| A cardiac patients' health status is jeopardized by non-adherence to cardiac rehabilitation. In the 1987 Public Health Service Assessment of Cardiac Rehabilitation Services it was concluded that cardiac rehabilitation significantly improves physiological functioning of patients who regularly attend scheduled sessions.;The purpose of this dissertation was to identify patients who do not adhere to cardiac rehabilitation. Self-efficacy theory was used to integrate prior research and derive hypotheses dealing with relationships between activity tolerance, self-efficacy, anxiety and adherence.;A sample of 101 consecutive patients entering cardiac rehabilitation were recruited from three centers in Northeastern Ohio. Patients' anxiety, self-efficacy, and activity tolerance were assessed when entering cardiac rehabilitation. Four week attendance data were collected from patient records.;During the first month of rehabilitation, 24% of the males and 33% of the females had missed one week or more of scheduled sessions. Seven patients (four males, three females) dropped out of rehabilitation. Six of the seven drop-outs did not have a bypass procedure.;Male non-adherent patients were not anxious, were more efficacious and better able to tolerate physical activity. Female non-adherent patients were anxious and were less efficacious. Regression equations were constructed to predict non-adherence from these variables, but were not significant.;Activity tolerance was significantly related to self-efficacy in males regardless of diagnosis. An inverse relationship was found between anxiety and self-efficacy in male non-bypass patients. There were no significant relations among activity tolerance, anxiety or self-efficacy in females.;Findings included differences between sexes and differences according to diagnosis. On admission to cardiac rehabilitation, females were less efficacious, more anxious, and less able to tolerate physical activity than males. Bypass male patients were significantly less efficacious than non-bypass males, although there was no difference in activity tolerance. A trend in females indicated similar results. |
