Modifiable risk factors and motivation for lifestyle change of CVD patients starting cardiac rehabilitation: The BENEFIT study

L. Breeman*, A.F.P. Alonso, D. Kühling-Romero, R.A. Kraaijenhagen, I. Al-Dhahir, R.V.H. IJzerman, R. van Eersel, K. Wolstencroft, T.N. Bonten, D.E. Atsma, N.H. Chavannes, L. van Gemert-Pijnen, H.M.C. Kemps, W. Scholte op Reimer, A.W.M. Evers, V.R. Janssen

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background
To improve lifestyle guidance within cardiac rehabilitation (CR), a comprehensive understanding of the motivation and lifestyle-supporting needs of patients with cardiovascular disease (CVD) is required.

Objectives
This study's purpose is to evaluate patients’ lifestyle and their motivation, self-efficacy and social support for change when starting CR.

Methods
1782 CVD patients (69 % male, mean age 62 years) from 7 Dutch outpatient CR centers participated between 2020 and 2022. Modifiable risk factors were assessed with a survey and interviews by healthcare professionals during CR intake. 

Results
Most patients exhibited an elevated risk in 3–4 domains. Elevated risks were most prominent in domains of (1) waist circumference and BMI (2) physical exercise (3) healthy foods intake and (4) sleep duration. Most patients chose to focus on increasing physical exercise, but about 20 % also wanted to focus on a healthy diet and/or decrease stress levels. Generally, motivation, self-efficacy and social support to reach new lifestyle goals were high. However, patients with an unfavorable risk profile had lower motivation and self-efficacy to work on lifestyle changes, while patients with lower social support had a higher chance to quit the program prematurely.

Conclusions
Our results underscore the need to begin CR with a comprehensive lifestyle assessment and highlight the importance of offering lifestyle interventions tailored to patients’ specific modifiable risk factors and lifestyle-supporting needs, targeting multiple lifestyle domains. Expanding the current scope of CR programs to address diverse patient needs and strengthening support may enhance motivation and adherence and lead to significant long-term benefits for cardiovascular health.

Original languageEnglish
Pages (from-to)31-39
Number of pages9
JournalHeart & Lung
Volume69
Early online date2024
DOIs
Publication statusE-pub ahead of print - 2024

Keywords

  • Cardiac rehabilitation
  • Cardiovascular disease
  • Lifestyle
  • Modifiable risk factors
  • Motivation

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