The effects of self-efficacy promoting cardiac rehabilitation program on self-efficacy, health behavior, and quality of life.

BACKGROUND Ischemic heart disease results from athesclerotic changes of the coronary artery. These changes are aggravated by hypercholesterolemia, smoking, obesity, lack of exercise, coronary-prone personality, and stress. Because these risk factors affect not only the prevalence of the ischemic heart disease but also recurrence of the disease, cardiac rehabilitation programs were introduced to help patients with ischemic heart disease reduce risk factors. Diverse cardiac rehabilitation programs are needed to motivate participation in cardiac rehabilitation and to enhance patients' quality of life. OBJECTIVES To examine the effect of a self-efficacy promoting cardiac rehabilitation program on self-efficacy, health behavior and quality of life of patients with ischemic heart disease. METHODS Data were collected from 45 hospitalized ischemic heart disease patients. Medical records were reviewed to obtain demographic and clinical characteristics. Data regarding self-efficacy, health behavior, and quality of life were obtained from interviews using structured questionnaires. The nonequivalent control group non-synchronized design was used to conduct this study. One session of conventional group education was given to patients in the control group while they were in the hospital. Patients in the experimental group participated in a newly developed cardiac rehabilitation program. It focused on strengthening self-efficacy with four self-efficacy sources - performance accomplishment, vicarious experiences, verbal persuasion and physical status using two individualized in-hospital education sessions and four weekly telephone counseling follow-up calls after discharge. RESULTS Four weeks after discharge, the increment of total self-efficacy score was significantly higher in the experimental group than in the control group (p<.01). There was also a significant difference in the total quality of life scores increments between the two groups (p<.01). However, no significant changes were noted in the increments of total health behavior scores between the two groups. CONCLUSION A cardiac rehabilitation program focusing on promoting self-efficacy was effective in improving self-efficacy, and quality of life of patients with ischemic heart disease.