| 1.Retrospective analysis of patient compliance in cardiac rehabilitation Objective:The purpose of the current study was to explore the effect of exercise-based cardiac rehabilitation(CR)on physical,psychological and health status in cardiovascular patients;Evaluate the prevalence and predictors of dropout and non-attention of an exercise-based cardiac rehabilitation programme.Methods:This part of the study was a retrospective analysis of patients who underwent cardiac rehabilitation at the cardiac rehabilitation center in Georgia,USA,from April 2012 to April 2018.Collected data included: basic information of patients,six-minute walking test,hospital anxiety and depression scale(HADS),self-report short form-36(SF-36)health survey questionnaires general health(GH)scales and physical functioning(PF)scales,etc.Data statistics was based on principal component analysis.Results:Total number of patients enrolled in this study was 685.In our CR programme,the completion rate was 61.4%,31.7% drop out,and 6.9% referral.The scores of the anxiety and depression scales were significantly lower than before after the patients graduated from cardiac rehabilitation programs.Six-minute walking test and physical flexibility and strength were significantly improved,and the general health and physical function improved too.Principal component analysis showed that psychosocial factors(anxiety,depression,SF36 GH and PF),age,and BMI had a greater impact on patients' compliance,which explained 66.8% of total variance.Conclusion:Among patients who completed CR sessions revealed better flexibility,six-minute walk distance,strength,general health,and physical function.61.4% of eligible subjects completed the CR program.The present study demonstrated that patients who were older,obesity,high level of depression and anxiety and low general health were more likely to drop out or non-attention of CR programme.Moreover,principal component analysis showed that three principal components explained the main reasons for CR compliance,namely psychosocial components(including SF36 GH,HADS depression,and HADS anxiety),age components and BMI components.2.Physical activity and sedentary behavior in patients with heart failureObjective:The purpose of the current study was to describe the levels of physical activity and sedentary behavior and examine factors correlated with it among heart failure patients who did not participate in any sports rehabilitation training by using accelerometers;we also try to explore the relationship between physical activity and sedentary behavior;analyze the main factors affecting physical behavior.Methods: Participants of the study were selected from Georgia and Nebraska who were in stable disease status after anti-heart failure treatment.Each participant received an accelerometer Acti Graph GT3X+ device used to record the daily physical activity and sedentary behavior under normal conditions.Participants wore a hip-worn accelerometer for 1 week that provided minute-by-minute information on physical activity/sedentary behavior.At the same time,the patient's basic information and questionnaire results were collected,including Atlanta heart failure knowledge test,self-efficacy,patient activation measurement,and self-care behavior.Statistical analyses were performed using decision trees and structural equation models.Results: A total of 130 patients attend this study,of which 123 were valid data,56 were male,67 were female,and the mean age was 69.19 ± 11.71 years.Most heart failure patients in this study live a sedentary lifestyle and spent averaging 1,248.54 ± 107.63 daily minutes on sedentary behavior.Among them,women had more time for low-intensity activities than men(male: 121.88 ± 69.10 minutes;female: 133.32 ± 73.86 minutes).The decision tree was used to classify the data with sedentary behavior as the dependent variable.The importance in turn of the independent variables is age,arthritis,work status and BMI level.With the increase in age,the sedentary time of patients also increased,and the physical activity of patients without arthritis was significantly higher than that of patients with joint degeneration.Sedentary behavior and low-intensity physical activity,daily-intensity physical activity,moderate-intensity physical activity,and high-intensity physical activity are significantly correlated.It was feasible to use structural equation modeling to analyze the influencing factors of physical behavior in patients with heart failure.After the modification of structural equation modeling,the fitness index of the model conformed to the criterion that means the model was reasonable.The results indicate that self-efficacy is associated with patient activation,and the impact coefficient was 0.90.Patient activation directly affected self-management behavior,and the impact coefficient was 0.59.Marital status directly affected family support,and the impact coefficient was-0.26.Self-management behavior showed direct effect on sedentary behavior(impact coefficient was-0.83),low-intensity physical activity(impact coefficient was 0.63),daily-intensity physical activity(impact coefficient was 0.53),and medium-intensity physical activity(impact coefficient was 0.37).Conclusion: Sedentary behavior accounts for most of the daily physical behavior in patients with heart failure.As the age increases,the patient's sedentary time also increases.Patients with arthritis had significantly lower physical activity level.Sedentary behavior is correlated with low-intensity physical activity,daily-intensity physical activity,moderate-intensity physical activity,and high-intensity physical activity.Self-efficacy,patient motivation,and self-management behavior have a direct or indirect effect on a patient's sedentary behavior,low intensity,daily intensity,and moderate intensity physical activity. |
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