Health Beliefs Related to Physical Activity in Patients Living with Implantable Cardioverter Defibrillators

Crawford, Rebecca Susan

Background: Low levels of physical activity (PA) are a significant predictor of early death among recipients of implantable cardioverter defibrillators (ICDs). Regular, moderate PA is associated with improved quality of life (QOL), reduced arrhythmia burden, and improved health outcomes in adult ICD recipients yet many do not engage in PA and reasons for lack of engagement are unclear.

Purpose: The purpose of this study was to examine health beliefs related to PA and QOL in adults with ICDs.

Methods: This study was a descriptive, cross-sectional design measuring the concepts, perceived benefits, perceived barriers and self-efficacy from the Health Belief Model as a theoretical framework.

Results: The sample (n = 81) was primarily male (71.6%) and white (77.8%), with a mean age of 70.23 years. Most were insured by Medicare (79%) and live in rural areas/small towns (75.3%). Most had heart failure (HF) (98.2%) and almost 40 % reported decreased PA levels since ICD implant. There were no differences in health beliefs and QOL scores between subjects who had an ICD as a primary or secondary prevention of sudden cardiac death. Almost 33 percent of variance in total PA participation can be explained by Self-Efficacy for Exercise (SEE) (β = .390, p < .01); Self-efficacy after ICD (SEICD) (β = .215, p < .05); age (β = -.234, p < .01); New York Heart Association (NYHA) Classification (β =-.198, p <.05); and ICD type (β = .014, p > 05). SEE alone accounted for almost 23 % of variance. Perceived barriers (β = -.310, p < .01) accounted for 9.3 % of variance in planned PA.

Conclusion: Findings indicate the strength of self-efficacy in predicting PA participation; and, perceived barriers predicting planned PA in adult ICD recipients. Findings support the need for more research in identifying barriers and predictors of PA participation more specific to adult, ICD recipients. Findings also support interventions aimed at increasing SE beliefs related secondary prevention behaviors, specifically physical activity.