"If you ask me … ": experienced cardiac rehabilitation patients' perspectives on maintaining regular heart-healthy physical activity.

Purpose: Despite the proven benefits of regular exercise and physical activity (PA), engagement of cardiac patients and adherence to recommended PA remain challenging. This study aimed to interview cardiac patients who are experienced in maintaining a physically active lifestyle to gain insight into how regular PA can become part of one's life after a cardiac event.

Methods: Twenty-five cardiac patients (18 men and 7 women; age range 39-83 years) participated in audio-recorded, semi-structured qualitative interviews. Patients were recruited from a clinical site in Salzburg, Austria, which offers ongoing weekly exercise classes under medical supervision for cardiac patients. Interview transcripts were analysed against the background of the Reasoned Action Approach and coded inductively.

Results: Eight themes were generated that elucidated patients' long-term engagement with PA: well-being and physical benefits; health literacy; community, groups, and partners; attitude, expectation and mindset; professional supervision; digital technology; nice distractions; and possibility of personalized tailoring. These themes are linked to several elements of the Reasoned Action Approach, including attitude, norm, behavioural control, skills, and environment.

Conclusion: This study highlights important aspects with respect to shaping a positive attitude towards PA and the significance of the social environment in establishing regular PA in cardiac patients.