Development and impact of exercise self-efficacy types during and after cardiac rehabilitation

Objective: Cardiovascular disease (CVD) is the leading cause of death in the developed world. Cardiac rehabilitation (CR) is a comprehensive treatment program centered on structured exercise that has been demonstrated to achieve significant decreases in mortality and morbidity in cardiac patients, yet few patients adhere to exercise post-CR and so fail to maintain any health benefits accrued during rehabilitation. One reason for the lack of adherence might be that CR fails to address the challenges to adherence faced by patients when they no longer have the resources and structure of CR to support them. Self-efficacy (SE) is a robust predictor of behavioral persistence. This study therefore focuses on changes in different types of SE during CR and the relationship of SE to subsequent levels of physical activity. Method: A sample of 63 CR patients completed assessments of task, scheduling and coping SE at baseline and the end of CR, as well as self-reported exercise behavior at the end of CR and 1-month post-CR. Results: Task SE (for performing elemental aspects of the behavior) was found to be most changed type of SE during CR and was strongly related to self-reported exercise at the end of CR. However, scheduling SE (for performing the behavior regularly) was most strongly related to selfreported exercise post-CR. Conclusions: These results are theoretically consistent and suggest that scheduling SE should be targeted during CR to improve post-CR exercise adherence.