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“为什么你们不听劝呢?就像是有人告诉你们中了彩票,而你们却决定不去领奖一样”:对急性心肌梗死后患者及其重要他人进行半结构化访谈,探讨影响其参与心脏康复和长期运动训练的因素。

"Why would you not listen? It is like being given the winning lottery numbers and deciding not to take them": semi-structured interviews with post-acute myocardial infarction patients and their significant others exploring factors that influence participation in cardiac rehabilitation and long-term exercise training.

机构信息

Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK.

School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.

出版信息

Disabil Rehabil. 2022 Aug;44(17):4750-4760. doi: 10.1080/09638288.2021.1919213. Epub 2021 May 7.

DOI:10.1080/09638288.2021.1919213
PMID:33961501
Abstract

PURPOSE

Despite the clinical benefits, coronary artery disease patient participation rates in cardiac rehabilitation (CR) and long-term exercise are poor. This study explored the factors related to participation in these interventions from the perspectives of post-acute myocardial infarction (AMI) patients and their significant others.

METHODS

Semi-structured interviews were performed with post-AMI patients (number () = 10) and their significant others ( = 10) following phase-III and phase-IV CR. Reflexive thematic analysis with an inductive orientation was utilised to identify themes within the dataset (ClinicalTrials.gov identifier: NCT03907293).

RESULTS

The overarching theme of the data was a perceived need to improve health, with the participants viewing health benefits as the principal motive for participating in CR and long-term exercise training. Three further themes were identified: motivation, extrinsic influences, and CR experience. These themes captured the underlying elements of the participants' decision to take part in CR and long-term exercise training for the purpose of health improvements.

CONCLUSION

An AMI collectively impacts the attitudes and beliefs of patients and their significant others in relation to CR participation, long-term exercise, and health. The factors identified in this study may inform strategies to promote patient enrollment in CR and adherence to long-term exercise.IMPLICATIONS FOR REHABILITATIONPost-AMI patients and their significant others reported that health benefits were the primary motive for participating in CR and long-term exercise, with aspects related to motivation, extrinsic influences, and CR experience underpinning the decision.Healthcare professionals should supply information about health benefits during the CR referral process, with insights into the experiences of CR graduates potentially improving the strength of recommendation.CR facilitators may promote long-term exercise adherence by assisting patients with the identification of an enjoyable exercise modality.Healthcare professionals should include significant others in the CR referral process, which may enable these individuals to support the patients' decisions.

摘要

目的

尽管有临床获益,但冠心病患者参与心脏康复(CR)和长期运动的比例仍然很低。本研究从急性心肌梗死(AMI)后患者及其主要照顾者的角度探讨了与参与这些干预措施相关的因素。

方法

对完成 III 期和 IV 期 CR 的 AMI 后患者(n=10)及其主要照顾者(n=10)进行半结构式访谈。采用具有归纳取向的反思性主题分析方法,对数据集(ClinicalTrials.gov 标识符:NCT03907293)中的主题进行识别。

结果

数据的首要主题是改善健康的需求,参与者认为健康益处是参与 CR 和长期运动训练的主要动机。还确定了三个进一步的主题:动机、外在影响和 CR 体验。这些主题捕捉到了参与者决定参与 CR 和长期运动训练以改善健康的潜在因素。

结论

AMI 共同影响患者及其主要照顾者对 CR 参与、长期运动和健康的态度和信念。本研究中确定的因素可能为促进患者参与 CR 和坚持长期运动提供策略。

对康复的影响

AMI 后患者及其主要照顾者报告称,健康益处是参与 CR 和长期运动的主要动机,与动机、外在影响和 CR 体验相关的因素是做出决定的基础。

医疗保健专业人员应在 CR 转诊过程中提供有关健康益处的信息,了解 CR 毕业生的经验可能会提高推荐的力度。

CR 促进者可以通过帮助患者确定愉快的运动方式来促进长期运动的坚持。

医疗保健专业人员应将主要照顾者纳入 CR 转诊过程,这可能使这些人能够支持患者的决定。

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