The roles of self-efficacy and motivation in the prediction of short- and long-term adherence to exercise among patients with coronary heart disease

• Published in: Health psychology Vol. 33; no. 11; p. 1344
• Main Authors: Slovinec D'Angelo, Monika E, Pelletier, Luc G, Reid, Robert D, Huta, Veronika
• Format: Journal Article
• Language: English
• Published: United States 01.11.2014
• Subjects: Adult; Aged; Aged, 80 and over; Coronary Disease - psychology; Coronary Disease - rehabilitation; Exercise - psychology; Female; Follow-Up Studies; Humans; Male; Middle Aged; Motivation; Patient Compliance - psychology; Patient Compliance - statistics & numerical data; Prospective Studies; Self Efficacy; Time Factors
• ISSN: 1930-7810
• DOI: 10.1037/hea0000094

Poor adherence to regular exercise is a documented challenge among people with heart disease. Identifying key determinants of exercise adherence and distinguishing between the processes driving short- and long-term adherence to regular exercise is a valuable endeavor. The purpose of the present study was to test a model of exercise behavior change, which incorporates motivational orientations and self-efficacy for exercise behavior, in the prediction of short- and long-term exercise adherence. Male and female patients (N = 801) hospitalized for coronary heart disease were recruited from 3 tertiary care cardiac centers and followed for a period of 1 year after hospital discharge. A prospective, longitudinal design was used to examine the roles of motivation and self-efficacy (measured at recruitment and at 2 and 6 months after discharge) in the prediction of exercise behavior at 6 and 12 months. Baseline measures of exercise and clinical and demographic covariates were included in the analyses. Structural equation modeling showed that both autonomous motivation and self-efficacy were important determinants of short-term (6-month) exercise behavior regulation, but that only autonomous motivation remained a significant predictor of long-term (12-month) exercise behavior. Self-efficacy partially mediated the relationship between motivation for exercise and 6-month exercise behavior. This research confirmed the roles of autonomous motivation and self-efficacy in the health behavior change process and emphasized the key function of autonomous motivation in exercise maintenance. Theoretical and cardiac rehabilitation program applications of this research are discussed.