Department of Psychology, University of Calgary, Calgary, Canada.
TotalCardiology Rehabilitation, Calgary, Canada.
Disabil Rehabil. 2020 May;42(9):1284-1291. doi: 10.1080/09638288.2018.1524519. Epub 2018 Nov 20.
Patients referred to cardiac rehabilitation after an acute coronary syndrome event commonly report strong intention to attend, but at least one-third do not participate. This study explored whether well-documented cardiac rehabilitation barriers (e.g., comorbidities, logistical/time constraints, and low social support) moderate the association between intention to participate and actual program enrollment and attendance. Following referral but prior to commencing a 12-week outpatient cardiac rehabilitation program, 100 patients with acute coronary syndrome completed measures of intention to attend cardiac rehabilitation, perceived cardiac rehabilitation barriers, and social support. Program enrollment and attendance were determined by chart review. Despite high reported intention to attend ( = 6.08/7.00, = 1.80), nearly one-in-five did not enroll. Weaker intention to attend ( = 0.46, = 0.16, = 0.004) and greater cardiac rehabilitation barriers (= -1.67, = 0.70, = 0.017) corresponded to lower program enrollment. Similarly, weaker intention ( 2.29, 0.50, < 0.001) and greater barriers (-6.19, = 1.55, < 0.001) predicted poorer attendance. Barriers moderated the association between intention to participate and cardiac rehabilitation enrollment (-0.60, 0.290.037) and attendance ( = -3.12, = 1.02, = 0.003). Perceived cardiac rehabilitation barriers influence whether patients successfully translate their intention to attend into actual program participation. Enhancing self-efficacy to overcome barriers may represent an important intervention target among prospective cardiac rehabilitation patients.Implications for RehabilitationPatients with acute coronary syndrome report strong intention to attend cardiac rehabilitation upon referral, yet cardiac rehabilitation programs remain underutilized.Assessing and addressing perceived barriers during the transition to cardiac rehabilitation, even when patients present as highly motivated to attend, may be critical to promoting program uptake.Rehabilitation professionals should ask patients about specific barriers to attending cardiac rehabilitation (e.g., financial constraints, transportation problems) and provide individualized solutions (e.g., fee subsidization, home- or web-based programs) to increase participation.
患者在急性冠状动脉综合征事件后被转介至心脏康复治疗，但据报告，他们通常表现出强烈的参与意愿，但仍有至少三分之一的患者未参与。本研究旨在探究记录详实的心脏康复治疗障碍（例如合并症、后勤/时间限制和社会支持度低）是否会影响参与意愿与实际参与康复治疗计划和出勤率之间的关联。100 名急性冠状动脉综合征患者在被转介但尚未开始为期 12 周的门诊心脏康复治疗计划前，完成了对参与心脏康复治疗意愿、感知的心脏康复治疗障碍和社会支持的评估。通过病历审查确定了计划的参与和出勤率。尽管报告的参与意愿很高（ = 6.08/7.00， = 1.80），但仍有近五分之一的患者未参与。较弱的参与意愿（ = 0.46， = 0.16， = 0.004）和更多的心脏康复治疗障碍（ = -1.67， = 0.70， = 0.017）与较低的计划参与率相对应。同样，较弱的意愿（ 2.29， 0.50， < 0.001）和更大的障碍（-6.19， = 1.55， < 0.001）预测了较差的出勤率。障碍调节了参与意愿和心脏康复治疗参与（-0.60， 0.290.037）以及出勤率（ = -3.12， = 1.02， = 0.003）之间的关联。感知到的心脏康复治疗障碍会影响患者是否能够成功地将参与意愿转化为实际的计划参与。增强克服障碍的自我效能感可能是未来心脏康复治疗患者的一个重要干预目标。康复意义患有急性冠状动脉综合征的患者在被转介至心脏康复治疗时报告出强烈的参与意愿，但心脏康复治疗计划的利用率仍然较低。在向心脏康复治疗过渡期间评估和解决感知到的障碍，即使患者表现出高度的参与意愿，对于促进计划参与率也可能至关重要。康复专业人员应询问患者参加心脏康复治疗的具体障碍（例如经济限制、交通问题），并提供个性化的解决方案（例如费用补贴、家庭或网络计划），以提高参与度。
