Determinants of physical activity and exercise self-efficacy among patients with Heart Failure attending cardiac clinic at Teaching Hospital Batticaloa, Sri Lanka.

Abstract

Heart failure (HF) is one of the major causes for morbidity and mortality worldwide including in Sri Lanka. Engaging adequate physical activity results in positive outcomes. Exercise self-efficacy has a crucial part in it. However, physical inactivity is common among HF patients due to various factors. The objective of the study is to identify the factors influence on physical activity and exercise self-efficacy among patients with HF, attending cardiac clinic at THB. Descriptive cross-sectional study was conducted by recruiting all registered patients with HF at cardiac clinic, THB by applying complete enumeration method from May 2024 to July 2024. Validated interviewer administered questionnaire was used to collect data on socio-demographic and clinical characteristics, level of physical activity and level of exercise self-efficacy. Statistical Package of Social Sciences version 26 (SPSS 26) was used for analysing the data based on objectives. Majority of the participants were male (70.2%), aged between 50-65 (59.1%), Tamil (55%), lived in urban area (74.6%), married (84%) and had primary (32%) as well as senior secondary (32%) education, unemployed (59.6%), had monthly income equal or less than LKR 15000 (53.6%). Regarding clinical charecteristics, majority was diagnosed as HF with the duration of ≤1 year (44.2%), had EF less than 40% (64.1%), with other co-morbidities (n=179,98.9%), notably history of acute coronary syndrome (n=147, 81.2%), prescribed with dieuretics (n=154, 90.6%), experienced symptoms while doing physical activity (n=167,92.3%), importantly dyspnea (n=118,65.2%), had concern of family members and friends that doing physical activity is harmful (n=147, 81.2%). The findings demonstrated, around one-third of participants exhibited low (38.6%) and approximately half of them enganged in moderate (47.1%) level of physical activity. Around half of the participants had low level (52.2%) as well as moderate level (47.2%) of exercise self-efficacy. The finding suggested there was a significant relationship between occupation (p=0.014), ejection fraction (p=0.019), information sources on HF [family (p=0.07), friends (p=0.02)] and physical activity. Relationship between exercise self-efficacy and gender (p=0.036), marital status (p=0.018), occupation (p=0.001), monthly income (p=0.000), ejection fraction (p=0.047) and symptoms experiencing while doing physical activity (p=0.001) were found to be significantly associated. Study participants had low, moderate level of physical activity as well as exercise self-efficacy. These results highlight the need for individualized interventions to improve the level of physical activity as well as exercise self-efficacy thus, improving functional capacity of patients with HF.