| Current research focuses on cognitive beliefs to explain health action decisions. Janis and Mann (1977), however, propose that psychological as well as cognitive factors influence how individuals make decisions. Based on this conceptualization of decision making, cognitive beliefs of exercise self-efficacy, perceived benefits and barriers to exercise; and psychological characteristics of stress and decision making behaviors were integrated in a decision making model to explain exercise participatory decisions of myocardial infarction patients. A structured interview was designed based on the operationalization of the model variables. The interview was introduced to myocardial infarction patients visiting cardiology clinics in two Jordanian military hospitals. Eighty eight patients, 40 of whom were exercise participants and 48 of whom were not, volunteered and completed the interview. After adjusting for demographics and health characteristics, variables of the proposed decision making model significantly increased the discrimination between exercise participants and nonparticipants by a small proportion (7%). Stepwise discriminant function analysis indicated that decision making behaviors were not significant predictors of myocardial infarction patients' decisions to exercise. The same analysis indicated that exercise self-efficacy, preinfarction exercise experience, and stress significantly discriminated between exercise participants and nonparticipants. Interaction between perceived benefits and perceived barriers was a significant predictor of stress in exercise nonparticipants. In exercise participants, rehospitalization for cardiac events was a significant predictor of stress. Results of this study indicated that decisional conflict and stress were characteristics of myocardial infarction patients who delayed or avoided exercising. Giving more attention to decision-based theories may reveal further information that explains exercise behavior. |
