Effects of an Individual and Family Self-Management Exercise Program on Exercise Behaviors and Exercise Capacity in Elderly Patients Post-Percutaneous Coronary Intervention

Abstract

Introduction Recurrent stenosis is a risk following percutaneous coronary intervention (PCI) in elderly patients diagnosed with Coronary Artery Disease (CAD). An effective exercise program with individual and family self-management has been shown to reduce the risk.

Objective To examine the effects of an individual and family self-management exercise program on exercise behaviors and exercise capacity in elderly patients with CAD after PCI.

Design A quasi-experimental with two-group, pretest-posttest design 

Methodology Sixty elderly patients diagnosed with CAD, who had undergone PCI and were admitted at a tertiary hospital in Bangkok, were purposively selected based on the inclusion criteria. Participants were randomly assigned into equal experimental and control groups, using matched pairs based on age and gender. The experimental group participated in an eight-week home-based self-management exercise program. The program development was guided by the individual and family self-management theory described by Ryan and Sawin, which served as the framework for the study. The control group received regular care before being discharged from the hospital. Data were collected using a demographic questionnaire, the exercise capacity record form (six-minute walk test, 6MWT), and the exercise behaviors questionnaire for elderly patients with coronary heart disease. The three instruments were content validated by experts, resulting in a content validity index (CVI) of 1.0, 1.0, and .89, respectively. The reliability test of the exercise behaviors questionnaire obtained a Cronbach’s alpha coefficient of .96. Data were collected both before and after the program. The data were then analyzed using descriptive statistics, Dependent t-test, and Independent t-test. 

Results The experimental and control groups consisted of an equal number of male and female participants (n = 15 each). There was no statistically significant difference in the mean age between the experimental group (M = 69.03, SD = 5.99 years) and the control group (M = 68.07, SD = 5.83 years). At baseline, both the experimental group and the control group revealed no statistical difference in exercise behaviors (M = 24.87, SD = 7.71; M = 24.37, SD = 7.54, respectively) and exercise capacity (M = 300.03, SD = 44.02; M = 307.50, SD = 38.72, respectively). After the program, the experimental group revealed significantly higher scores in exercise behaviors (M = 42.83, SD = 2.31) and exercise capacity (M = 344.50, SD = 67.78) compared to baseline (t = 15.019, p < .001; t = 6.290, p < .001, respectively) and the control group (M = 24.57, SD = 7.60; M = 310.83, SD = 43.97, respectively; t = 12.596, p < .001; t = 2.283, p = .027, respectively). The program’s findings indicate its effectiveness in modifying exercise behaviors and increasing exercise capacity in the elderly patients. 

Recommendations Nurses and healthcare teams should encourage and closely monitor elderly patients with coronary heart disease post-percutaneous coronary intervention to engage in regular exercise. The implementation of a home-based self-management exercise program for cardiac rehabilitation is strongly recommended, as it can significantly promote better health status and reduce the risk of recurrent coronary disease following PCI.