GAP BETWEEN SPONTANEOUS AWARENESS, SELF-REPORTED USE OF PHYSICAL ACTIVITY AS A PREVENTIVE MEASURE, AND QUESTIONNAIRE-ASSESSED MOVEMENT BEHAVIOUR AFTER MYOCARDIAL INFARCTION: A CROSS-SECTIONAL ANALYSIS OF A STRATIFIED RANDOM SAMPLE

Objective. To determine the discrepancy and degree of agreement between spontaneous awareness, self-reported adherence, and questionnaire-assessed physical activity in patients during long-term follow-up after myocardial infarction, and to identify independent informational, sociodemographic, and clinical factors associated with engagement in approximately 30 minutes of continuous physical activity. Materials and Methods. A secondary cross-sectional analysis was conducted on a stratified proportional random sample of 333 patients following myocardial infarction. Spontaneous awareness was assessed using an open-ended question; self-reported behavioural adherence was evaluated based on spontaneously reported preventive measures that patients were actually implementing. Daily walking, approximately 30 minutes of continuous purposeful physical activity, barriers, and the doctor's recommendation regarding exercise were assessed separately. The primary outcome was engagement in approximately 30 minutes of continuous purposeful physical activity. Independent associations were assessed using modified Poisson regression. Results. Data regarding approximately 30 minutes of continuous purposeful physical activity were available for 315 patients; 98 of these were active – 31.1% (95% CI 26.3–36.4%). At the same time, 240 out of 333 participants (72.1%) reported walking for at least 30 minutes a day. The largest behavioural group consisted of patients who walked for ≥30 minutes but did not engage in 30 minutes of purposeful physical activity – 48.6%. Overall, 14.3% of participants spontaneously identified physical activity as a means of secondary prevention, whilst 11.2% spontaneously reported actually using it as a preventive measure. The agreement between these indicators was low: κ = 0.237; positive agreement was 33.3%, and negative agreement was 90.2%. Spontaneous awareness was associated with a higher prevalence of purposeful physical activity: adjusted prevalence ratio 1.46 (95% CI 1.01–2.13; p = 0.047). Receiving a doctor's recommendation showed a stronger association: 1.97 (1.27–3.05; p = 0.002). Diabetes mellitus was associated with lower activity levels: 0.46 (0.23–0.96; p = 0.037). The main barriers were health status – 45.6%, lack of willpower – 32.1%, lack of time – 13.5%, and underestimating the benefits of exercise – 10.2%.. Conclusions. In the long-term period following myocardial infarction, a discrepancy was found between everyday walking, spontaneous awareness of the preventive role of physical activity, self-reported use of physical activity as a preventive measure, and engagement in approximately 30 minutes of continuous purposeful activity. A doctor's recommendation was associated with a higher prevalence of such activity; however, the cross-sectional design does not allow for the establishment of causality.