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| Author(s): |
Thaís Moreira São João
Total Authors: 1
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| Document type: | Master's Dissertation |
| Press: | Campinas, SP. |
| Institution: | Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas |
| Defense date: | 2009-07-28 |
| Examining board members: |
Roberta Cunha Matheus Rodrigues;
Emilia Campos de Carvalho;
Neusa Maria Costa Alexandre
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| Advisor: | Maria Cecilia Bueno Jayme Gallani; Roberta Cunha Matheus Rodrigues |
| Abstract | |
The literature provides extensive reporting of the benefits of regular physical activity (PA) for patients with coronary heart disease (CHD). However, in equal proportion has been reported the difficulty of health professionals, including nurses, to promote adherence and maintenance of this behavior. Among the difficulties mentioned there is a scarcity of experimental studies that have tested the effectiveness of educational strategies to address well-defined future interventions. This study aimed to verify the effectiveness of an intervention based on a combination of strategies of (a) action planning and (b) coping planning in the implementation of the performance of AF (walking) and Habitual Physical Activity (HPA - measured by the Baecke questionnaire) between CHD outpatients. The study was conducted in the Cardiology Clinic of a university hospital in the state of São Paulo. The sample comprised 144 CHD outpatients, who underwent a 2 month hospital-based physical activity intervention program. Inclusion criteria for the study were diagnosed CHD and medical recommendation to engage in regular physical training. An experimental longitudinal trial was conducted, with three stages of data collection. In the first phase (T0) were collected data on sociodemographic and clinical characterization and measurement of variables: Intention (I0), Behavior (B0) (walk 30 minutes per day, 3 times per week) and HPA (HPA0). Then the subjects were randomized into control (CG) and intervention (GI) groups. In the first (T1) and second (T2) months of follow-up, new measures were collected of Intention and Behavior (I1, B1, I2, B2, HPA1, HPA2). GI was submitted sequentially to the strategies of Action Planning and Coping Planning. Data were analyzed using statistical tests of association, comparison, correlation and variance. The sample of 144 patients was composed of men (63.9%), with 59.4 (± 8.8) years of age, Caucasian (82.6%), inactive (80.5%), with low individual income and 4.7 (± 2.1) years of study. Measurements of behavior (walking) and HPA revealed sedentary lifestyle among patients with high motivation for achievement of future PA. Significant differences in levels of behavior and intention were observed only for women, history of angina and non-smokers. Higher age and lower income, and lower number of associated conditions, less time elapsed since the last coronary syndrome and higher values of body mass index were correlated to lower levels of PA. For intervention effectiveness analysis, 136 patients who completed the study were evaluated. The intervention based on the combination of Action Planning and Coping Planning strategies was effective in increasing PA levels in IG compared to CG. Increased scores in the measure of behavior (walking) and the total HPA score during follow up were found in both groups, and statistically significant difference in the comparison between groups at times T0 and T2. The findings suggest that the PA pattern and motivation vary among CHD outpatients according to sociodemographic and clinical profile, and therefore such features should be considered in planning educational activities to achieve higher adherence to PA guidelines. The results of this study to subsidize nursing care to CHD outpatients engaged in secondary prevention programs or cardiac rehabilitation and suggest that PA patterns and its motivation change among CHD outpatients according to sociodemographic and clinical profile; and point to implementation intentions as a valuable strategy on PA promotion among these patients. (AU) | |