Women's initiation of a more physically active lifestyle after a cardiac event: processes, patterns and influences

In the U.S., coronary heart disease is the leading cause of death and disability in women over the age of 50. Increasing physical activity is a major component of cardiac rehabilitation programs; but physical activity behaviors decline dramatically during the months following a cardiac event, especially for women. Little is known about the processes of women's adoption of a more physically active lifestyle or the factors involved. Therefore, the purpose of this dissertation was to describe and explore, for women participating in a 12 week formal, Phase II CR program, intra-individual patterns of change in the processes of recovery, specifically in adopting increased levels of physical activity. The first article provides an integrative review and critique of the current research examining self-efficacy and physical activity behaviors in older women and women with CHD. The literature is characterized by a limited number of women in the studies of individuals with CHD, a reliance on self-reports for the measurement of behavior, and a limited assessment of the process of health behavior change. The second article presents the results from the study of 20 women who were followed during their 12 weeks of participation in a program of cardiac rehabilitation. At baseline, 4, 8, and 12 weeks, the women completed measures of physical activity (pedometer) and a ii i variety of psychosocial and behavioral assessments. Findings indicated that most (80%) women's physical activity declined during the last month of rehabilitation. Self-efficacy expectations for walking and for overcoming barriers to physical activity also declined during the last month of rehabilitation. Most women reported being neutral about goal setting activities, indicating that goal setting was not an important behavior change strategy. Implications for clinical practice and future directions for research are suggested. The third article discusses the findings related to social comparisons (comparing one's situation and behaviors to others) gathered from a questionnaire and open-ended interviews. Social comparisons did not seem to be a major psychosocial factor in adjusting to heart disease or in increasing physical activity levels. Rather, women relied on feedback and input from their physicians and from the exercise staff for gauging their progress.