Abstract
Moderate-vigorous exercise, an important self-care behavior, is recommended in multiple clinical practice guidelines. In HF, exercise improves clinical outcomes but participation rates are low. Knowledge of exercise and physical activity guidelines may play a role in exercise participation; however, prior studies have included small samples from single sites. The purpose of this study was to determine the relationship between demographic and clinical factors and exercise knowledge levels of patients with HF.
This sub-analysis of a multi-site (5 USA and 1 Swedish site) correlational study enrolled a convenience sample. Demographics (gender, age, marital status, ethnicity, highest education, and employment), clinical and HF characteristics (including NYHA class, BMI, depression, comorbidity score, previous cardiac rehabilitation, type of physician seen), past and current participation in physical activity, and knowledge about endurance exercise levels (higher scores greater knowledge), were collected. Correlations and ANOVA were used to determine relationships and differences in exercise knowledge levels by demographic and clinical characteristics.
Of 492 participants, mean (SD) age was 63 (13.6) years and BMI 29.3 (6.73) kg/ml/m2. Other characteristics were 65.8% male; 76.2% Caucasian; 58.9% married; 30.9% NYHA class III/IV. Only 46% exercised moderately-vigorously. Mean (SD) exercise knowledge was poor, 35% (20%) on a 0-100% scale and US knowledge scores were higher than Swedish scores (36.2 vs 29.2, p = 0.001). Those who described past (p<.001) and current (p= 0.001) exercise levels as vigorous had higher mean exercise knowledge than non-exercisers. In univariate analysis, knowledge scores were higher if married (p = 0.014), more highly educated (p < 0.001), lower NYHA class (p < 0.001), lower depression score (p = 0.002) and employed (p < 0.001).
Among patients with HF, exercise knowledge level was low, and knowledge differed by several demographic and clinical characteristics. Exercise behaviors are modifiable and educational interventions targeted to individuals with lower knowledge levels are necessary.