Exercise behavior among women post-myocardial infarction: Applying the transtheoretical model of behavior change

Exercise adherence among women post-myocardial infarction (MI) is a major health issue. The lack of exercise adherence prevents women from attaining the multiple benefits of exercise and exacerbates cardiovascular disease. Factors identified as determining adherence to therapeutic regimen for women post-MI include personal factors, interpersonal factors, and environmental factors.;A descriptive survey design utilizing the Transtheoretical Model of Behavior Change (TTM) (Prochaska & DiClemente, 1982) was used to investigate the relationships among stage of change for exercise behavior, processes of change, decisional balance (pros and cons), and self-efficacy for exercise in women post-MI. The following research questions were addressed: (a) How does pre-MI stage of change for exercise relate to post-MI stage for follow-up exercise prescription? (b) What are the relationships among the stage of change for exercise processes of change, decisional balance, and self-efficacy for exercise for women who have had a MI within the past five weeks? (c) For those women who made a stage progression, what processes of change for exercise did they use?;For Phase I of this study, a convenience sample of nine women post-MI completed the following instruments: Demographic and Medical Data; Exercise: Stage of Change for one month prior to MI and four-five weeks after MI; Exercise: Processes of Change; Exercise: Decisional Balance; and Exercise: Self-efficacy based on the constructs of the TTM. Phase II of this study involved a follow-up interview several months after hospital discharge to obtain more in-depth answers to the research questions.;Quantitative data were analyzed using descriptive statistics. The interviews were analyzed using Miles & Huberman's (1994) approach to qualitative analysis. Two participants increased their exercise stage of change, two participants decreased their stage of change, and three participants maintained their stage of change. The processes of change, decisional balance (pros and cons), and self-efficacy for exercise were identified for each stage of change and compared to the TTM for consistency. Five categories of pros along with five categories of cons for exercise were identified from the qualitative analysis of data. These results have implications for developing individualized interventions for exercise behavior change for women post-MI.