiac rehabilitation program.

20. Further studies are needed to examine the long-term effect of theory-based intervention on heart failure patients’physical activity and QoL.

21. Thank you for your attention