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dc.contributor.authorYeh, Gloria Y.en_US
dc.contributor.authorChan, Caroline W.en_US
dc.contributor.authorWayne, Peter M.en_US
dc.contributor.authorConboy, Lisaen_US
dc.date.accessioned2016-06-14T18:52:16Z
dc.date.issued2016en_US
dc.identifier.citationYeh, Gloria Y., Caroline W. Chan, Peter M. Wayne, and Lisa Conboy. 2016. “The Impact of Tai Chi Exercise on Self-Efficacy, Social Support, and Empowerment in Heart Failure: Insights from a Qualitative Sub-Study from a Randomized Controlled Trial.” PLoS ONE 11 (5): e0154678. doi:10.1371/journal.pone.0154678. http://dx.doi.org/10.1371/journal.pone.0154678.en
dc.identifier.issn1932-6203en
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:27320336
dc.description.abstractObjective: To qualitatively explore perceived physical and psychosocial effects and overall patient experience associated with a 12-week tai chi (TC) intervention and an education group in a clinical trial of patients with chronic heart failure (HF). Subjects and Methods We randomized 100 patients with chronic systolic HF (NYHA Class 1–3, ejection fraction≤40%) to a 12-week group TC program or an education control. At 12-weeks, semi-structured interviews were conducted on a random subset (n = 32; n = 17 in TC, n = 15 in control), audiorecorded and transcribed verbatim. Two independent reviewers extracted information using grounded-theory methods for emergent themes. We explored similarities and differences in themes/sub-themes between the groups, and examined qualitative association with changes from baseline to post-intervention in previously reported quantitative measures (e.g., Minnesota Living with HF, Cardiac Exercise Self Efficacy and Profile of Mood States). Results: The mean age (±SD) of participants was 68±9 years, baseline ejection fraction 29±7%, and median New York Heart Association class 2 HF. We idenitifed themes related to the patient’s experience of illness, perceptions of self, and relationship to others. Specific psychosocial and physical benefits were described. Common themes emerged from both groups including: social support and self-efficacy related to activity/exercise and diet. The tai chi group, however, also exhibited a more global empowerment and perceived control. Additional themes in TC included mindfulness/self-awareness, decreased stress reactivity, and renewed social role. These themes mirrored improvements in previously reported quantitative measures (quality-of-life, self-efficacy, and mood) in TC compared to control. Patients in TC also reported physical benefits (e.g., decreased pain, improved energy, endurance, flexibility). Conclusion: Positive themes emerged from both groups, although there were qualitative differences in concepts of self-efficacy and perceived control between groups. Those in tai chi reported not only self efficacy and social support, but overall empowerment with additional gains such as internal locus of control, self-awareness and stress management. Future studies of mind-body exercise might further examine perceived control, self-efficacy, and locus-of-control as potential mediators of effect.en
dc.language.isoen_USen
dc.publisherPublic Library of Scienceen
dc.relation.isversionofdoi:10.1371/journal.pone.0154678en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4866692/pdf/en
dash.licenseLAAen_US
dc.subjectMedicine and Health Sciencesen
dc.subjectCardiologyen
dc.subjectHeart Failureen
dc.subjectPublic and Occupational Healthen
dc.subjectPhysical Activityen
dc.subjectPhysical Fitnessen
dc.subjectExerciseen
dc.subjectSports and Exercise Medicineen
dc.subjectBiology and Life Sciencesen
dc.subjectSports Scienceen
dc.subjectHealth Careen
dc.subjectPatientsen
dc.subjectQuality of Lifeen
dc.subjectHealth Education and Awarenessen
dc.subjectMental Health and Psychiatryen
dc.subjectPsychological Stressen
dc.subjectPsychologyen
dc.subjectSocial Sciencesen
dc.titleThe Impact of Tai Chi Exercise on Self-Efficacy, Social Support, and Empowerment in Heart Failure: Insights from a Qualitative Sub-Study from a Randomized Controlled Trialen
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalPLoS ONEen
dash.depositing.authorYeh, Gloria Y.en_US
dc.date.available2016-06-14T18:52:16Z
dc.identifier.doi10.1371/journal.pone.0154678*
dash.contributor.affiliatedWayne, Peter
dash.contributor.affiliatedYeh, Gloria


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