From need to action: decoding the role of motivation in adherence to home-based cardiac rehabilitation exercise in chronic heart failure patients.

IF 3.1 2区 医学 Q1 NURSING
Zhen Yang, Hao Huang, Linyu Xu, Yu Gao, Chunqi Zhang, Aiping Wang
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Abstract

Background: Adherence to home-based cardiac rehabilitation exercise remains suboptimal, and motivation may be the intrinsic driving force. This study aimed to explore the role of exercise regulatory motivation in mediating the relationship between psychological needs and exercise adherence among chronic heart failure patients, and to develop a mechanism model.

Methods: This study adopted an explanatory sequential mixed-methods design. A hypothesized model of adherence behavior was developed. A survey was used to test the theory-driven model. A semi-structured interview delved deeper into chronic heart failure patients' experiences with HBCR exercise, identifying reasons behind significant mediation effects and refining the mechanism model.

Results: A total of 248 eligible chronic heart failure patients participated in the quantitative study. Exercise regulatory motivation partially mediated the relationship between psychological needs and exercise adherence. In the qualitative study, 18 chronic heart failure patients from the quantitative sample were purposefully selected. Five sub-themes emerged from the textual data, which were distilled into two overarching themes: "Specific Functions of Pathway Variables" and "Reasons for Mediation Path Significance." Integrating the qualitative and quantitative results, it was found that satisfying patients' psychological needs for exercise activates regulatory motivation, which in turn triggers sustained exercise behavior. As motivation becomes increasingly internalized, patients are able to set clear goals and maintain or adjust their home-based cardiac rehabilitation exercise over the long term.

Conclusion: From a health psychology perspective, this study is the first to reveal the role of exercise regulatory motivation in linking psychological needs and exercise adherence among chronic heart failure patients, ultimately developing a mechanism model.

Clinical trial number: Not applicable.

从需要到行动:解码慢性心力衰竭患者坚持以家庭为基础的心脏康复运动的动机的作用。
背景:坚持以家庭为基础的心脏康复训练仍然是次优的,动机可能是内在的驱动力。本研究旨在探讨运动调节动机在慢性心力衰竭患者心理需求与运动依从性之间的中介作用,并建立机制模型。方法:本研究采用解释性顺序混合方法设计。建立了一个假设的依从性行为模型。一项调查被用来检验理论驱动的模型。一项半结构化访谈深入研究了慢性心力衰竭患者HBCR运动的经历,找出了显著中介效应背后的原因,并完善了机制模型。结果:共有248例符合条件的慢性心力衰竭患者参与了定量研究。运动调节动机在心理需求与运动依从性之间起部分中介作用。在定性研究中,有目的地从定量样本中选择18例慢性心力衰竭患者。从文本数据中出现了五个子主题,这些子主题被提炼成两个总体主题:“路径变量的特定功能”和“中介路径意义的原因”。综合定性和定量结果发现,满足患者对运动的心理需求会激活调节动机,进而引发持续的运动行为。随着动机变得越来越内化,患者能够设定明确的目标,并长期维持或调整他们的家庭心脏康复锻炼。结论:本研究首次从健康心理学角度揭示了运动调节动机在慢性心力衰竭患者心理需求与运动依从性之间的关联作用,并最终建立了机制模型。临床试验号:不适用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Nursing
BMC Nursing Nursing-General Nursing
CiteScore
3.90
自引率
6.20%
发文量
317
审稿时长
30 weeks
期刊介绍: BMC Nursing is an open access, peer-reviewed journal that considers articles on all aspects of nursing research, training, education and practice.
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