Rouleau Codie R, King-Shier Kathryn M, Tomfohr-Madsen Lianne M, Aggarwal Sandeep G, Arena Ross, Campbell Tavis S
a Department of Psychology , University of Calgary , Calgary , Alberta , Canada.
b Faculty of Nursing and Department of Community Health Sciences , University of Calgary , Calgary , Alberta , Canada.
Disabil Rehabil. 2018 Feb;40(4):469-478. doi: 10.1080/09638288.2016.1261417. Epub 2016 Dec 15.
This study explored patients' decision-making about whether or not to enroll in cardiac rehabilitation (CR), an underutilized program that is associated with significantly improved health outcomes.
Face-to-face interviews were conducted with acute coronary syndrome patients (n = 14) after referral to a local CR center, but prior to program enrollment. Thematic analysis was used to derive themes from interview transcripts.
Three themes emerged including anticipated benefit, perceived ability, and contextual influences. Participants believed key benefits of CR would be access to specialist health care providers, improved longevity, reduced cardiovascular risk, as well as improved motivation, accountability, learning opportunities, and general fitness. Participants were concerned about their ability to engage in and travel to exercise sessions, pay the program fee, and manage scheduling conflicts. Contextual influences on decision-making included health care provider recommendation, first impressions of the CR center, knowledge gaps about what CR entails, input from family and peers, and psychological distress.
The period following CR referral but prior to enrollment represents an optimal opportunity to promote in-the-moment decisions in favor of CR. Patients report both positive and negative aspects of CR, suggesting individualized efforts to resolve ambivalence may increase program participation. Implications for Rehabilitation Cardiovascular disease is a leading cause of mortality worldwide. Cardiac rehabilitation (CR) is an effective secondary prevention strategy to improve cardiovascular morbidity and mortality, but only a subset of eligible patients enroll. After referral but prior to enrollment, patients anticipate both positive and negative aspects of CR participation. Individualized efforts to resolve ambivalence, address knowledge gaps, and problem-solve barriers may increase uptake into CR programs.
本研究探讨了患者对于是否参加心脏康复（CR）项目的决策过程，该项目未得到充分利用，但与显著改善健康结果相关。
对转诊至当地CR中心但尚未登记参加项目的急性冠状动脉综合征患者（n = 14）进行面对面访谈。采用主题分析法从访谈记录中提炼主题。
出现了三个主题，包括预期益处、感知能力和情境影响。参与者认为CR的主要益处包括能够接触到专科医疗服务提供者、延长寿命、降低心血管风险，以及提高积极性、责任感、学习机会和总体健康水平。参与者担心自己参与锻炼课程的能力、前往锻炼场所的交通问题、支付项目费用以及处理日程冲突的能力。对决策的情境影响包括医疗服务提供者的建议、对CR中心的第一印象、对CR内容的知识空白、家人和同伴的意见以及心理困扰。
CR转诊后但登记前这段时间是促进即时做出支持CR决策的最佳时机。患者报告了CR的积极和消极方面，表明采取个性化措施解决矛盾心理可能会增加项目参与度。康复的意义心血管疾病是全球主要的死亡原因。心脏康复（CR）是改善心血管发病率和死亡率的有效二级预防策略，但只有一部分符合条件的患者参加。在转诊后但登记前，患者预期参与CR既有积极方面也有消极方面。采取个性化措施解决矛盾心理、填补知识空白并解决障碍可能会增加CR项目的参与率。
