Women's exercise levels drop more than men's after major heart surgery, even as they report fewer exercise fears, according to a study led by Chris M. Blanchard, PhD, of Dalhousie University in Halifax, Nova Scotia, and published in February in Rehabilitation Psychology (Vol. 52, No. 1).
In the study, Blanchard investigated two potential effects on male and female cardiac patients' exercise patterns: participation in cardiac rehabilitation and perceived ability to overcome such barriers as breathlessness or chest pain during exertion--what Blanchard terms "barrier self-efficacy" (BSE).
He and his colleagues assessed 801 cardiac patients' BSE and physical activity levels via questionnaire during hospitalization, and two, six and 12 months afterward. Typical procedures patients underwent included angioplasty and coronary artery bypass surgery. Cardiac rehabilitation consisted of 12 weeks of twice weekly, supervised exercise sessions that occurred throughout the 12 month period. Of the participants, 554 men and 145 women did not attend cardiac rehabilitation; 247 men and 52 women did.
The researchers found that most patients exercised diligently in the first two months after hospitalization. However, both rehabilitation and non-rehabilitation participants' exercise levels declined steadily after two months. That trend was especially pronounced among women.
More gender differences emerged when looking at the relationship between BSE and exercise. BSE significantly predicted physical activity for both men and women at two months, but the relationship significantly weakened among women by six months, and deteriorated even more by a year. For men it remained comparatively strong.
This trend suggests that, for women, exercise confidence doesn't necessarily lead to more exercising, says Blanchard.
"In the early stages following heart surgery, we need to focus on getting both men and women confident," says Blanchard. "But as time goes by, for women, it seems we need to focus on something else to get their activity levels up."
That something else depends on what's impeding women's exercising, adds Blanchard. Some possibilities include neighborhood crime that keeps women indoors or gender-role socialization that conditions women to worry about others before themselves.
"It could be they don't feel their own health is a top priority and put it on the backburner," says Blanchard.
He aims to explore such possibilities--and test interventions such as ongoing Web-based exercise support--in future research.
--B. Murray Law
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