Motivating Patients in Cardiac Rehabilitation Programs: A Multicenter Randomized Controlled Trial

Abstract

Concerns have been raised about motivation and psychological distress when implementing telerehabilitation in patients with heart failure. The current study compared conventional and telerehabilitation in two groups (n=67; n=70) of patients with heart failure at 0, 6, and 12 months on measures of motivation (Self-Determination Theory measures) and psychological distress (Hospital Anxiety and Depression scale). We found no significant changes in motivation across groups, although our telerehabilitation group had a slightly lower level of controlled motivation and higher levels of relatedness. In addition, there were no differences between groups with regard to psychological distress. This study demonstrates that telerehabilitation motivates patients with heart failure to the same degree as conventional rehabilitation, and that telerehabilitation is not associated with increased psychological distress. As such, telerehabilitation offers an alternative to conventional rehabilitation and addresses some of the barriers for participating in rehabilitation identified in the literature.

Increased motivation for and use of digital services in heart failure patients participating in a telerehabilitation program: a randomized controlled trial

“…The fact that our TR group felt more motivated to use digital services indicate that the FPT program may have successfully motivated patients to use the digital telerehabilitation platform, as they engaged in using relevant digital health services. As such, these findings supports the notion that when designing telerehabilitation programs, it is important to create digital health services that motivate and match the needs of the users in order to give them a positive user experience ( 25 ). Simply digitalizing existing services is not sufficient for successful engagement in telerehabilitation, motivation is essential for digital practices becoming a routine part of the patients’ everyday lives, in turn improving disease management and self-care.…”

Exercise Self-efficacy Improvements During Cardiac Rehabilitation

“…24 This proposition is supported by a study that examined motivation in patients participating in cardiac telerehabilitation versus traditional CR, which found that the traditional CR group was more likely to be dependent on external sources of motivation, such as health personnel, compared with the telerehabilitation group. 47 This study has several limitations. Given the observational study design, cause and effect could not be implied.…”

“…Remote methods of CR delivery may have been more appealing to those who were already self-motivated to exercise, whereas in-person sessions were preferred by patients who needed more support because of closer and direct instruction, guidance, and supervision 24. This proposition is supported by a study that examined motivation in patients participating in cardiac telerehabilitation versus traditional CR, which found that the traditional CR group was more likely to be dependent on external sources of motivation, such as health personnel, compared with the telerehabilitation group 47…”

Exercise-Based Cardiac Rehabilitation: Analyzing Clinical Effectiveness

“…Rehabilitation programs often include educational components that help patients understand the importance of regular exercise and strategies for coping with motivational difficulties. In addition, group exercise sessions can provide social support and a sense of community, which also positively affects patient engagement [17,18].…”