The Association between Perceived Social Support and Adherence to Cardiac Rehabilitation in Patients with Myocardial Infarction

The association between perceived social support and adherence

Background: Myocardial infarction (MI) patients face a higher risk of recurrent cardiovascular events and reduced quality of life. Cardiac rehabilitation (CR) is a comprehensive secondary prevention program that improves outcomes, but adherence remains suboptimal. Perceived social support has been identified as a potential determinant of CR adherence. The current study explored the connection between MI patients' adherence to CR and their perceived social support.

Methods: This cross-sectional study was conducted at a tertiary care hospital in Baghdad, Iraq. The sample included 150 MI patients enrolled in a CR program. The MSPSS (Multidimensional Scale of Perceived Social Support) was employed to evaluate perceived social support, and attendance records measured adherence to CR. Clinical and sociodemographic data were collected. Logistic regression analyses, including multivariate and univariate approaches, were carried out to analyze the association between adherence to CR and perceived social support.

Results: Adherent patients had significantly higher MSPSS scores than non-adherent patients (68.3 ± 12.8 vs. 57.2 ± 14.1, P <0.001). In the multivariate analysis, perceived social support was significantly associated with adherence to CR (adjusted OR=1.06, 95% CI: 1.03-1.10, P <0.001) after controlling for sociodemographic and clinical variables. Education level was also significantly associated with adherence, with patients having a secondary education or higher showing 2.4 times higher odds of adherence (adjusted OR = 2.40, 95% CI: 1.08-5.34, P = 0.032). The association between perceived social support and adherence to CR was significant among male participants but not among female participants.

Conclusion: Increased perceived social support was significantly associated with higher CR adherence, especially in male patients (adjusted OR=1.06, 95% CI=1.03-1.10, P<0.001). Interventions to enhance social support, especially for male patients and those with lower education levels, may improve CR participation and completion rates. Healthcare providers should assess patients' social support networks and engage family members and significant others in the CR process to promote better cardiovascular health outcomes.