Abstract
Background: Lack of physical activity (PA) is a major health risk factor, associated with high burden of ischemic heart disease (IHD) [1]. Increasing PA demonstrates health benefits but meeting PA guidelines is difficult for patients with IHD. Furthermore, patients with IHD who experience hopelessness, a negative outlook and sense of helplessness about the future [2], may face additional barriers in meeting PA guidelines. This study used a qualitative approach to explore the self-reported barriers and motivating factors to meeting PA goals for patients with IHD.
Methods: The Heart Up! Study was an RCT testing a 6-week motivational intervention in individuals who reported hopelessness during IHD-related hospitalization [3]. The intervention group engaged in motivational interviewing (MI) [4] with a nurse interventionist, with discussion of 1) obstacles to PA, 2) strategies to overcome obstacles, and 3) next steps to meet PA goals. This secondary analysis used open content analysis [5] to qualitatively code the three categories of MI data. All responses were coded by two study team members with consensus meetings to reach agreement.
Results: Data from 92 participants were analyzed (33% women, mean age 62). Obstacles: lacking time (work/family) or material resources, concerns about weather, physical health status (e.g., fatigue, pain, mobility), and mental health (fear, negative emotion, motivation). Strategies to overcome obstacles: practical support, family members as key support, healthcare provider guidance, functional adaptation to new deficits (e.g., slowing down, using assistive devices), practical adaptations (e.g., changing modalities, new routines), sources of motivation/positive attitude, and prioritizing PA. Next steps: both generic activity goals (e.g., walk, bike) and specific activity goals (e.g., walk to the end of the driveway), attending cardiac rehabilitation or physical therapy, support from healthcare providers (e.g., pain control), life changes (e.g., cutting down work), social support to facilitate PA, and focusing on motivations (e.g., being present for family milestones).
Conclusions: These findings identify critical factors that healthcare providers can support to help patients with IHD reach their PA goals when experiencing hopelessness. The period following an IHD-related hospitalization is a time of great transition, and early intervention during this time can help guide patients toward improved health and well-being outcomes.
Notes
References:
1. Lobelo F, et al. Routine Assessment and Promotion of Physical Activity in Healthcare Settings: A Scientific Statement From the American Heart Association. Circulation. 2018 May 1;137(18):e495-e522. doi: 10.1161/CIR.0000000000000559
2. Liu RT, Kleiman EM, Nestor BA, Cheek SM. The Hopelessness Theory of Depression: A Quarter Century in Review. Clin Psychol. 2015 Dec 1;22(4):345-365. doi: 10.1111/cpsp.12125
3. Dunn SL, et al. Heart up! RCT protocol to increase physical activity in cardiac patients who report hopelessness: Amended for the COVID-19 pandemic. Res Nurs Health. 2021 Apr;44(2):279-294. doi: 10.1002/nur.22106
4. Markland D, Ryan RM, Tobin VJ, Rollnick S. Motivational Interviewing and Self-Determination Theory. J Soc Clin Psych. 2005 Oct 1;24(6):811–831. Doi: 10.1521/jscp.2005.24.6.811
5. Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005 Nov;15(9):1277-88. doi: 10.1177/1049732305276687
Sigma Membership
Alpha Lambda
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Secondary Analysis
Research Approach
Qualitative Research
Keywords:
Coronary Disease, Despair, Physical Activity
Recommended Citation
Rivera, Eleanor; Coke, Lola; Tintle, Nathan; Goodyke, Madison; Luong, Anna; and Dunn, Susan, "Factors Influencing Physical Activity Post-hospitalization in Cardiac Patients Reporting Hopelessness" (2026). International Nursing Research Congress (INRC). 231.
https://www.sigmarepository.org/inrc/2026/presentations_2026/231
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-08-27
Factors Influencing Physical Activity Post-hospitalization in Cardiac Patients Reporting Hopelessness
Toronto, Ontario, Canada
Background: Lack of physical activity (PA) is a major health risk factor, associated with high burden of ischemic heart disease (IHD) [1]. Increasing PA demonstrates health benefits but meeting PA guidelines is difficult for patients with IHD. Furthermore, patients with IHD who experience hopelessness, a negative outlook and sense of helplessness about the future [2], may face additional barriers in meeting PA guidelines. This study used a qualitative approach to explore the self-reported barriers and motivating factors to meeting PA goals for patients with IHD.
Methods: The Heart Up! Study was an RCT testing a 6-week motivational intervention in individuals who reported hopelessness during IHD-related hospitalization [3]. The intervention group engaged in motivational interviewing (MI) [4] with a nurse interventionist, with discussion of 1) obstacles to PA, 2) strategies to overcome obstacles, and 3) next steps to meet PA goals. This secondary analysis used open content analysis [5] to qualitatively code the three categories of MI data. All responses were coded by two study team members with consensus meetings to reach agreement.
Results: Data from 92 participants were analyzed (33% women, mean age 62). Obstacles: lacking time (work/family) or material resources, concerns about weather, physical health status (e.g., fatigue, pain, mobility), and mental health (fear, negative emotion, motivation). Strategies to overcome obstacles: practical support, family members as key support, healthcare provider guidance, functional adaptation to new deficits (e.g., slowing down, using assistive devices), practical adaptations (e.g., changing modalities, new routines), sources of motivation/positive attitude, and prioritizing PA. Next steps: both generic activity goals (e.g., walk, bike) and specific activity goals (e.g., walk to the end of the driveway), attending cardiac rehabilitation or physical therapy, support from healthcare providers (e.g., pain control), life changes (e.g., cutting down work), social support to facilitate PA, and focusing on motivations (e.g., being present for family milestones).
Conclusions: These findings identify critical factors that healthcare providers can support to help patients with IHD reach their PA goals when experiencing hopelessness. The period following an IHD-related hospitalization is a time of great transition, and early intervention during this time can help guide patients toward improved health and well-being outcomes.
Description
This study used a qualitative approach to explore self-reported barriers and motivating factors to meeting physical activity goals for patients who are experiencing hopelessness after an ischemic heart disease-related hospitalization. Our findings identify critical factors to support and help patients; early intervention after hospitalization can help guide patients toward improved health and well-being outcomes.