Bäck Maria, Öberg Birgitta, Krevers Barbro
Department of Medical and Health Sciences, Division of Physiotherapy, Faculty of Medicine and Health Sciences, Linköping University, SE-581 83, Linköping, Sweden.
Department of Medical and Health Sciences, Division of Health Care Analysis, Faculty of Medicine and Health Sciences, Linköping University, SE-581 83, Linköping, Sweden.
BMC Cardiovasc Disord. 2017 Mar 14;17(1):77. doi: 10.1186/s12872-017-0512-7.
In order to improve attendance at exercise-based cardiac rehabilitation (CR), a greater insight into patients' perspectives is necessary. The aim of the study was to explore aspects that influence patients' attendance at exercise-based CR after acute coronary artery disease (CAD) and the role of the physiotherapist in patients' attendance at exercise-based CR.
A total of 16 informants, (5 women; median age 64.5, range 47-79 years), diagnosed with CAD, were included in the study at the Cardiology Department, Linköping University Hospital, Sweden. Qualitative interviews were conducted and analysed according to inductive content analysis.
Four main categories were identified: (i) previous experience of exercise, (ii) needs in the acute phase, (iii) important prerequisites for attending exercise-based CR and (iv) future ambitions. The categories demonstrate that there are connections between the past, the present and the future, in terms of attitudes to facilitators, barriers and the use of strategies for managing exercise. An overall theme, defined as existential thoughts, had a major impact on the patients' attitudes to attending exercise-based CR. The interaction and meetings with the physiotherapists in the acute phase were described as important factors for attending exercise-based CR. Moreover, informants could feel that the physiotherapists supported them in learning the right level of effort during exercise and reducing the fear of exercise.
This study adds to previous knowledge of barriers and facilitators for exercise-based CR that patients with CAD get existential thoughts both related to exercise during the rehabilitation process and for future attitudes to exercise. This knowledge might necessitate greater attention to the physiotherapist-patient interaction. To be able to tailor exercise-based CR for patients, physiotherapists need to be aware of patients' past experiences of exercise and previous phases of the rehabilitation process as these are important for how patients' perceive their need and ability of exercise.
为了提高基于运动的心脏康复（CR）的参与率，有必要更深入地了解患者的观点。本研究的目的是探讨影响急性冠状动脉疾病（CAD）患者参与基于运动的CR的因素，以及物理治疗师在患者参与基于运动的CR中的作用。
共有16名被诊断为CAD的受试者（5名女性；中位年龄64.5岁，范围47 - 79岁）纳入瑞典林雪平大学医院心脏病科的研究。进行了定性访谈，并根据归纳性内容分析法进行分析。
确定了四个主要类别：（i）以往的运动经历，（ii）急性期的需求，（iii）参与基于运动的CR的重要先决条件，以及（iv）未来的抱负。这些类别表明，就对促进因素、障碍的态度以及运动管理策略的使用而言，过去、现在和未来之间存在联系。一个被定义为存在性思考的总体主题对患者参与基于运动的CR的态度产生了重大影响。急性期与物理治疗师的互动和会面被描述为参与基于运动的CR的重要因素。此外，受试者能感觉到物理治疗师在帮助他们学习运动时的正确用力水平以及减轻对运动的恐惧方面给予了支持。
本研究增加了以往关于CAD患者参与基于运动的CR的障碍和促进因素的知识，即患者在康复过程中对运动以及未来运动态度方面都会产生存在性思考。这些知识可能需要更加关注物理治疗师与患者之间的互动。为了能够为患者量身定制基于运动的CR，物理治疗师需要了解患者过去的运动经历以及康复过程的先前阶段，因为这些对于患者如何看待自己的运动需求和能力很重要。
