TotalCardiology Rehabilitation, Calgary, Alberta, Canada (Mr Giannoccaro, Dr Aggarwal and Rouleau, and Ms Hauer); Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada (Dr Aggarwal); Faculty of Health, York University, Toronto, Ontario, Canada (Dr Grace); Knowledge, Innovation, Talent, Everywhere (KITE), University Health Network, Toronto, Ontario, Canada (Dr Grace); Department of Psychology, University of Calgary, Calgary, Alberta, Canada (Drs Campbell and Rouleau); and Department of Physical Therapy, University of Illinois at Chicago (Dr Arena).
J Cardiopulm Rehabil Prev. 2020 May;40(3):E22-E25. doi: 10.1097/HCR.0000000000000486.
Patients with coronary artery disease (CAD) often fail to maintain secondary prevention gains after completing cardiac rehabilitation (CR). Follow-up appointments aimed at assessing cardiac status and encouraging maintenance of health behaviors after CR completion are generally offered but not well-attended. This study explored patient characteristics and barriers associated with nonattendance at a 1-yr follow-up visit following CR completion.
Forty-five patients with CAD who completed a 12-wk outpatient CR program but did not attend the 1-yr follow-up appointment were included. Participants responded to a survey consisting of open-ended questions about follow-up attendance, a modified version of the Cardiac Rehabilitation Barriers Scale, and self-report items regarding current health practices and perceived strength of recommendation to attend. Thematic analysis was used to derive categories from open-ended questionnaire responses. Linear regression was used to assess characteristics associated with appointment attendance barriers.
Barrier themes were as follows: (1) lack of awareness; (2) perception of appointment as unnecessary; (3) practical or scheduling issues; (4) comorbid health issues; and (5) anticipated an unpleasant experience at the appointment. Greater self-reported barriers (mean ± SD = 1.97/5.00 ± 0.57) were significantly associated with lower perceived strength of recommendation to attend the follow-up appointment (2.82/5.00 ± 1.45), P = .005.
Providing a stronger recommendation to attend, enhancing patient awareness, highlighting potential benefits, and supporting self-efficacy might increase 1-yr follow-up appointment attendance and, in turn, support long-term adherence to cardiovascular risk reduction behaviors.
患有冠状动脉疾病（CAD）的患者在完成心脏康复（CR）后常常无法保持二级预防的效果。通常会提供旨在评估心脏状况并鼓励在完成 CR 后维持健康行为的随访预约，但参加率并不高。本研究探讨了与完成 CR 后 1 年随访预约不参加相关的患者特征和障碍。
共纳入 45 例完成 12 周门诊 CR 项目但未参加 1 年随访预约的 CAD 患者。参与者对一份调查问卷做出了回应，该问卷由关于随访参加情况的开放性问题、经过修改的心脏康复障碍量表以及关于当前健康实践和对参加建议的感知强度的自我报告条目组成。采用主题分析法从开放性问卷的回答中得出类别。采用线性回归分析评估与预约参加障碍相关的特征。
障碍主题如下：（1）缺乏意识；（2）认为预约不必要；（3）实际或时间安排问题；（4）合并健康问题；以及（5）预计在预约时会有不愉快的体验。自我报告的障碍越大（平均值±标准差=1.97/5.00±0.57），则对参加随访预约的感知推荐力度越低（2.82/5.00±1.45），P=0.005。
提供更强的参加建议、增强患者意识、突出潜在益处并支持自我效能感，可能会增加 1 年随访预约的参加率，进而支持长期遵守心血管风险降低行为。
