Motivational processes and well-being in cardiac rehabilitation: a self-determination theory perspective

Abstract

This research examined the processes underpinning changes in psychological well-being and behavioural regulation in Cardiac Rehabilitation (CR) patients using Self-Determination Theory (SDT; Deci & Ryan, 1985). A repeated measures design was used to identify the longitudinal relationships between SDT variables, psychological well-being and exercise behaviour during and following a structured CR programme. Participants were 389 cardiac patients (aged 36-84 years; M age = 64 ± 9 years; 34.3% female) referred to a 12 week supervised CR programme. Psychological need satisfaction, behavioural regulation, healthrelated quality of life, physical self-worth, anxiety and depression were measured at programme entry, exit and 6 month post-programme. During the programme, increases in autonomy satisfaction predicted positive changes in behavioural regulation, and improvements in competence and relatedness satisfaction predicted improvements in behavioural regulation and well-being. Competence satisfaction also positively predicted habitual physical activity. Decreases in external regulation and, increases in intrinsic motivation, predicted improvements in physical self-worth and physical well-being respectively. Significant longitudinal relationships were identified whereby changes during the programme predicted changes in habitual physical activity and the mental quality of life from exit to 6 month follow-up. Findings provide insight into the factors explaining psychological changes seen during CR. They highlight the importance of increasing patients' perceptions of psychological need satisfaction and self-determined motivation to improve well-being during the structured component of a CR programme and longer-term physical activity.3

Sense of coherence and psychological well-being in cardiac patients: Is the association mediated by self-efficacy?

“…Since SOC is understood as a global orientation that expresses the extent to which individuals have an enduring and dynamic feeling of confidence in their life [8,17], the positive relationship between SOC and wellbeing can be expected. This result was reported for example in the studies of Rahman, Hudson, Thøgersen-Ntoumani, and Doustd [18] and in the research conducted by [19].…”

“…Self-efficacy seems to be crucial in the functioning of cardiac patients, since its motivational role for participation in cardiac rehabilitation programmes [18], enhancing patients' functioning after cardiac problems [29] or influencing the patients' quality of life in general [30]. One can expect that people with a higher level of self-efficacy will declare a higher level of well-being in comparison to people with a lower level of selfefficacy.…”

Promoting a sense of security in everyday life—A case study of patients and professionals moving towards co‐production in an atrial fibrillation “learning café”

“…Furthermore, the programme created conditions for interacting with—relating to—fellow patients, family members and knowledgeable health‐care staff. Competence and relatedness can facilitate coping and promote patient autonomy . Some participating patients reported actual or anticipated changes in their patterns of health‐care utilization, expecting that they would refrain from going to the emergency room so quickly, due to the Learning Café experience.…”

The Need-Relevant Instructor Behaviors Scale: Development and Initial Validation

“…The evidence linking need-supportive instructing styles with adaptive outcomes for exercisers is substantial in volume (Standage & Ryan, 2012), yet predominantly reliant on self-report data and correlational analyses. Few intervention studies have attempted to manipulate the communication style used by exercise instructors to create a more need-supportive atmosphere; such studies have predominantly taken place in clinical settings (e.g., Mildestvedt, Meland, & Eide, 2008;Rahman, Hudson, Thøgersen-Ntoumani, & Doust, 2015). Very few studies have targeted behaviors of instructors working in commercial fitness settings designed for healthy adults.…”