title: Motivational processes and well-being in cardiac rehabilitation: a self-determination theory perspective.
abstract: This research examined the processes underpinning changes in psychological well-being and behavioural regulation in cardiac rehabilitation (CR) patients using self-determination theory (SDT). A repeated measures design was used to identify the longitudinal relationships between SDT variables, psychological well-being and exercise behaviour during and following a structured CR programme. Participants were 389 cardiac patients (aged 36-84 years; M(age) = 64 ± 9 years; 34.3% female) referred to a 12-week-supervised CR programme. Psychological need satisfaction, behavioural regulation, health-related quality of life, physical self-worth, anxiety and depression were measured at programme entry, exit and six month post-programme. During the programme, increases in autonomy satisfaction predicted positive changes in behavioural regulation, and improvements in competence and relatedness satisfaction predicted improvements in behavioural regulation and well-being. Competence satisfaction also positively predicted habitual physical activity. Decreases in external regulation and increases in intrinsic motivation predicted improvements in physical self-worth and physical well-being, respectively. Significant longitudinal relationships were identified whereby changes during the programme predicted changes in habitual physical activity and the mental quality of life from exit to six month follow-up. Findings provide insight into the factors explaining psychological changes seen during CR. They highlight the importance of increasing patients' perceptions of psychological need satisfaction and self-determined motivation to improve well-being during the structured component of a CR programme and longer term physical activity.
authors.affiliation: a Department of Psychology , Aberystwyth University , Penbryn 5, Penglais Campus, Aberystwyth SY23 3UX , Ceredigion , UK.
authors.forename: Rachel Jane
authors.initials: RJ
authors.lastname: Rahman
authors.forename: Joanne
authors.initials: J
authors.lastname: Hudson
authors.forename: Cecilie
authors.initials: C
authors.lastname: Thøgersen-Ntoumani
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Doust
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006331:Heart Diseases / Q000523:psychology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D026684:Personal Autonomy; D010549:Personal Satisfaction; D011582:Psychological Theory
keywords: behavioural regulation; cardiac rehabilitation; psychological need satisfaction; self-determination theory; well-being