{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:41:24Z","timestamp":1777678884290,"version":"3.51.4"},"reference-count":33,"publisher":"Belitung Raya Foundation","issue":"1","license":[{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"award":[""],"award-info":[{"award-number":[""]}]}],"content-domain":{"domain":["belitungraya.org"],"crossmark-restriction":true},"short-container-title":["Belitung Nurs J"],"abstract":"<jats:p>Background:\u00a0Maintaining regular physical activity (PA) is a critical challenge for patients undergoing cardiac rehabilitation (CR), as inadequate adherence can lead to adverse outcomes, including disease recurrence. Enhancing motivation is key to improving PA adherence. Motivational interviewing (MI) has been shown to overcome psychological barriers by building intrinsic motivation. However, there is a need to explore how to integrate MI techniques with digital technology to enhance intervention accessibility and leverage the strengths of both approaches.\nObjective:\u00a0This study aimed to evaluate the effects of a hybrid intervention model integrating phone-based motivational interviewing with mobile phone-based management on motivation and physical activity in patients undergoing CR.\nMethods:\u00a0This pilot randomized controlled trial was conducted in China between January and June 2024, involving 52 patients undergoing cardiac rehabilitation. The intervention group (n = 25) received usual care plus a 4-week phone-based motivational interviewing intervention, which included a face-to-face session, weekly phone MI sessions (OARS technique), and personalized support via WeChat. The control group (n = 27) received only usual cardiac rehabilitation guidance. Outcomes measured were steps\/day (using a smart band) and motivation, assessed using the Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2). Two-way repeated-measures ANOVA was used for data analysis.\nResults:\u00a0Compared with the control group, the intervention group showed a significant interaction effect of Group*Time on both steps\/day (p &lt;0.001, \u03b7p2 = 0.706) and the BREQ-2 (RAI) (p &lt;0.001, \u03b7p2 = 0.349). The intervention group\u2019s daily steps significantly increased from 3582.80 \u00b1 649.59 to 9444.79 \u00b1 1413.72 (p &lt;0.001).\nConclusion:\u00a0This study indicates that a phone-based motivational interviewing intervention delivered by trained researchers can effectively increase physical activity levels and enhance autonomous motivation for PA in CR patients. This approach provides a scalable model for the routine care of cardiac rehabilitation patients, especially in resource-limited settings. For nursing practice, the findings highlight the importance of incorporating MI as a core skill and utilizing a hybrid, technology-supported care model to extend continuous professional support into patients\u2019 homes.\nTrial Registry Number: Chinese Clinical Trial Registry (ChiCTR2400079877)<\/jats:p>","DOI":"10.33546\/bnj.4258","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T03:57:24Z","timestamp":1769140644000},"page":"40-48","update-policy":"https:\/\/doi.org\/10.33546\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Phone-based motivational interviewing intervention among patients undergoing cardiac rehabilitation: A randomized controlled trial in China"],"prefix":"10.33546","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2690-3091","authenticated-orcid":false,"given":"Yu","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1266-6120","authenticated-orcid":false,"given":"Chintana","family":"Wacharasin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6278-7860","authenticated-orcid":false,"given":"Khemaradee","family":"Masingboon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"19163","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"key":"138604","doi-asserted-by":"crossref","unstructured":"Bailey, R. R. (2019). Self-efficacy, self-regulation, social support, and outcomes expectations for daily physical activity in adults with chronic stroke: A descriptive, exploratory study. Occupational Therapy in Health Care, 33(2), 129-141. https:\/\/doi.org\/10.1080\/07380577.2018.1558326","DOI":"10.1080\/07380577.2018.1558326"},{"key":"138605","doi-asserted-by":"crossref","unstructured":"Bondaronek, P., Alkhaldi, G., Slee, A., Hamilton, F. L., & Murray, E. (2018). Quality of publicly available physical activity apps: Review and content analysis. JMIR mHealth and uHealth, 6(3), e9069. https:\/\/doi.org\/10.2196\/mhealth.9069","DOI":"10.2196\/mhealth.9069"},{"key":"138606","doi-asserted-by":"crossref","unstructured":"Brouwer-Goossensen, D., Scheele, M., van Genugten, L., Lingsma, H. F., Dippel, D. W. J., Koudstaal, P. J., & den Hertog, H. M. (2022). Motivational interviewing in a nurse-led outpatient clinic to support lifestyle behaviour change after admission to a stroke unit: A randomized controlled trial. European Journal of Cardiovascular Nursing, 21(1), 36-45. https:\/\/doi.org\/10.1093\/eurjcn\/zvab001","DOI":"10.1093\/eurjcn\/zvab001"},{"key":"138607","doi-asserted-by":"crossref","unstructured":"Charlson, M. E., Carrozzino, D., Guidi, J., & Patierno, C. (2022). Charlson comorbidity index: A critical review of clinimetric properties. Psychotherapy and Psychosomatics, 91(1), 8-35. https:\/\/doi.org\/10.1159\/000521288","DOI":"10.1159\/000521288"},{"key":"138608","doi-asserted-by":"crossref","unstructured":"Claes, J., Cornelissen, V., McDermott, C., Moyna, N., Pattyn, N., Cornelis, N., Gallagher, A., McCormack, C., Newton, H., & Gillain, A. (2020). Feasibility, acceptability, and clinical effectiveness of a technology-enabled cardiac rehabilitation platform (physical activity toward health-I): Randomized controlled trial. Journal of Medical Internet Research, 22(2), e14221. https:\/\/doi.org\/10.2196\/14221","DOI":"10.2196\/preprints.14221"},{"key":"138609","doi-asserted-by":"crossref","unstructured":"Cole, S. A., Sannidhi, D., Jadotte, Y. T., & Rozanski, A. (2023). Using motivational interviewing and brief action planning for adopting and maintaining positive health behaviors. Progress in Cardiovascular Diseases, 77, 86-94. https:\/\/doi.org\/10.1016\/j.pcad.2023.02.003","DOI":"10.1016\/j.pcad.2023.02.003"},{"key":"138610","doi-asserted-by":"crossref","unstructured":"Cruz-Cobo, C., Bernal-Jim\u00e9nez, M. \u00c1., Vazquez-Garcia, R., & Santi-Cano, M. J. (2022). Effectiveness of mHealth interventions in the control of lifestyle and cardiovascular risk factors in patients after a coronary event: Systematic review and meta-analysis. JMIR mHealth and uHealth, 10(12), e39593. https:\/\/doi.org\/10.2196\/39593","DOI":"10.2196\/39593"},{"key":"138611","doi-asserted-by":"crossref","unstructured":"Cunningham, C., O'Sullivan, R., Caserotti, P., & Tully, M. A. (2020). Consequences of physical inactivity in older adults: A systematic review of reviews and meta\u2010analyses. Scandinavian Journal of Medicine & Science in Sports, 30(5), 816-827. https:\/\/doi.org\/10.1111\/sms.13616","DOI":"10.1111\/sms.13616"},{"key":"138612","doi-asserted-by":"crossref","unstructured":"De la Torre, S., Spruijt-Metz, D., & Farias, A. J. (2022). Survivors\u2019 health competence mediates the association between wearable activity tracker use and self-rated health: HINTS analysis. Journal of Cancer Survivorship, 16(6), 1268-1278. https:\/\/doi.org\/10.1007\/s11764-021-01112-9","DOI":"10.1007\/s11764-021-01112-9"},{"key":"138613","unstructured":"Di, W., Ming, T., Yongmei, C., Yu, C., Hemei, W., & Lu, Z. (2024). Evidence summary of phase \u2161 cardiac rehabilitation for patients with chronic heart failure. Chinese Journal of Emergency and Critical Care Nursing, 5(3), 222-229. https:\/\/doi.org\/10.3761\/j.issn.2096-7446.2024.03.005"},{"key":"138614","doi-asserted-by":"crossref","unstructured":"Flannery, M. (2017). Self-determination theory: Intrinsic motivation and behavioral change. Oncology Nursing Forum, 44(2), 155-156. https:\/\/doi.org\/10.1188\/17.onf.155-156","DOI":"10.1188\/17.ONF.155-156"},{"key":"138615","doi-asserted-by":"crossref","unstructured":"Fraser, M. J., Leslie, S. J., Gorely, T., Foster, E., & Walters, R. (2022). Barriers and facilitators to participating in cardiac rehabilitation and physical activity: A cross-sectional survey. World Journal of Cardiology, 14(2), 83-95. https:\/\/doi.org\/10.4330\/wjc.v14.i2.83","DOI":"10.4330\/wjc.v14.i2.83"},{"key":"138616","doi-asserted-by":"crossref","unstructured":"Hacke, C., & Weisser, B. (2021). Sport and exercise in prevention and therapy of cardiovascular diseases. Deutsche Medizinische Wochenschrift (1946), 146(6), 381-388. https:\/\/doi.org\/10.1055\/a-1342-3070","DOI":"10.1055\/a-1342-3070"},{"key":"138617","doi-asserted-by":"crossref","unstructured":"Harkin, K., Apostolopoulos, V., Tangalakis, K., Irvine, S., Tripodi, N., & Feehan, J. (2023). The impact of motivational interviewing on behavioural change and health outcomes in cancer patients and survivors. A systematic review and meta-analysis. Maturitas, 170, 9-21. https:\/\/doi.org\/10.1016\/j.maturitas.2023.01.004","DOI":"10.1016\/j.maturitas.2023.01.004"},{"key":"138618","doi-asserted-by":"crossref","unstructured":"Heidenreich, P. A., Bozkurt, B., Aguilar, D., Allen, L. A., Byun, J. J., Colvin, M. M., Deswal, A., Drazner, M. H., Dunlay, S. M., Evers, L. R., Fang, J. C., Fedson, S. E., Fonarow, G. C., Hayek, S. S., Hernandez, A. F., Khazanie, P., Kittleson, M. M., Lee, C. S., Link, M. S., . . . Yancy, C. W. (2022). 2022 AHA\/ACC\/HFSA Guideline for the management of heart failure: A report of the American College of Cardiology\/American Heart Association Joint Committee on clinical practice guidelines. Circulation, 145(18), e895-e1032. https:\/\/doi.org\/10.1161\/CIR.0000000000001063","DOI":"10.1161\/CIR.0000000000001063"},{"key":"138619","doi-asserted-by":"crossref","unstructured":"Huang, H., Wang, H. H. X., Donaghy, E., Henderson, D., & Mercer, S. W. (2022). Using self\u2010determination theory in research and evaluation in primary care. Health Expectations, 25(6), 2700-2708. https:\/\/doi.org\/10.1111\/hex.13620","DOI":"10.1111\/hex.13620"},{"key":"138620","doi-asserted-by":"crossref","unstructured":"Kang, H., Yang, T., Banu, N., Ng, S. W. T., & Lee, J. K. (2025). Exploring smart health wearable adoption among Singaporean older adults based on self-determination theory: Web-based survey study. JMIR Aging, 8(1), e69008. https:\/\/doi.org\/10.2196\/69008","DOI":"10.2196\/69008"},{"key":"138621","doi-asserted-by":"crossref","unstructured":"Lakens, D. (2013). Calculating and reporting effect sizes to facilitate cumulative science: A practical primer for t-tests and ANOVAs. Frontiers in Psychology, 4, 863. https:\/\/doi.org\/10.3389\/fpsyg.2013.00863","DOI":"10.3389\/fpsyg.2013.00863"},{"key":"138622","doi-asserted-by":"crossref","unstructured":"Li, X., Yang, S., Wang, Y., Yang, B., & Zhang, J. (2020). Effects of a transtheoretical model-based intervention and motivational interviewing on the management of depression in hospitalized patients with coronary heart disease: A randomized controlled trial. BMC Public Health, 20(1), 420. https:\/\/doi.org\/10.1186\/s12889-020-08568-x","DOI":"10.1186\/s12889-020-08568-x"},{"key":"138623","doi-asserted-by":"crossref","unstructured":"Makita, S., Yasu, T., Akashi, Y. J., Adachi, H., Izawa, H., Ishihara, S., Iso, Y., Ohuchi, H., Omiya, K., & Ohya, Y. (2022). JCS\/JACR 2021 guideline on rehabilitation in patients with cardiovascular disease. Circulation Journal, 87(1), 155-235. https:\/\/doi.org\/10.1253\/circj.CJ-22-0234","DOI":"10.1253\/circj.CJ-22-0234"},{"key":"138624","doi-asserted-by":"crossref","unstructured":"Markland, D., & Tobin, V. (2004). A modification to the behavioural regulation in exercise questionnaire to include an assessment of amotivation. Journal of Sport and Exercise Psychology, 26(2), 191-196. https:\/\/doi.org\/10.1123\/jsep.26.2.191","DOI":"10.1123\/jsep.26.2.191"},{"key":"138625","unstructured":"Miller, W. R., & Rollnick, S. (2012). Motivational Interviewing: Helping People Change. Guilford Publications. https:\/\/books.google.co.th\/books?id=o1-ZpM7QqVQC"},{"key":"138626","doi-asserted-by":"crossref","unstructured":"Nogg, K. A., Vaughn, A. A., Levy, S. S., & Blashill, A. J. (2021). 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Circulation, 147(16), e699-e715. https:\/\/doi.org\/10.1161\/CIR.0000000000001122","DOI":"10.1161\/CIR.0000000000001122"},{"key":"138629","doi-asserted-by":"crossref","unstructured":"Samdal, G. B., Eide, G. E., Barth, T., Williams, G., & Meland, E. (2017). Effective behaviour change techniques for physical activity and healthy eating in overweight and obese adults; Systematic review and meta-regression analyses. International Journal of Behavioral Nutrition and Physical Activity, 14(1), 42. https:\/\/doi.org\/10.1186\/s12966-017-0494-y","DOI":"10.1186\/s12966-017-0494-y"},{"key":"138630","doi-asserted-by":"crossref","unstructured":"Su, G., Xu, Y., Xu, X., Xu, H., Lu, L., Marrone, G., Lindholm, B., Wen, Z., Liu, X., & Johnson, D. W. (2018). Association between reduced renal function and cardiovascular mortality in patients hospitalized with infection: A multi-center cohort study. European Journal of Internal Medicine, 57, 32-38. https:\/\/doi.org\/10.1016\/j.ejim.2018.06.017","DOI":"10.1016\/j.ejim.2018.06.017"},{"key":"138631","doi-asserted-by":"crossref","unstructured":"Van Rhoon, L., Byrne, M., Morrissey, E., Murphy, J., & McSharry, J. (2020). A systematic review of the behaviour change techniques and digital features in technology-driven type 2 diabetes prevention interventions. Digital Health, 6, 2055207620914427. https:\/\/doi.org\/10.1177\/2055207620914427","DOI":"10.1177\/2055207620914427"},{"key":"138632","doi-asserted-by":"crossref","unstructured":"Verloigne, M., De Bourdeaudhuij, I., Tanghe, A., D'Hondt, E., Theuwis, L., Vansteenkiste, M., & Deforche, B. (2011). Self-determined motivation towards physical activity in adolescents treated for obesity: An observational study. International Journal of Behavioral Nutrition and Physical Activity, 8(1), 97. https:\/\/doi.org\/10.1186\/1479-5868-8-97","DOI":"10.1186\/1479-5868-8-97"},{"key":"138633","doi-asserted-by":"crossref","unstructured":"Warehime, S., Dinkel, D., Alonso, W., & Pozehl, B. (2020). Long-term exercise adherence in patients with heart failure: A qualitative study. Heart & Lung, 49(6), 696-701. https:\/\/doi.org\/10.1016\/j.hrtlng.2020.08.016","DOI":"10.1016\/j.hrtlng.2020.08.016"},{"key":"138634","doi-asserted-by":"crossref","unstructured":"Wongvibulsin, S., Habeos, E. E., Huynh, P. P., Xun, H., Shan, R., Porosnicu Rodriguez, K. A., Wang, J., Gandapur, Y. K., Osuji, N., & Shah, L. M. (2021). Digital health interventions for cardiac rehabilitation: Systematic literature review. Journal of Medical Internet Research, 23(2), e18773. https:\/\/doi.org\/10.2196\/18773","DOI":"10.2196\/18773"},{"key":"138635","doi-asserted-by":"crossref","unstructured":"Zhu, S., Sinha, D., Kirk, M., Michalopoulou, M., Hajizadeh, A., Wren, G., Doody, P., Mackillop, L., Smith, R., & Jebb, S. A. (2024). Effectiveness of behavioural interventions with motivational interviewing on physical activity outcomes in adults: Systematic review and meta-analysis. BMJ, 386, e078713. https:\/\/doi.org\/10.1136\/bmj-2023-078713","DOI":"10.1136\/bmj-2023-078713"},{"key":"138636","doi-asserted-by":"crossref","unstructured":"Zou, Y., Janus, S., Du, J., Qu, N., Zuidema, K., Burger, H., Ahaus, K., Guo, Z., & Zuidema, S. (2025). Barriers and facilitators of cardiac rehabilitation in a middle-income country: A qualitative study from China. International Journal of Environmental Research and Public Health, 22(4), 574. https:\/\/doi.org\/10.3390\/ijerph22040574","DOI":"10.3390\/ijerph22040574"}],"container-title":["Belitung Nursing Journal"],"original-title":[],"link":[{"URL":"https:\/\/www.belitungraya.org\/BRP\/index.php\/bnj\/article\/download\/4258\/1300","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.belitungraya.org\/BRP\/index.php\/bnj\/article\/download\/4258\/1313","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.belitungraya.org\/BRP\/index.php\/bnj\/article\/download\/4258\/1300","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T04:29:39Z","timestamp":1769142579000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.belitungraya.org\/BRP\/index.php\/bnj\/article\/view\/4258"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,23]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,23]]}},"URL":"https:\/\/doi.org\/10.33546\/bnj.4258","relation":{},"ISSN":["2477-4073"],"issn-type":[{"value":"2477-4073","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,23]]},"assertion":[{"value":"2025-09-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-06","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}