This article was adapted from a thesis by Su Jin Kwon in partial fulfillment of the requirements for the master's degree at Yonsei University of Korea.
This study was supported by Chijung Sim scholarship of the College of Nursing of Yonsei University in 2018.
We aimed to identify factors influencing physical activity in adolescents with complex congenital heart disease.
We recruited 92 adolescents with complex congenital heart disease from a tertiary medical center in Seoul, measured their levels of physical activity, and identified factors that influenced their physical activity levels using the Global Physical Activity Questionnaire, the New York Heart Association classification, congenital heart disease complexity, the Self-Efficacy Scale, and the Parental Bonding Instrument scale. Stepwise multiple linear regression was used to determine factors influencing physical activity.
Total physical activity was higher in males than in females (t=4.46,
It is necessary to develop nursing interventions that enhance self-efficacy in order to promote physical activity in adolescents with complex congenital heart disease. Physical activity should also be promoted in an individualized manner, taking into account gender, disease severity, and parental attitude.
Although Korea’s birthrate is rapidly falling, the percentage of infants born with congenital anomalies is gradually increasing. The number of congenital heart disease operation performed annually has increased from 4546 in 2006 to 5398 in 2016, an increase of 1000 within a decade [
During growth, illnesses in adolescents might not be measurable in the same way as in adults although poor health in adolescence can affect health in adulthood. Therefore, appropriate interventions for health management are necessary starting in adolescence, and positive health behaviors must be promoted to ensure a healthy adult life [
Physical activity impacts adolescent health positively; however, almost half of patients with congenital heart disease rarely follow physical activity recommendations [
Although it is theoretically evident that regular physical activities have improved one’s quality of life, a lot of adolescents with congenital heart disease have been found lack of physical activity [
Lack of physical activity is a risk factor for noninfectious diseases such as cardiovascular disease, ischemic stroke, type II diabetes mellitus, obesity, colon cancer, and breast cancer. The WHO developed the Global Physical Activity Questionnaire (GPAQ) to investigate analyze factors causing such noninfectious diseases and to compare the amount of physical activity across countries [
The present study aimed to examine the characteristics of adolescents with complex congenital heart disease and their amount of physical activity depending on disease severity, utilizing the GPAQ developed by the WHO, and to derive factors influencing the physical activity of adolescents with complex congenital heart disease. It is expected that the findings of this study will be utilized as a basis for developing of nursing interventions and educational programs aimed at promoting physical activity among adolescents with complex congenital heart disease, and that this study will help enable a healthy transition from adolescence to adulthood.
The objective of this study was to examine the characteristics of adolescents with complex congenital heart disease and their amount of physical activity depending on disease severity, and to analyze factors influencing their physical activity.
Disease severity in adolescents with complex heart disease was examined.
The impact of differences in various characteristics of adolescents with complex heart disease on their physical activity was examined.
The impact of differences in disease severity of adolescents with complex heart disease on their physical activity was examined.
The correlations between physical activity, self-efficacy, and parental attitude in adolescents with complex heart disease were examined.
Factors influencing the physical activity of adolescents with complex congenital heart disease were derived.
This is a descriptive study conducted to examine factors that influence physical activity in adolescents with complex congenital heart disease.
This study involved patients aged 12 to 18 years who had been diagnosed with complex congenital heart disease at a tertiary care hospital located in Seoul, and were under ambulatory tracking and monitoring at the pediatric cardiology or pediatric cardiac surgery department.
To determine the number of subjects necessary for multiple regression analysis, the G-power 3.1.9.2 program was used. The significance level was set to .05. The power of the test was set to .95 and six predictors were analyzed (gender, participation in physical education classes at school, New York Heart Association (NYHA) classification, self-efficacy, paternal care as a sub-item of parental attitude, and sedentary behaviour). When the effect size was set to .30 similar to a previous study [
Nine questions collected general information about the participants, including age, gender, current residential area, school/grade, type of school, school performance, participation in physical education classes at school, financial condition, and body mass index (height and weight). Six questions were on disease characteristics, including a confirmed diagnosis of congenital heart disease, number of operations to date, age at first surgery, number of medications currently taken, and whether advice was given by medical staff regarding physical activity. As a biological index, oxygen saturation at rest was also recorded.
Disease severity was determined by two measures: congenital heart disease (CHD) complexity and the NYHA classification.
The first method (CHD complexity) classified complex congenital heart diseases as being of moderate or great complexity based on the structure of congenital heart disease, as proposed in the ACC/AHA 2018 Guideline published by the American College of Cardiology (ACC) and the AHA [
The second method was the NYHA classification, which divides cardiac functional states into stages I to IV. Questions from the translated version were used, as it was designed to include questions for better patient understanding. The higher the class, the higher the level of disease severity [
Physical activity was measured using the GPAQ developed by the WHO. The GPAQ consists of 15 questions ─ six questions about physical activity at school (work-related activity), six questions about after-school activity of sports (leisure activity), and three questions about travel to and from places ─ as well as one question about sedentary behaviour [
To measure the level of self-efficacy specifically relevant to physical activity as recognized by the participants, the Self-Efficacy Scale developed by Motl et al. [
To measure parents’ attitude towards adolescents with complex congenital heart disease, the Korean version of the Parental Bonding Instrument developed by Parker et al. and translated by Song [
The researcher obtained approval for this study from the hospital’s Institutional Review Board (IRB) (No. 2018-0444). Hospital permission and cooperation for the survey also were obtained from the nursing department, pediatric cardiac surgery department, pediatric cardiology department, and ambulatory care team. The structured questionnaire was filled out by the participants, and the survey took about 10 minutes to complete. Survey respondents were given a token gift and data collection lasted for 7 months, from April 16 to November 30, 2018.
The collected data were analyzed using SPSS version 25.0 (IBM Corp., Armonk, NY, USA). The extent of physical activity depending on participants’ characteristics and disease severity was analyzed in terms of frequency, percentage, average, and standard deviation. Differences in physical activity depending on participants’ characteristics and disease severity were analyzed using the independent t-test and analysis of variance (for post-hoc analysis, the Scheffé test was used). The correlations among the research variables were analyzed by Pearson correlation analysis. Finally, stepwise multiple linear regression was conducted to derive factors on influencing physical activity in adolescents with complex congenital heart disease.
Ninety-two adolescents with complex congenital heart disease participated in the study, and their general characteristics are presented in
Disease severity was categorized as shown in
The total amount of physical activity among adolescents with complex congenital heart disease was presented as METs (minutes/week). The average amount of physical activity was 1710.00±1562.64 METs, and the average time spent sitting was 10.94±2.70 hours/day. The amount of physical activity was significantly higher among: 1) male students as compared to female students (t=4.46,
Differences in physical activity depending on disease severity were noted (
Stepwise multiple linear regression was conducted based on six variables including self-efficacy (r=.52,
This study applied the GPAQ developed by the WHO to examine the amount of physical activity of adolescents with complex congenital heart disease. Factors influencing physical activity were derived based on disease severity, self-efficacy, and parental attitude.
First, the average amount of physical activity of adolescents with complex congenital heart disease was 1710.00±1562.64 METs (minutes/week), which was less than the WHO physical activity recommendation of at least 60 minutes per day (intense physical activity at a moderate to vigorous level) for children and adolescents aged 5 to 17 years. This is similar to findings in a previous study in which 34.1% of adolescents with complex congenital heart disease matched the recommended level of physical activity, which was a lower proportion than observed for both normal adolescents (64.1%) and for adolescents with simple congenital heart disease (54.5%) [
The following factors influenced physical activity in adolescents with complex congenital heart disease. Self-efficacy had a significant positive correlation with physical activity in adolescents with complex congenital heart disease, and it affected physical activity, similar to the findings of Ray and Henry et al. [
Paternal care was positively correlated with physical activity but was not found to be a factor influencing physical activity. In contrast, Määttä, Ray, and Roos [
This study verified gender to be a factor influencing physical activity in adolescents with complex congenital heart disease. The amount of time spent on physical activity was significantly larger among male participants than female participants, which corresponds to the findings of a previous study [
Finally, it was found that attending in school physical education classes influenced physical activity in adolescents with complex congenital heart disease. Participation in physical education classes at school was related to the NYHA classification which indicated the extent of cardiac insufficiency. Specifically, of the participants who did not attend physical education classes at school, 8 (62%) were categorized as NYHA class II or III. This indicates that among adolescents with complex congenital heart disease, a greater severity of disease was related to a lower rate of participation in physical education classes at school.
Statistically significant differences in the amount of time spent engaging in physical activity were also observed according to CHD complexity and the NYHA classification, as indices of disease severity. However, these were not found to be factors that influenced physical activity in the stepwise regression analysis, for the following reasons. First, this study only examined the amount of physical activity only among adolescents with complex congenital heart disease, and did not include adolescents with simple congenital heart disease. Hence, there was a statistically significant difference between the participants with moderate-complexity disease and those with disease of great-complexity, but it was not found to be a factor influencing physical activity. Second, the percentage of participants in NYHA classes II to III was smaller than that of participants in NYHA class I, and most survey respondents were outpatients whose physical symptoms were controlled. For this reason, the NYHA classification was not an influencing factor.
Nonetheless, the NYHA classification is an important clinical tool for the assessment of patients with congenital heart disease. It has significant correlations with brain natriuretic peptide levels and peak oxygen uptake, making it a useful index to assess the prognosis of patients with congenital heart disease. It is recommended that the NYHA classification of patients should be checked each visit to the hospital [
When adolescents with congenital heart disease have to make decisions about physical activity, advice from medical staff regarding physical activity is of great importance in terms of self-efficacy, in addition to the direct importance of such advice for facilitating physical activity. Therefore, encouragement and advice on physical activity from medical staff are essential for adolescents with complex congenital heart disease [
Despite these limitations, it is still possible to enhance patients’ self-efficacy and to increase their amount of physical activity, as nurses are both aware of the specific diagnoses of adolescents with complex congenital heart disease and are familiar with suitable forms of physical activity depending on patients’ physical characteristics. The combination enables nurses to offer guidance on physical activity tailored to each patient. In addition, early interventions ─ both for adolescents and for their parents ─ will contribute to the proper growth and development of children with congenital heart disease. For this purpose, first of all, it is necessary to provide specific information and guidelines on the possible scope of patients’ physical activity to nurses caring for patients with congenital heart disease.
This study is significant in that it provides a basis for follow-up through its classification of patients by severity levels and via the reported measurements of the amount of physical activity specifically in adolescents with complex congenital heart disease, as distinct from measurements in patients with congenital heart disease more broadly. In addition, it will be possible to promote enhanced levels of physical activity based on self-efficacy by developing nursing interventions that encourage physical activity in adolescents with complex congenital heart disease and their parents with due consideration of gender and disease severity.
However, since this study applied convenience sampling to patients aged 12~18 years at one hospital, it is unlikely to be representative of all adolescents with complex congenital heart disease in Korea. Therefore, attention needs to be paid to the generalizability of its findings. Since patients with cardiac insufficiency and arrhythmia were excluded from this study, it was not possible to examine the amount of physical activity of NYHA class IV patients with severe cardiac insufficiency, which is a limitation of the sampling of this study. Finally, cross-sectional research involves certain inherent limitations as it samples participants at a single point in time. Future research needs to examine changes in physical activity over time from infancy to adolescence, rather than focusing solely on adolescence in patients with complex congenital heart disease. Doing so would help obtain longitudinal finding relevant for understanding the growth and development of pediatric patients affected by complex congenital heart disease.
This descriptive study was conducted to examine the factors influencing physical activity in adolescents with complex congenital heart disease, and identified gender, attendance of physical education classes at school, and self-efficacy as factors affecting their physical activity. Hence, to motivate these adolescents effectively, it is necessary to take gender into consideration, as well as their diagnoses and physical conditions when emphasizing the necessity of physical activity and recommending proper types of physical activity. In addition, nursing interventions focusing on self-efficacy by supporting the family and advice from medical staff regarding physical activity are expected to contribute significantly to promoting physical activity in adolescents with complex congenital heart disease, thereby improving their health.
In addition, it is necessary to inform parents that the father’s roles, although it was not found to be a factor influencing physical activity, is as important as the mother’s role in childcare because parental caring attitude, particularly paternal care, has positive effects on physical activity. Meanwhile, overprotection by parents needs to be avoided. Nurses can play a helpful role as health managers by providing education to adolescents with complex congenital heart disease on the possible range and types of physical activity based on their diagnoses and physical conditions.
The results of this study recommend as follows. First, only 21.7% of the respondents in this study were given recommendations on physical activity from medical staff. It is necessary to examine the perceptions of health management experts who personally treat adolescents with congenital heart disease, such as doctors, nurses, and school nurses, regarding physical activity in adolescents with congenital heart disease. Second, it is necessary to conduct replication studies on parental attitudes ─ not only for adolescents, but also for infants, preschool, and school age children─ when developing nursing interventions aiming at improving the self-efficacy of children with congenital heart disease. It is also necessary to examine adolescents’ peer relationships and social support.
No existing or potential conflict of interest relevant to this article was reported.
Characteristics of Adolescents with Complex Congenital Heart Disease (
Variables | Characteristics | Categories | n (%) | M±SD |
---|---|---|---|---|
General | Age (year) | 12~15 | 48 (52.2) | 15.03±1.92 |
16~18 | 44 (47.8) | |||
Gender | Male | 54 (58.7) | ||
Female | 38 (41.3) | |||
Residence area | Urban | 35 (38.0) | ||
Rural | 57 (62.0) | |||
School type | Middle school | 45 (48.9) | ||
High school | 42 (45.7) | |||
Others |
5 (5.4) | |||
School performance | Top | 13 (14.1) | ||
Middle | 49 (53.3) | |||
Bottom | 30 (32.6) | |||
Participation in physical education class | Yes | 79 (85.9) | ||
No | 13 (14.1) | |||
BMI (kg/m2) | Underweight (<20) | 45 (48.9) | 21.07±3.72 | |
Normal (20~24.9) | 33 (35.9) | |||
Overweight & obese (>25) | 14 (15.2) | |||
Perceived economic condition | Above average | 11 (12.0) | ||
Average | 69 (75.0) | |||
Below average | 12 (13.0) | |||
Disease | Number of surgical procedures | One | 26 (28.2) | |
Two | 25 (27.2) | |||
≥Three | 41 (44.6) | |||
Age at the first surgical procedure | <1 year | 71 (77.2) | ||
≥1 year | 21 (21.8) | |||
SpO2 | 94.90±3.75 | |||
Number of medications | None | 50 (54.4) | ||
One | 22 (23.9) | |||
Two or more | 20 (21.7) | |||
Health professional who gave advice on physical activity | None | 72 (78.3) | ||
Doctor | 15 (16.3) | |||
Nurse | 3 (3.2) | |||
Doctor & nurse | 2 (2.2) |
Including taking the qualification examination, while studying abroad;
BMI=Body mass index; SpO2=Saturation of percutaneous oxygen.
Classification of Participants by Complexity of Congenital Heart Disease Diagnosis and New York Heart Association Class (
Characteristics | Categories | n (%) |
---|---|---|
Moderate complexity | TOF | 24 (26.1) |
Complete AVSD | 4 (4.3) | |
Partial AVSD | 2 (2.2) | |
CoA | 7 (7.3) | |
Congenital mitral valve disease | 2 (2.2) | |
Congenital aortic valve disease | 1 (1.1) | |
Supravalvular aortic stenosis | 3 (3.3) | |
Total | 43 (46.7) | |
Great complexity | PA | 4 (4.3) |
TGA | 7 (7.6) | |
MA | 1 (1.1) | |
DORV | 2 (2.2) | |
Truncus arteriosus | 3 (3.3) | |
FSV |
32 (34.8) | |
Total | 49 (53.3) | |
NYHA class | Class I | 76 (82.6) |
Class II | 12 (13.0) | |
Class III | 4 (4.4) | |
Class IV | 0 (0.0) |
Including double inlet left ventricle, tricuspid atresia, hypoplastic left heart syndrome, and any other anatomic abnormality with a functionally single ventricle;
TOF=Tetralogy of Fallot; AVSD=Atrioventricular septal defect; CoA=Coarctation of the aorta; PA=Pulmonary atresia; TGA=Transposition of the great arteries; MA=Mitral atresia; DORV=Double outlet right ventricle; FSV=Functionally single ventricle; NYHA class=New York Heart Association classification.
Physical Activity by Characteristics of Adolescents with Complex Congenital Heart Disease (
Variables | Characteristics | Categories | n (%) | Total school (MET-mins/week) |
Transportation (MET-mins/week) |
Total leisure (MET-mins/week) |
Total physical activity |
Sedentary behaviour (hours/day) |
|||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
M±SD | t or F ( |
M±SD | t or F ( |
M±SD | t or F ( |
M±SD | t or F ( |
M±SD | t or F ( |
||||
General | Age (year) | 12~15 | 48 (52.2) | 646.67±664.62 | 0.84 (.406) | 486.88±597.79 | 0.26 (.797) | 707.08±1,236.28 | 0.84 (.404) | 1,840.63±1,670.69 | 0.84 (.405) | 10.68±2.66 | 0.96 (.342) |
16~18 | 44 (47.8) | 540.23±545.81 | 520.00±634.06 | 507.27±1,026.91 | 1,567.50±1,441.16 | 11.22±2.75 | |||||||
Gender | Male | 54 (58.7) | 721.67±708.81 | 2.68 (.009) | 562.59±695.32 | 1.12 (.266) | 935.93±1,355.44 | 3.98 (<.001) | 2,220.19±1,723.47 | 4.46 (<.001) | 10.44±2.82 | 2.12 (.037) | |
Female | 38 (41.3) | 416.84±372.39 | 417.63±465.43 | 150.53±433.86 | 985.00±911.61 | 11.63±2.38 | |||||||
Residence area | Urban | 35 (38.0) | 590.00±503.04 | 0.07 (.944) | 411.43±456.36 | 1.12 (.265) | 646.86±1,060.27 | 0.23 (.817) | 1,648.29±1,232.51 | 0.30 (.768) | 10.99±2.38 | 0.14 (.888) | |
Rural | 57 (62.0) | 599.30±671.16 | 558.70±688.63 | 589.82±1,193.76 | 1,747.89±1,744.09 | 10.90±2.90 | |||||||
School performance | Top | 13 (14.1) | 821.54±940.44 | 2.79 (.067) | 707.69±863.81 | 1.48 (.233) | 609.23±769.27 | 0.39 (.680) | 2,138.46±1,985.77 | 2.23 (.114) | 10.81±2.69 | 0.33 (.718) | |
Middle | 49 (53.3) | 656.12±591.44 | 528.78±570.85 | 700.82±1,248.89 | 1,885.71±1,589.55 | 10.77±2.40 | |||||||
Bottom | 30 (32.6) | 399.33±390.81 | 371.33±538.68 | 466.67±1,100.27 | 1,237.33±1,217.76 | 11.27±3.19 | |||||||
Participation physical education class | Yes | 79 (85.9) | 684.68±613.46 | 8.79 (<.001) | 553.04±637.05 | 1.97 (.051) | 681.27±1,208.89 | 2.98 (.004) | 1,918.99±1,582.27 | 6.77 (<.001) | 10.63±2.40 | 2.01 (.064) | |
No | 13 (14.1) | 55.38±68.39 | 196.92±294.04 | 187.69±339.96 | 440.00±457.31 | 12.77±3.70 | |||||||
BMI (kg/m2) | Under weight | 45 (48.9) | 604.89±685.38 | 2.74 (.070) | 494.44±780.41 | 0.10 (.909) | 846.22±1,464.53 | 1.93 (.151) | 1,945.60±1,938.12 | 1.06 (.350) | 10.83±2.38 | 0.91 (.405) | |
Normal | 33 (35.9) | 454.24±396.84 | 486.06±381.72 | 436.36±687.92 | 1,376.67±1,033.27 | 11.44±3.07 | |||||||
Over weight | 14 (15.2) | 900.00±688.50 | 568.57±444.99 | 270.00±515.53 | 1,738.57±1,129.61 | 10.07±2.67 | |||||||
Perceived economic condition | <Average | 12 (13.0) | 393.33±451.21 | 1.58 (.213) | 405.83±574.88 | 2.28 (.109) | 618.33±1,496.70 | 0.78 (.460) | 1,417.50±1,646.72 | 0.98 (.380) | 12.08±1.98 | 1.42 (.248) | |
Average | 69 (75.0) | 660.43±660.23 | 462.03±553.93 | 546.67±1,053.50 | 1,669.13±1,529.14 | 10.70±2.88 | |||||||
>Average | 11 (12.0) | 410.91±281.76 | 863.40±891.51 | 1,010.91±1,262.50 | 2,285.45±1,690.92 | 11.18±1.94 | |||||||
Disease | Number of surgical procedures | One | 26 (28.3) | 618.08±581.56 | 0.03 (.970) | 666.15±682.67 | 3.08 (.051) | 672.31±1,192.87 | 0.68 (.509) | 1,956.54±1,593.99 | 1.72 (.184) | 10.08±2.49 | 2.05 (.135) |
Two | 25 (27.2) | 598.40±687.63 | 613.60±742.27 | 789.60±1,207.60 | 2,001.60±1,706.71 | 11.52±2.40 | |||||||
≥Three | 41 (44.5) | 580.00±561.71 | 331.46±419.21 | 464.39±1,069.43 | 1,375.85±1,418.57 | 11.12±2.92 | |||||||
Age at the first operation | <1 year | 71 (77.2) | 580.00±649.05 | 0.45 (.651) | 686.62±438.46 | 2.49 (.021) | 562.82±1,187.21 | 0.75 (.454) | 1,529.44±1,467.80 | 2.08 (.041) | 11.10±2.78 | 0.39 (.697) | |
≥1 year | 21 (22.8) | 649.05±669.58 | 895.24±907.15 | 776.19±966.84 | 2,320.48±1,750.08 | 10.38±2.37 | |||||||
Number of medications | Nonea | 50 (54.4) | 705.80±664.34 | 1.82 (.168) | 545.60±561.70 | 1.61 (.205) | 775.20±1,227.08 | 1.14 (.326) | 2,026.60±1,650.19 | 2.48 (.089) | 10.13±2.46 | 6.26 (.003) | |
Oneb | 22 (23.9) | 458.18±435.12 | 598.18±808.50 | 405.45±1,153.60 | 1,461.82±1,505.39 | 11.41±2.28 | |||||||
≥Twoc | 20 (21.7) | 472.00±602.68 | 290.50±442.93 | 429.00±840.69 | 1,191.50±1,248.76 | 12.43±3.05 | c>a |
||||||
Physical activity advice | None | 72 (78.3) | 575.69±578.89 | 0.60 (.552) | 550.56±663.01 | 1.43 (.156) | 643.61±1,236.46 | 0.51 (.611) | 1,769.86±1,663.48 | 0.70 (.489) | 10.99±2.67 | 0.39 (.697) | |
Doctor or nurse | 20 (21.7) | 668.00±722.00 | 330.50±335.57 | 496.00±696.14 | 1,494.50±1,136.73 | 10.73±2.86 | |||||||
CHD complexity | Moderate complexity | 43 (46.7) | 680.23±689.48 | 1.28 (.205) | 640.00±615.48 | 2.10 (.039) | 778.18±1,267.50 | 1.35 (.181) | 2,098.41±1,734.34 | 2.31 (.023) | 10.33±2.27 | 2.10 (.037) | |
Great complexity | 49 (53.3) | 518.33±521.65 | 376.88±587.63 | 458.75±996.50 | 1,353.96±1,305.82 | 11.49±2.95 | |||||||
NYHA class | Class I | 76 (82.6) | 683.82±617.63 | 4.50 (<.001) | 547.76±633.58 | 1.55 (.125) | 721.05±1,222.19 | 4.15 (<.001) | 1,952.63±1,594.90 | 5.83 (<.001) | 10.54±2.38 | 3.21 (.002) | |
Class II~III | 16 (17.4) | 177.50±349.54 | 288.75±455.66 | 91.25±234.15 | 557.50±616.52 | 12.81±3.35 |
Total physical activity=Total school+transportation+total leisure;
Scheffé test;
BMI=Body mass index; CHD=Congenital heart disease; NYHA class=New York Heart Association classification.
Correlations between Physical Activity, Self-efficacy, and Parental Attitude (
Variables | 1 |
2 |
3 |
4 |
5 |
6 |
7 |
---|---|---|---|---|---|---|---|
r ( |
r ( |
r ( |
r ( |
r ( |
r ( |
r ( |
|
1. Self-efficacy | 1 | ||||||
2. Maternal care | .29 (.007) | 1 | |||||
3. Maternal overprotection | -.38 (<.001) | -.47 (<.001) | 1 | ||||
4. Paternal care | .37 (.001) | .72 (<.001) | -.41 (<.001) | 1 | |||
5. Paternal overprotection | -.29 (.007) | -.43 (<.001) | .81 (<.001) | -.37 (<.001) | 1 | ||
6. Sedentary behaviour | -.33 (.001) | -.02 (.823) | .19 (.081) | -.01 (.958) | .17 (.124) | 1 | |
7. Total physical activity |
.52 (<.001) | .09 (.424) | -.18 (.095) | .21 (.046) | -.10 (.361) | -.33 (.001) | 1 |
Total physical activity=Total school+transportation+total leisure.
Factors Affecting Physical Activity in Adolescents with Complex Congenital Heart Disease (
Variables | (Reference) | B | SE | β | t | |
---|---|---|---|---|---|---|
(Constant) | -2,017.02 | 535.40 | 3.77 | <.001 | ||
Self-efficacy | 99.68 | 22.08 | .41 | 4.51 | <.001 | |
Gender | (Female) | 1,167.28 | 267.72 | .37 | 4.36 | <.001 |
Participation in physical education class | (No participation) | 850.21 | 411.28 | .19 | 2.07 | .042 |
R2=.422, Adj. R2=.401, F=20.21, |