Date of Award


Degree Type


Degree Name

Doctor of Philosophy in Nursing



First Advisor

Jaqueline Fortin


Exercise is a critical component of cardiac rehabilitation associated with physical and psychological benefits; however, patients are often reluctant to participate in cardiac rehabilitation programs. Their reticence often grows out of their own attitudes towards exercise and the attitudes of people they value. Ajzen and Fishbein's (1980) theory of reasoned action suggest that personal attitudes and subjective norm influence behavioral intention which in tum predicts the likelihood of performing a specific behavior. Both attitude and subjective norm can be measured directly and indirectly. However, Ajzen and Fishbein report the direct measures of attitude and subjective norm result in better prediction of behavioral intention than the indirect measures. Therefore, this study tested the direct and indirect measures of Ajzen and Fishbein's theory of reasoned action in predicting the behavioral intention to enroll in and subsequent attendance behavior in a 36-session exercise cardiac rehabilitation program for post myocardial infarction patients. This study was conducted in three phases in eight participating hospitals. Phase I was conducted on 50 post myocardial infarction patients who identified a belief inventory for cardiac patients contemplating exercise. Phases II and III were conducted on a second sample of 194 post myocardial infarction patients that resulted in a 6-scale measure that tested the study hypotheses. The regression analyses of Phase III revealed that the attitude and subjective norm measures taken directly and indirectly were found to be significant predictors for the behavioral intention to enroll in a cardiac rehabilitation exercise program. Limitations of the study, recommendations for practice and implication for further research are discussed.



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