Synergistic tension among the music and lyrics of late-Romantic choral songs.

Cardiovascular diseases, including coronary heart disease (CHD), remain one of the leading causes of death worldwide and are associated with significant health consequences in older adults, such as arrhythmias, heart failure, and stroke (). While coronary revascularization procedures (e.g., coronary artery bypass grafting and percutaneous coronary intervention) are essential, the long-term management of CHD relies heavily on secondary prevention strategies aimed at improving lifestyle habits (e.g., adopting a healthy diet, smoking cessation, stress management, and regular physical activity) (). Specifically, adopting or maintaining physical activity is crucial to prevent complications and reduce mortality among older adults following coronary revascularization (; ; ). In addition to its cardioprotective effects, physical activity is also associated with improvements in quality of life (), which is a key concern and priority for many older adults post-revascularization (). Secondary prevention interventions, such as cardiac rehabilitation programs, are recognized as effective strategies for promoting healthy lifestyle habits among individuals with CHD (). These programs typically include multidisciplinary follow-up, structured group exercise sessions, and psychological support (). Despite their well-established benefits, cardiac rehabilitation programs remain underutilized by older adults (). Older adults may have difficulty accessing these center-based programs, or may be excluded due to frailty, physical limitations or the use of walking aids (). Additionally, healthcare professionals may be less likely to refer older patients to these programs due to their age, comorbidities, and perceived lower ability to participate (), even though they could significantly benefit from them (; ). Furthermore, most existing rehabilitation programs are designed for individuals of all ages living with CHD, without specific adaptations for older adults. Yet, several authors have emphasized the importance of developing age-tailored interventions that address the unique challenges and needs of this population (; ). Older adults represent a highly heterogeneous group with diverse characteristics and life contexts (e.g., health status, frailty, functional capacity, changes in social roles), which may influence their secondary prevention needs (). However, these needs remain underexplored, particularly in relation to behavioral change. In particular, several behavioral determinants may act as barriers to the adoption and maintenance of healthy lifestyle habits in this population. Older adults with CHD can experience challenges such as limited motivation to change lifestyle habits, reduced self-efficacy associated with physical limitations, and an insufficient awareness of the benefits of secondary prevention (; ). Given these challenges, healthcare professionals, particularly nurses, may play a key role in supporting behavior change. Given their strong relational skills, which are highly valued by older adults (; ; ), as well as their well-established role in managing chronic diseases, including CHD (), nurses may help enhance motivation, strengthen self-efficacy, and increase awareness of the benefits of lifestyle changes, thereby supporting the adoption and maintenance of health behaviors. In this context, alternative interventions to cardiac rehabilitation programs may help address existing barriers to access and support behavior change among older adults.