Predictors of behavioural risk factors modification in patients recovering from acute coronary heart disease.
|Title:||Predictors of behavioural risk factors modification in patients recovering from acute coronary heart disease.|
|Authors:||Lee, Alison Claire.|
|Abstract:||This present investigation is a prospective study of 123 cardiac patients who attended a community-based program of education and support, following hospital admission for acute cardiovascular disease. The objective of the study was to derive a predictive model that would maximally discriminate between participants who were vs. participants who were not successful in modifying a health-risk behaviour. The four behaviours examined were following a low-fat diet, performing regular exercise, weight reduction and smoking cessation. Readiness for change was assessed prior to the commencement of the eight-week program, at post-treatment and at five-month follow-up. Participants were grouped into two outcome groups based on their stage of change as delineated by the Transtheoretical Model. Subjects who were in the action or maintenance stages of change at seven-month follow-up were classified as Progressors, and those who were in pre-action stages were classified as Non-progressors. The variables included in the predictive model were optimism, psychological distress, social intimacy and self-efficacy. Neuroticism was also included to explore its relationship with optimism. Discriminant function analysis showed that the variables that maximally separated individuals who were successful in risk-factor modification from those who were unsuccessful were social intimacy and self-efficacy. A secondary objective of this study was to compare Progressing subjects with Non-progressing subjects on psychological distress and on two Transtheoretical Model measures, decisional balance and the processes of change. Repeated measures analysis of variance indicated a slight reduction over time in scores on the measure of psychological distress for all participants as a group. However, no differences were found in psychological distress between participants who changed their health-risk behaviour and those who did not. Because more subjects than anticipated were successful in changing their target health-risk behaviour, there were insufficient data to further compare successful changers with unsuccessful changers. Thus the data did not provide for a robust test of how individuals progress through the Transtheoretical model stages of change following a coronary event. Overall this thesis emphasizes the importance of the social context of behaviour change as evidenced by the contribution of the measure of social intimacy. In addition, this thesis offers some information on the relationship between personality constructs (e.g., neuroticism) and behaviour change, although this requires further investigation.|
|Collection||Thèses, 1910 - 2010 // Theses, 1910 - 2010|