Process and outcome in cardiac rehabilitation: an examination of cross-lagged effects.
Cardiac rehabilitation patients improve cardiorespiratory fitness and quality of life, yet therapeutic processes that produce these changes remain unknown. A cross-lagged panel design was used to determine whether early-treatment enhancement of self-efficacy regarding abilities to change diet and exercise habits and the quality of the patient-staff working alliance predicted late-treatment changes in a wide range of outcomes, but not vice versa. Eighty cardiac patients participating in a 12-week program completed measures at early, mid- and late treatment. Early-treatment changes in exercise self-efficacy predicted late-treatment changes in activity level, depression, and working alliance, but not vice versa. Diet self-efficacy changes correlated with concurrent changes in fat intake and body weight. Early-treatment changes in cardiorespiratory fitness and activity level predicted late-treatment changes in working alliance, but not vice versa. Findings suggest that increased exercise self-efficacy represents an important therapeutic mechanism by which rehabilitation gains are realized. ((c) 2004 APA, all rights reserved)
Evon
Donna M
DM
Department of Psychology, Finch University of Health Sciences/Chicago Medical School, Chicago, IL 60064, USA.
Burns
John W
JW
D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D001835:Body Weight; D001026:Coronary Artery Bypass / Q000379:methods; D018592:Cross-Over Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology*; D004032:Diet; D015444:Exercise; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000534:rehabilitation* / Q000628:therapy; D010101:Oxygen Consumption / Q000502:physiology*; D010809:Physical Fitness; D011788:Quality of Life; D015203:Reproducibility of Results; D012119:Respiration; D020377:Self Efficacy; D011795:Surveys and Questionnaires