Maddocks Stacy, Cobbing Saul
Department of Physiotherapy, School of Health Sciences, University of KwaZulu-Natal (Westville Campus), Durban, South Africa.
Physiother Can. 2017;69(4):333-340. doi: 10.3138/ptc.2016-39GH.
This study explored and described patients' experiences and perceptions of phase 1 cardiac rehabilitation (CR) after a coronary artery bypass graft (CABG) at a public hospital in the province of KwaZulu-Natal, South Africa. CR is recognized around the world as an effective means of preventing disability and prolonging life in post-CABG patients. Despite this, participation in CR is low. Furthermore, little is known about patients' perceptions of CR programmes in South Africa. We used a descriptive qualitative study design to study nine purposively selected participants (mean age 56 y) who had received only individualized CR post-CABG or individualized CR in combination with group CR exercise. The participants were organized into focus groups of attenders and non-attenders of the group CR exercise classes. The four attenders were all men, and the non-attenders were three men and two women. Interviews were transcribed verbatim and subjected to thematic analysis. The three main themes that emerged were communication challenges between health care professionals and patients, the patients' experience of physiotherapy, and their recommendations for service delivery. Patients' perceptions of the current delivery of phase 1 CR in this study setting emphasized that improvements need to be made in the areas of patient-centred care, equality of access to programmes, and appropriateness of programme content. The results appear to indicate that patients have a limited awareness of and participation in in-patient and outpatient CR programmes. Research into improving the design of CR programmes in South Africa is required, in consultation with patients and the multidisciplinary health care team.
本研究探讨并描述了南非夸祖鲁 - 纳塔尔省一家公立医院中冠状动脉搭桥术(CABG)后患者对一期心脏康复(CR)的体验和看法。CR在全球范围内被公认为是预防CABG术后患者残疾和延长寿命的有效手段。尽管如此,参与CR的比例仍然很低。此外,对于南非患者对CR项目的看法知之甚少。我们采用描述性定性研究设计,研究了9名有目的地选择的参与者(平均年龄56岁),他们在CABG术后仅接受了个体化CR或个体化CR与团体CR运动相结合的治疗。参与者被分为团体CR运动课程的参加者和未参加者焦点小组。4名参加者均为男性,未参加者为3名男性和2名女性。访谈被逐字记录并进行了主题分析。出现的三个主要主题是医护人员与患者之间的沟通挑战、患者的物理治疗体验以及他们对服务提供的建议。本研究环境中患者对当前一期CR服务的看法强调,需要在以患者为中心的护理、项目获取的平等性以及项目内容的适宜性等方面做出改进。结果似乎表明,患者对住院和门诊CR项目的认知和参与有限。需要与患者和多学科医护团队协商,开展关于改进南非CR项目设计的研究。