| The purpose of this correlational and longitudinal study was to: (a) determine differences in lifestyle exercise (amount and intensity) during the 6-month period after completing a CR program among cardiac patients both with and without diabetes and (b) examine factors (perceived benefits and barriers to exercise, pain, self-efficacy, and social support) associated with lifestyle exercise when controlling for race, gender, education, retirement, and fitness. The subjects (N = 110) in this secondary analysis were drawn from the control group of a clinical trial of adults who had completed a CR program after having MI, CABG, and/or PTCA. These subjects were primarily Caucasian, older, married, and fairly highly educated. Lifestyle exercise (amount and intensity) was collected monthly using portable wristwatch heart rate monitors during exercise and activity diaries.;Hierarchical multiple regressions indicated no statistically significant differences in lifestyle exercise between CHD patients with and without diabetes when controlling for the covariates. Mean (SD) amount of exercise, however, in patients with diabetes was 39.0 (34.9), as compared to 53.4 (39.8) for those without diabetes. It is important to note with a sufficient sample, there may be a significant difference in lifestyle exercise between subjects with and without diabetes. Furthermore, all subjects participated in low levels of exercise over the 6-month period, with only 39% of the subjects exercising at levels consistent with recommended guidelines.;Although diabetes status was an independent predictor of exercise amount, its effect did not remain when controlling for the covariates. Barriers self-efficacy and gender were significant independent predictors of exercise amount after controlling for the covariates. However, no predictors of exercise intensity were found. Twenty-one and twelve percent of the variances in exercise amount and exercise intensity, respectively, were explained. Health care providers must be aware of the importance of self-efficacy and employ techniques to increase it, thereby enhancing exercise in CHD patients. Future research should aim to study whether different education programs for lifestyle exercise should be provided for subjects with diabetes, as compared to those without diabetes. Booster sessions are also suggested starting at 2 months after completion of a CR program. |
