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参与或不参与心脏康复计划:影响患者决策的因素。

Participating or not in a cardiac rehabilitation programme: factors influencing a patient's decision.

机构信息

Deloitte Life Sciences and Healthcare, Brussels, Belgium.

出版信息

Eur J Prev Cardiol. 2013 Apr;20(2):341-8. doi: 10.1177/2047487312437057. Epub 2012 Jan 20.

Abstract

BACKGROUND

International research indicates that attendance of patients to a proposed cardiac rehabilitation (CR) programme varies between 21% and 75%. Addressing the reasons why cardiac patients are not participating will improve accessibility to CR. The objective of this study was to investigate patient compliance with cardiac rehabilitation and the reasons of refusing or abandoning the programme.

METHODS

Twenty hospital centres were recruited to participate. Each centre was asked to recruit patients from three patient groups, namely: percutaneous coronary intervention patients, patients that underwent major cardiac surgery, and patients being admitted because of an acute myocardial infarction and not belonging to the other two groups. Patients were asked to fill out a questionnaire during a follow-up outpatient consultation after the cardiac intervention.

RESULTS

In total, 226 patients participated in the survey. Most patients were proposed (86%) and accepted (81% out of proposed) to attend a CR programme. Of those who accepted, 77% completed the programme. The main reasons that led to patients' refusal to participate in a CR programme were distance to the CR centre, patients' belief they could handle their own problems, and lack of time. The main three reasons for not completing an initiated CR programme were other physical problems, patients' belief they could handle their own problems, and the cost of rehabilitation.

CONCLUSION

Our findings demonstrate the importance of raising patients' awareness of the benefits of CR. Addressing potential barriers to attend a CR programme should be investigated with patients individually in order to ensure compliance.

摘要

背景

国际研究表明,患者参加拟议的心脏康复(CR)计划的比例在 21%至 75%之间有所不同。解决患者不参与的原因将提高 CR 的可及性。本研究的目的是调查患者对心脏康复的依从性以及拒绝或放弃该计划的原因。

方法

招募了 20 家医院参与。每个中心被要求从三个患者群体中招募患者,即:经皮冠状动脉介入治疗患者、接受重大心脏手术的患者以及因急性心肌梗死入院且不属于其他两个群体的患者。患者在心脏介入后的随访门诊就诊期间被要求填写一份问卷。

结果

共有 226 名患者参与了调查。大多数患者被提议(86%)并接受(拟议的 81%)参加 CR 计划。在接受的患者中,77%完成了该计划。导致患者拒绝参加 CR 计划的主要原因是距离 CR 中心的距离、患者认为自己可以处理自己的问题以及缺乏时间。未完成启动的 CR 计划的三个主要原因是其他身体问题、患者认为自己可以处理自己的问题以及康复费用。

结论

我们的研究结果表明,提高患者对 CR 益处的认识非常重要。应针对每个患者单独调查参加 CR 计划的潜在障碍,以确保依从性。

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