Date on Master's Thesis/Doctoral Dissertation

5-2024

Document Type

Doctoral Dissertation

Degree Name

Ph. D.

Department

Nursing

Degree Program

Nursing, PhD

Committee Chair

Hall, Lynne

Committee Co-Chair (if applicable)

Roser, Lynn

Committee Member

Roser, Lynn

Committee Member

Ridner, Lee

Committee Member

Sha, Shuying

Committee Member

Khan, Abdur

Author's Keywords

Nursing research; cardiovascular disease; cardiac rehabilitation; secondary prevention; social support; health promotion

Abstract

Introduction: Cardiovascular disease (CVD) is a leading cause of mortality worldwide. Cardiac Rehabilitation (CR) is a Class I, level A indication for treatment and prevention further complications of CVD. The attendance rate for CR in the U.S. is very low, especially among female patients. Dimensions of social support, sex of the support provider, and the quality of primary intimate relationship are associated with health-promoting behavior and may influence CR adherence in patients. Purpose: The purpose of this study was to examine the relationship between dimensions of social support and CR adherence, and whether these relationships were moderated by factors such as sex of the support provider and type of primary intimate. Method: A longitudinal, observational study was conducted with a sample of 56 adults attending CR. Multiple regression was used to assess the relationships between dimensions of social support and CR adherence. Moderated multiple regression was used to evaluate modification effects of sex and type of primary intimate on the association between dimensions of social support and CR adherence. Results: Sex of the CR participant significantly moderated the association between emotional/informational support and CR attendance (p = .02). There was a significant negative relationship between emotional/informational support and CR adherence for female participants only (β = -.56; p = .05), but the association between emotional/informational support and CR adherence participants was not significant in males (β = .13; p = .43). Conclusion: Sex of the CR participant modified the relationship between emotional/informational support and CR adherence. Though the results for the other aims were non-significant, the results inform future research on this topic. The small sample size limited generalizability. Many participants had characteristics, aside from social support, that are associated with greater CR enrollment and adherence. Moderation analysis typically has low statistical power. The limitations of this study highlight the difficulty of analyzing data on CR adherence. Further research is needed with a larger sample of female CR participants and different types of primary intimate relationships to determine precisely how social support dimensions affect CR adherence.

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