Exercise Behavior in Heart Failure Patients

描述(申请人提供)：每年有55万名新患者被诊断为心力衰竭(HF)。2006年，据报告有110万人出院，2010年美国心力衰竭的直接和间接成本估计约为392亿美元。有证据表明，运动可以帮助心力衰竭患者提高他们的功能能力和生活质量，并与降低死亡率和住院有关。运动已被证明对纽约心脏协会所有分类(I-IV)中确诊的人是有效和安全的。然而，心力衰竭患者发起和/或维持运动行为的比例很低，因为心力衰竭患者报告说，与其他处方的心力衰竭管理活动相比，运动更困难。了解增强或阻碍心力衰竭患者开始和维持运动行为能力的因素对于制定干预措施以帮助他们改善其功能能力和生活质量是重要的。自我效能感、结果预期和社会支持都来自班杜拉的社会认知理论。这些特定的社会认知理论概念已经被证明是一些老年人群体中运动启动和维持的重要预测因子。已经有几个模型被测试来解释锻炼行为，利用社会认知理论的组成部分，一般适用于老年人和心脏康复患者。这些模型彼此并不相同，到目前为止，还没有使用社会认知理论的特定概念的运动行为模型在HF人群中进行测试。这项研究的目的是了解影响其他人群运动行为的因素是否可以解释心力衰竭患者的运动行为。这项研究的具体目的是确定和确定与心力衰竭患者运动行为相关的理论驱动因素的强度。更好地了解与心力衰竭患者运动行为增加相关的因素将导致开发更有效的干预措施来促进运动行为，从而改善整体健康状况并减少住院人数。 公共卫生相关性：心力衰竭(HF)是一种疾病，它降低了人们的功能能力和生活质量，给社会上的许多人带来了负担。研究表明，锻炼可以帮助心力衰竭患者增加白天的活动能力，从而提高他们的生活质量。然而，心力衰竭患者报告说，运动比其他规定的心力衰竭管理行为(例如，吃低钠饮食或定期称体重)更难进行。为了设计干预措施，帮助心力衰竭患者增加运动行为，我们需要了解在这一人群中，哪些因素与运动密切相关。

DESCRIPTION (provided by applicant): Each year 550,000 new people are diagnosed with heart failure (HF). In the year 2006, 1.1 million hospital discharges were reported, and the estimated direct and indirect cost of HF in the United States is approximately $39.2 billion for 2010. There is evidence that exercise can help patients with HF improve their functional capacity and quality of life as well as being associated with decreased mortality and hospitalization. Exercise has been shown to be efficacious and safe for people diagnosed in all New York Heart Association Classifications (I - IV). However, a low percentage of HF patients initiate and/or maintain exercise behavior as HF patients have reported more difficulty with exercising compared to other prescribed HF management activities. Understanding the factors that enhance or hinder HF patients' ability to begin and maintain exercise behavior is important for development of interventions to assist them in improving their functional capacity and quality of life. Self-efficacy, outcome expectancy, and social support are all concepts from Bandura's social- cognitive theory. These specific concepts of social cognitive theory have been shown to be significant predictors for exercise initiation and maintenance in some older adult populations. There have been several models tested to explain exercise behavior utilizing components of social cognitive theory in general for older adults and patients in cardiac rehabilitation. These models are not identical to each other and to date no model of exercise behavior using specific concepts of social cognitive theory has been tested in the HF population. The purpose of this study is to understand if factors affecting exercise behavior in other populations explain exercise behavior in HF patients. The specific aim of this research is to identify and determine the strength of theory-driven factors associated with exercise behavior in HF patients. A greater understanding of factors associated with increased exercise behavior in HF patients will lead to the development of more effective interventions to promote exercise behavior that improves overall health status and decreases hospitalizations. PUBLIC HEALTH RELEVANCE: Heart failure (HF) is a disease that burdens many people in our society by decreasing their functional ability and quality of life. Exercise has been shown to help people with HF increase what they are able to do during the day which improves their quality of life. However, HF patients have reported that exercise is more difficult to perform than other prescribed HF management behaviors (e.g. eating a low sodium diet or regularly weighing themselves). In order to design interventions to help people with HF to increase exercise behavior, we need to understand what factors are strongly associated with exercise in this population.