title: Exercise self-efficacy and symptoms of depression after cardiac rehabilitation: predicting changes over time using a piecewise growth curve analysis.
abstract: BACKGROUND
  Cardiac rehabilitation is often recommended after experiencing a cardiac event and has been shown to significantly improve health outcomes among patients. Several psychosocial variables have been linked with cardiac rehabilitation program success, including exercise self-efficacy. However, little is known about temporal patterns in patients' exercise self-efficacy after program completion.
  
  
  OBJECTIVE
  This study examined changes in exercise self-efficacy among 133 cardiac rehabilitation patients and whether symptoms of depression impacted the rate of change in exercise self-efficacy.
  
  
  METHODS
  Participants completed questionnaires at the beginning and end of cardiac rehabilitation and at 6-month intervals for 2 years.
  
  
  RESULTS
  Growth curve analyses showed that exercise self-efficacy levels were highest at the beginning of cardiac rehabilitation, significantly declined 6 months after cardiac rehabilitation, and leveled off over the next 18 months. Results also showed that baseline depressive symptoms interacted with time: Compared with participants with fewer symptoms, participants high in depressive symptoms began cardiac rehabilitation with lower levels of exercise self-efficacy and evidenced significant declines 6 months after cardiac rehabilitation. At no time were they equal to their counterparts in exercise self-efficacy, and their means were lower 2 years after cardiac rehabilitation than before cardiac rehabilitation.
  
  
  CONCLUSIONS
  Our findings imply that patients show unrealistic optimism surrounding the ease of initiating and maintaining an exercise program and that integrating efficacy-building activities into cardiac rehabilitation, especially for patients who show signs of distress, is advisable.
authors: Alisha D. Howarter, MA Doctoral Candidate, Department of Psychology, University of Missouri-Kansas City. Kymberley K. Bennett, PhD Assistant Professor, Department of Psychology, University of Missouri-Kansas City. Carolyn E. Barber, PhD Assistant Professor, Department of Counseling and Educational Psychology, University of Missouri-Kansas City. Stacia N. Gessner, MA Graduate Student, Department of Psychology, University of Missouri-Kansas City. Jillian M.R. Clark, BS Graduate Student, Department of Psychology, University of Missouri-Kansas City.
authors: Alisha D
authors: AD
authors: Howarter
authors: Kymberley K
authors: KK
authors: Bennett
authors: Carolyn E
authors: CE
authors: Barber
authors: Stacia N
authors: SN
authors: Gessner
authors: Jillian M R
authors: JM
authors: Clark
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000072038:Cardiac Rehabilitation; D002318:Cardiovascular Diseases / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D003865:Major Depressive Disorder / Q000523:psychology; D015444:Exercise / Q000523:psychology*; D005081:Exercise Therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020377:Self Efficacy