This section was adapted from the Cardiac Rehabilitation booklet from the Wellness Institute at Seven Oaks Hospital in Winnipeg, Manitoba, 2009.

At the beginning of your cardiac rehabilitation program, we asked you to tell us which results you are hoping to reach. As you know, heart disease is a condition that requires long-term care. Many of you may have goals regarding your risk factors for heart disease. Some of you may simply want to improve your strength and endurance to return to all of the activities you want and need to do.

We will provide you with your risk factor report, which can show you possible areas for change. However, it is up to you to decide what changes you are willing to make. In other words, we are encouraging you to take an active role in your health.

Setting goals is an important part of making these changes. In this section, we will guide you to set realistic goals/action plans to help you move towards your desired results. Think of the goal as the steps you will take to reach your desired outcomes.

GETTING STARTED

Decide what you want to achieve. Remember this should be something that is important to you, not just something others have said you should do.

If you already know exactly what you want to do, you can skip ahead to the section about S.M.A.R.T. Goals. Otherwise, we invite you to answer the questions below.

1. Make a list of the results you want to reach regarding your heart health.
   Take a moment to think about these results and put a star next to the one you want to work on first.
2. Consider why this result is important to you (these are your reasons to change).
3. On a scale of 0 to 10, how important is it to you to make this change?
   0=Not at all important 3=Unsure 5=Somewhat important 8=Very important 10=Extremely important
4. Now think about the reasons which keep you from making this change (these barriers could be situations, thoughts or feelings).
5. There are often many ways to reach a specific result. Try to think of steps you can take to help you reach your desired result. Do not limit yourself at this time. Write down each option, even if you do not think it is possible at this time. Feel free to discuss with others and get their ideas.
6. Now choose one option you would like to work on

Next, you need to decide how hard you are willing to work for this result. Most lifestyle changes require some effort on your part. If you are not willing to do or give up what it takes to reach your result, you may not be ready for this particular goal. You could be setting yourself up for disappointment. You may want to focus instead on a different plan to help you move toward the same result or work towards a different result.

However, if you decide this is still the right plan of action for you at this time, consider asking for support. Some people are able to do these types of changes on their own but most of us benefit greatly from the support of others. It could be someone to make the change along with you, to give you reminders and check in on your progress, to provide advice or simply to encourage you. Do not hesitate to ask your family, friends, colleagues or neighbours for help.

Who could be a source of support for you and how can they help you?

S.M.A.R.T. Goals

The next step is to turn the result you want to achieve into an action plan or short-term goal. As you do this, think of the word SMART.

Specific: What? Decide exactly what you will do. Be as precise as you can.
Measurable: How much?
Achievable: When, where, how often?
Realistic/rewarding: This is a reality check: is this challenging but doable? Make sure it is something important to you.
Timeline: When will you check on your progress?

My Action Plan

Here is an example:

This week, I will walk on the treadmill (what)
before lunch (when)
at the gym at work (where)
for 20 minutes (how much)
three times per week (how often)

Write down your first action plan.

This week I will:

(what)
(when)
(where)
(how much)
(how often)

Now, how confident are you that you can complete this plan? On a scale of 0 to 10, 0 being not at all confident and 10 being completely confident, how sure are you that you can complete this plan?

Not confident at all to Completely confident
0 - - - - - - - - - 1 - - - - - - - - 2 - - - - - - - - 3 - - - - - - - - 4 - - - - - - - - 5 - - - - - - - - 6 - - - - - - - - 7 - - - - - - - - 8 - - - - - - - - 9 - - - - - - - - 1 0

If your answer is seven or above, this is probably a realistic plan for you. However, if your answer is below seven, you should rethink your action plan. Ask yourself why you are not certain you can make this plan succeed. What barriers do you see? See if you can come up with some solutions to solve these problems or change your plan to one where you feel more confident.

Logging My Progress

Congratulations, you are ready to put your plan into action. It is now important to keep track of your progress.

Here is an example of a table to keep track of your progress.

Progress Tracker (PDF)

Checking the Results and Problem Solving

At the end of each week, check your results. If you are reaching your goals easily, it may be time to challenge yourself a little more. Be careful to make the changes gradually to keep them realistic.

For example, if you walked 20 minutes three times, you could increase to four or five times for the following week but do not jump to seven days per week immediately.

If you have struggled to reach your goal, try to determine the cause of your difficulty. Be very honest with yourself.

1. Identify the problem
2. List possible solutions
3. Select one solution to try
4. Re-assess your progress
5. Try another solution if the first did not work

Keeping Things Going Strong

Once you have started to meet your goals, you need to think about how you will maintain these changes in the future.

On a scale of 0 to 10, 0 being not at all confident and 10 being completely confident, how sure are you that you can maintain this change over the next year?

Not confident at all to Completely confident
0 - - - - - - - - - 1 - - - - - - - - 2 - - - - - - - - 3 - - - - - - - - 4 - - - - - - - - 5 - - - - - - - - 6 - - - - - - - - 7 - - - - - - - - 8 - - - - - - - - 9 - - - - - - - - 1 0

Why did you give yourself this score?
What are some barriers that could prevent you from maintaining these changes?
Can you think of some ways to get around these obstacles?

BARRIERS	SOLUTIONS

 

It is often helpful to think about the benefits you are getting with the changes that you have made. This can help with motivation.

My benefits:

It is also important to reward yourself for a job well done. This can also help to boost your motivation to continue working hard. Think of rewards that will not set you back in your results.

My rewards:

Dealing with Setbacks

It is completely normal to have an occasional setback. Try to avoid blaming yourself or thinking the worst will happen.

Think of the factors which led to the setback. Think about how, when, and where, instead of why it happened.

What did you do or not do:
1. Before the setback?
2. During the setback?
3. After the setback?

What can you do to get back on track as soon as possible? Set some short-term goals.

What would you do differently in the future?

Try to identify high-risk situations and make a plan for them.