Amount and Socio-Ecological Correlates of Exercise in Men and Women at Cardiac Rehabilitation Completion.

OBJECTIVE: The aim of the study was to describe (1) the amount of physical activity (PA) in cardiac rehabilitation (CR) graduates by sex, and (2) the correlates of their PA. DESIGN: Secondary analysis of baseline data from a randomized trial was undertaken. Graduates were recruited from three CR programs. Participants completed a questionnaire, which assessed constructs from the socio-ecological model (i.e., individual-level, social- and physical-environmental levels). Physical activity was measured objectively using an ActiGraph GT3X accelerometer. Multilevel modeling was performed. RESULTS: Two hundred fifty-five patients consented, of which 200 (78.4%) completed the survey and provided valid accelerometer data. Participants self-reported engaging in a mean ± standard deviation of 184.51 ± 129.10 min of moderate-to-vigorous-intensity PA (MVPA) per week (with men engaging in more than women, P < 0.05). Accelerometer data revealed participants engaged in 169.65 ± 136.49 mins of MVPA per week, with 43 (25.1%) meeting recommendations. In the mixed models, the socio-ecological correlate significantly related to greater self-reported MVPA was self-regulation (P = 0.01); the correlate of accelerometer-derived MVPA was neighborhood aesthetics (P = 0.02). CONCLUSIONS: Approximately one-quarter of CR program completers are achieving MVPA recommendations, although two-thirds perceive they are. The CR programs should exploit accelerometry and promote self-regulation skills, namely, self-monitoring, goal-setting, positive reinforcement, time management, and relapse prevention. Patients should be encouraged to exercise in pleasing locations.

Perceptions of seniors with heart failure regarding autonomous zero-effort monitoring of physiological parameters in the smart-home environment.

BACKGROUND: Technological advances are leading to the ability to autonomously monitor patient's health status in their own homes, to enable aging-in-place. OBJECTIVES: To understand the perceptions of seniors with heart failure (HF) regarding smart-home systems to monitor their physiological parameters. METHODS: In this qualitative study, HF outpatients were invited to a smart-home lab, where they completed a sequence of activities, during which the capacity of 5 autonomous sensing modalities was compared to gold standard measures. Afterwards, a semi-structured interview was undertaken. These were transcribed and analyzed using an interpretive-descriptive approach. RESULTS: Five themes emerged from the 26 interviews: (1) perceptions of technology, (2) perceived benefits of autonomous health monitoring, (3) disadvantages of autonomous monitoring, (4) lack of perceived need for continuous health monitoring, and (5) preferences for autonomous monitoring. CONCLUSIONS: Patient perception towards autonomous monitoring devices was positive, lending credence to zero-effort technology as a viable and promising approach.

Patient-Reported Outcomes in Cardiac Rehabilitation: WHAT DO WE KNOW ABOUT PROGRAM SATISFACTION? A REVIEW.

PURPOSE: Patient satisfaction has become an important indicator of quality and may be related to greater adherence to cardiac rehabilitation (CR). The objectives of this narrative review were to investigate (1) patient satisfaction with CR and its relationship to adherence or health outcomes, and (2) assessment tools applicable to CR. METHODS: A literature search was conducted on key resource databases, including MEDLINE, Health and Psychosocial Instruments, and Patient-Reported Outcomes and Quality of Life Instruments. A focused Internet and gray literature search was also conducted. RESULTS OF DATA SYNTHESIS: Eight studies were included. Patient satisfaction was high overall, especially related to education received. In 4 studies, patient satisfaction with treatment was compared in patients who attended CR with those who did not. In 2 of these studies where items were investigator generated, significant differences favoring CR were found. In the 2 studies where the treatment satisfaction subscale of the Seattle Angina Questionnaire was administered, no differences were observed. Only 1 study was identified, which examined the relationship of patient satisfaction with any outcome, and revealed that greater satisfaction was related to greater program adherence. There was a dearth of valid assessment tools. CONCLUSIONS: Despite recommendations in CR association guidelines to consider patient satisfaction, there is an absence of research assessing it. The studies that have assessed it administered tools of questionable psychometric rigor. It remains to be determined whether patient satisfaction is related to any meaningful outcomes.