title: Everyday physical activity in ambulatory heart transplant candidates: the role of expected health benefits, social support, and potential barriers.
abstract: BACKGROUND
  Physical activity (PA) is recommended for stable patients with advanced heart failure (HF).
  
  
  OBJECTIVE
  We evaluated expected health benefits of PA and social support as facilitators of PA, and physical symptom distress and psychological distress (depression, anxiety) as barriers to PA. Additionally, we investigated if facilitators of PA are of particular importance for patients who report barriers.
  
  
  METHODS
  We analyzed data assessed at time of waitlisting in 231 ambulatory patients (53.4 ± 10.3 years, 18 % women) who were enrolled in the multisite Waiting for a New Heart Study in 1 Austrian and 16 German hospitals. Self-reported everyday PA scores (number of activities, duration of activities) was regressed on demographic characteristics and indicators of disease severity (ejection fraction, peak oxygen consumption), facilitators (expected health benefits of PA, perceived emotional support, perceived support for PA), and barriers to PA (physical symptom distress, psychological distress). Interaction terms of facilitators with barriers were also examined.
  
  
  RESULTS
  PA was positively associated with higher peak oxygen consumption, validating self-reported PA. Regarding facilitators, expected health benefits of PA were independently associated with higher PA (p values < 0.001). There were no main effects for social support on PA. Regarding barriers, depression tended to be associated with fewer activities (p = 0.068). However, in the presence of barriers (depression, physical symptoms), feeling supported for being physically active was positively associated with PA (p values < 0.05).
  
  
  CONCLUSIONS
  Interventions to improve PA may benefit from strengthening positive expectations of health outcomes associated with everyday PA and fostering PA-specific social support for those distressed by HF symptoms or depression.
authors.affiliation: Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Gerhardt
authors.forename: Gerdi
authors.initials: G
authors.lastname: Weidner
authors.forename: Mariel
authors.initials: M
authors.lastname: Grassmann
authors.forename: Heike
authors.initials: H
authors.lastname: Spaderna
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology; D003863:Depression / Q000523:psychology; D005260:Female; D006333:Heart Failure / Q000503:physiopathology / Q000523:psychology*; D016027:Heart Transplantation / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010101:Oxygen Consumption / Q000502:physiology; D010465:Perception; D012944:Social Support; D013312:Stress, Physiological / Q000502:physiology; D013315:Stress, Psychological / Q000523:psychology*; D013318:Stroke Volume / Q000502:physiology; D055815:Young Adult
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