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Patient-Selected Strategies for Post Cardiac Rehabilitation Exercise Adherence in Heart Failure

Nielsen, Jessica, DNP, APRN-NP1; Duncan, Kathleen, PhD, RN2; Pozehl, Bunny, PhD, APRN-NP, FAHA, FAAN2

doi: 10.1097/rnj.0000000000000127

Purpose The aim of this study was to evaluate the use of patient-selected exercise adherence strategies following cardiac rehabilitation (CR).

Design Twenty patients with heart failure (HF) were recruited and randomly assigned to the intervention or control group at completion of CR.

Methods The intervention included the use of six adherence strategies (logs, graphs, pedometers, phone follow-up, education, and a letter from CR staff), which were provided for 6 weeks post CR and during home-based exercise. After 6 weeks, the intervention group selected strategies to continue, and only those were provided for the last 6 weeks. At 12 weeks, patients were retested.

Findings Patients with HF demonstrated improvement in distance walked and less HF symptoms and adhered to exercise at levels recommended during CR.

Conclusion Inclusion of patient-selected adherence strategies supports continued exercise and helps to sustain physiological improvements.

Clinical Relevance Results from this study have implications for CR programs serving HF patients and provide insight into adherence strategies.

1 College of Nursing-Omaha Division, University of Nebraska Medical Center, Omaha, NE, USA

2 College of Nursing-Lincoln Division, University of Nebraska Medical Center, Omaha, NE, USA

Correspondence: Jessica Nielsen, College of Nursing-Omaha Division, University of Nebraska Medical Center, 985330 Nebraska Medical Center, 4111 Dewey Avenue, Omaha, NE 68198–5330, USA. E-mail:

Funding for his study was received from University of Nebraska Medical Center, College of Nursing, Dean’s Grant. The authors declare no conflicts of interest.

All authors have read and approved submission of the manuscript and the manuscript has not been published and is not being considered for publication elsewhere in whole or part in any language except as an abstract.

Cite this article as: Nielsen, J., Duncan, K., & Pozehl, B. (2019). Patient-selected strategies for post cardiac rehabilitation exercise adherence in heart failure. Rehabilitation Nursing, 44(3), 181–185. doi:10.1097/rnj.0000000000000127

© 2019 Association of Rehabilitation Nurses.
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