Using a theoretical approach to identify factors influencing adherence to an exercise program for adults with venous leg ulcers

Introduction: Adults with venous leg ulcers currently do not meet physical activity guidelines for a myriad of reasons. Research suggests that exercise programmes which are based on theoretical frameworks are more likely to be successful for increasing adherence. Social Cognitive Theory (SCT) is one commonly used health theory that posits that learning occurs in a social context with a dynamic and reciprocal interaction of the person, environment, and behaviour. This study therefore sought to identify the relationships between self-efficacy, outcome expectations, fear-avoidance beliefs, depression and social support and adherence to an exercise for a home-based exercise programme for adults with venous leg ulcers.

Methods: Patients were randomised to receive either a 12week exercise intervention with a telephone coaching component, or usual care plus telephone calls at the same timepoints. Data on health, psychosocial variables and adherence to leg exercises were obtained from self-report surveys and data on medical and ulcer history were obtained from medical records.

Results: This study included 63 patients with venous leg ulcers. Of those in the exercise intervention group, 59% adhered to the exercise protocol more than 75% of the time. As per SCT there was a significant relationship between self-efficacy and outcome expectations and both of these constructs were significantly related to adherence to the leg exercise programme. Adherence significantly correlated with wound healing indicating a possible pathway to healing.

Conclusion: In this sample, self-efficacy and outcome expectations were found to be significantly related to adherence to the prescribed leg exercises. Introduction: Adults with venous leg ulcers currently do not meet physical activity guidelines for a myriad of reasons. Research suggests that exercise programmes which are based on theoretical frameworks are more likely to be successful for increasing adherence. Social Cognitive Theory (SCT) is one commonly used health theory that posits that learning occurs in a social context with a dynamic and reciprocal interaction of the person, environment, and behaviour. This study therefore sought to identify the relationships between self-efficacy, outcome expectations, fear-avoidance beliefs, depression and social support and adherence to an exercise for a home-based exercise programme for adults with venous leg ulcers.

Methods: Patients were randomised to receive either a 12week exercise intervention with a telephone coaching component, or usual care plus telephone calls at the same timepoints. Data on health, psychosocial variables and adherence to leg exercises were obtained from self-report surveys and data on medical and ulcer history were obtained from medical records.

Results: This study included 63 patients with venous leg ulcers. Of those in the exercise intervention group, 59% adhered to the exercise protocol more than 75% of the time. As per SCT there was a significant relationship between self-efficacy and outcome expectations and both of these constructs were significantly related to adherence to the leg exercise programme. Adherence significantly correlated with wound healing indicating a possible pathway to healing.

Conclusion: In this sample, self-efficacy and outcome expectations were found to be significantly related to adherence to the prescribed leg exercises.