Exercise Motivation and Self-Efficacy Vary Among Patients with Heart Failure – An Explorative Analysis Using Data from the HF-Wii Study

Abstract

Purpose

To examine profiles in patients with heart failure (HF) regarding their exercise motivation and self-efficacy.

Patients & Methods

The baseline data of patients with HF participating in the HF-Wii study were analysed. In total, 517 patients were divided into four groups based on their exercise motivation (exercise motivation index) and self-efficacy (exercise self-efficacy scale). To describe the differences in demographic and clinical variables between the groups, chi-square cross-tabulations and ANOVAs were conducted.

Results

The four groups were labelled as insecure avoiders (25%), laid-back strugglers (10%), conscientious self-doubters (42%) and determined achievers (22%). Patients’ profiles differ according to their motivations and self-efficacy towards exercise. Most patients were conscientious self-doubters (high motivation and low self-efficacy), and these patients had more comorbidities and lower exercise capacity compared to the other groups, which could decrease their confidence in exercising. However, only half of the patients who were determined achievers (high motivation and high self-efficacy) reached the recommended amount of physical activity per week. This indicates that motivation and self-efficacy are crucial determinants, but more factors are important for becoming more physically active.

Conclusion

Understanding patients’ motivations and self-efficacy are necessary in order to provide meaningful physical activity counselling and promotion.

Keywords:

• motivation
• self-efficacy
• physical activity
• exercise
• heart failure

Data Sharing Statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Acknowledgments

This article is written on behalf of the HF-Wii study team: T. Jaarsma, A. Strömberg, L. Klompstra, B. Ben Avraham, T. Ben Gal, J. Boyne, K. Dickstein, M. Bäck, O. Chiala, L. Evangelista, A. Hagenow, A. Hoes, E. Hägglund, J. Mårtensson, M.F. Piepoli, E. Vellone and N.P.A. Zuithoff.

We also want to thank: Norrköping: A. Hammarskiold, L. Nestor, C. Norrman, M. Viklander, A. Waldemar, R.M. Petterson; M. Wärfman. Jönköping: E. Lundberg, H. Sköldbäck, M. Sahlin.

Linköping: A. Gylling, L. Hjelmfors, M. Huss, M. Jonsson, N.P. Kato, P. Wodlin.

Stockholm: E. Hägglund, U. Lennmark.

Nyköping: E. Säfström.

The Netherlands: H.P. Brunner-La Rocca, M. Spanjers, A. van de Voorde, G. Cleuren.

Italy: R. Corsi, G.A. Ortali,

Israel: S. Donanhirsh, Y. Navon, V. Yaari.

Germany: A. Kuntzsch.

USA: J. Ardo, J. Nguyen, M. Cacciata.

Statistical advice: M. Fredrikson, N.P.A. Zuithoff.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This work was supported by the Swedish National Science Council (K2013-69X-22302-01-3, 2016-01390), the Swedish National Science Council/the Swedish Research Council for Health, Working Life and Welfare, VR-FORTE (2014-4100), the Swedish Heart and Lung Association (E085/12), the Swedish Heart and Lung Foundation (20130340, 20160439), the Vårdal Foundation (2014–0018) and the Medical Research Council of Southeast Sweden (FORSS 474681).