Frontiers in medicine · 2026
A randomized controlled trial of staged cardiac rehabilitation based on the Health Belief Model on kinesiophobia, self-efficacy and activities of daily living in elderly patients with coronary heart disease.
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Zheng Xiaoqin, Tan Ya, Wang Xiao, Li Qi, Li Jinyan, Lan Xin, Zhang Song
Аннотация
INTRODUCTION: Kinesiophobia is highly prevalent in elderly patients with coronary heart disease (CHD) and severely limits participation in cardiac rehabilitation. However, phased, theory-based interventions targeting this population are lacking.
METHODS: This single-blind randomized controlled trial of 139 elderly CHD patients evaluated a staged cardiac rehabilitation intervention based on the Health Belief Model (HBM). The intervention group (n = 69) received a staged HBM-based programme plus usual care; the control group (n = 70) received usual care only. Outcomes (TSK-SV Heart, Barthel Index, SEE) were measured at admission (T0), discharge (T1), and 1 month (T2) and 3 months (T3) post-discharge.
RESULTS: Repeated-measures ANOVA revealed significant time, group, and interaction effects for all outcomes (P < 0.05). The intervention group showed significantly higher Barthel Index and SEE scores at T1, T2, and T3, and lower TSK-SV Heart scores at T2 and T3 versus controls (P < 0.05). Within the intervention group, kinesiophobia at T2/T3 was lower than at T0/T1, and self-efficacy at T1-T3 was higher than at T0 (P < α'). No exercise-related adverse events occurred.
DISCUSSION: A staged HBM-based cardiac rehabilitation programme reduces kinesiophobia, improves ADL, and enhances exercise self-efficacy in elderly CHD patients, with sustained effects and excellent safety. This nurse-led, low-cost programme can be integrated into standard cardiac rehabilitation pathways for older adults.
METHODS: This single-blind randomized controlled trial of 139 elderly CHD patients evaluated a staged cardiac rehabilitation intervention based on the Health Belief Model (HBM). The intervention group (n = 69) received a staged HBM-based programme plus usual care; the control group (n = 70) received usual care only. Outcomes (TSK-SV Heart, Barthel Index, SEE) were measured at admission (T0), discharge (T1), and 1 month (T2) and 3 months (T3) post-discharge.
RESULTS: Repeated-measures ANOVA revealed significant time, group, and interaction effects for all outcomes (P < 0.05). The intervention group showed significantly higher Barthel Index and SEE scores at T1, T2, and T3, and lower TSK-SV Heart scores at T2 and T3 versus controls (P < 0.05). Within the intervention group, kinesiophobia at T2/T3 was lower than at T0/T1, and self-efficacy at T1-T3 was higher than at T0 (P < α'). No exercise-related adverse events occurred.
DISCUSSION: A staged HBM-based cardiac rehabilitation programme reduces kinesiophobia, improves ADL, and enhances exercise self-efficacy in elderly CHD patients, with sustained effects and excellent safety. This nurse-led, low-cost programme can be integrated into standard cardiac rehabilitation pathways for older adults.