Background and Rationale: Cardiovascular disease (CVD) is the leading cause of death among women in Canada, accounting for 41% of all deaths annually. The benefits of exercise-based cardiac rehabilitation (CR) are well established for both men and women with CVD. Research indicates that women have the potential to benefit as much as men from participation in CR, despite the fact that women are generally older at the time of their CVD diagnosis and have lower levels of reported health-related quality of life (HRQL) and physical functioning. Nonetheless, to obtain these benefits, it is necessary for women to adhere to an exercise program during CR. Previous research has demonstrated that women who enroll in CR demonstrate poor attendance and adherence to their exercise prescriptions. Therefore, it has been suggested that CR programs be adapted (by including women's only exercise and education groups and implementing strategies to improve social support) to meet the unique exercise and educational needs of women. To promote increased utilization of CR, a women's only exercise and education program (WP) was developed.
Purpose: The purpose of the present study was to examine the association between participation in a WP and HRQL, self-efficacy, anxiety, depression, body image, and exercise adherence (percent attendance).
Methods and Design: The study employed a single group pre-post design. WP participants (n = 45) attended one 2-hour exercise and education session each week for 10 to 12 weeks. WP participants completed psychosocial measures (HRQL, self-efficacy, anxiety, depression, and body image questionnaires) upon entry to the program and at discharge. Program attendance was monitored throughout. The study also compared the WP participants to a matched (age and referral event) cohort of women (n = 45) who were concurrently enrolled in an outpatient CR program, but not the WP, on utilization of ancillary CR services.
Results: Compared to baseline scores, women who completed the WP-reported significant increases in self-efficacy for stair climbing (P < .01), lifting (P < .01), and walking (P = .001). There were also significant positive changes in anxiety (P < .01), depression (P < .01), satisfaction with physical function (P < .01), and satisfaction with body appearance (P < .001). There were no changes in physical or mental HRQL (P > .05). Mean adherence to the WP was 75.71%. Compared to matched controls, WP participants utilized a significantly greater amount of CR services (including supervised hospital-based exercise, home-based exercise, nursing, and nutrition services).
Conclusion: This study provides preliminary support for the utility and potential benefits of providing women's only exercise and education programs in CR. Given the prevalence of CVD among women in Canada, intervention programs designed to enhance adherence to CR and improve psychosocial well-being should be developed and examined in future research.