School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia.
Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia.
Eur J Cardiovasc Nurs. 2022 Aug 29;21(6):548-558. doi: 10.1093/eurjcn/zvab118.
Delivery of cardiac rehabilitation (CR) was challenged during the pandemic caused by the Coronavirus disease (COVID-19), due to government stay-at-home directives which restricted in-person programmes. The Australian state of Victoria experienced the longest and most severe COVID-19 restrictions and was in lockdown for ∼6 months of 2020. We aimed to explore (i) clinicians' experiences and perceptions and (ii) identify barriers and enablers, for delivering CR during the COVID-19 pandemic.
Victorian members of the Australian Cardiovascular Health and Rehabilitation Association (ACRA) were invited to attend an exploratory qualitative online consultation in November 2020. An inductive thematic analysis was undertaken, before deductively applying the Non-adoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework to identify barriers and enablers for technology adoption in CR. Thirty members participated in a 106-min consultation. Seventeen members who provided demographics represented multiple disciplines (nursing n = 13, exercise physiology n = 3, and physiotherapy n = 1) and geographical settings (metropolitan n = 10, regional n = 4, and rural n = 3). Four main themes were inductively identified: consequences of change; use of technology; capacity; and the way forward. The deductive NASSS analysis demonstrated the main challenges of continuing remotely delivered CR lie with adopters (staff, patients, and carers) and with organizations.
The COVID-19 pandemic expedited significant changes to CR delivery models. While clinicians are eager to retain technology-enabled delivery in addition to resuming in-person CR, it is now timely to review remote models of care, tools used and plan how they will be integrated with traditional in-person programmes.
由于冠状病毒病(COVID-19)大流行导致政府的居家令限制了面对面的项目,心脏康复(CR)的实施受到了挑战。澳大利亚维多利亚州经历了最长和最严重的 COVID-19 限制,在 2020 年有大约 6 个月的时间处于封锁状态。我们旨在探讨(i)临床医生的经验和看法,以及(ii)在 COVID-19 大流行期间提供 CR 所面临的障碍和促进因素。
邀请澳大利亚心血管健康与康复协会(ACRA)的维多利亚州成员参加 2020 年 11 月的一次探索性定性在线咨询。在应用非采用、放弃、扩大、传播和可持续性(NASSS)框架来确定 CR 技术采用的障碍和促进因素之前,采用了归纳主题分析。30 名成员参加了 106 分钟的咨询。17 名提供人口统计学资料的成员代表了多个学科(护理 n = 13,运动生理学 n = 3,物理治疗 n = 1)和地理环境(大都市 n = 10,区域 n = 4,农村 n = 3)。归纳出四个主要主题:变化的后果;技术的使用;能力;以及前进的道路。演绎的 NASSS 分析表明,远程提供的 CR 持续存在的主要挑战在于采用者(员工、患者和护理人员)和组织。
COVID-19 大流行加速了 CR 交付模式的重大变化。虽然临床医生渴望在恢复面授 CR 的同时保留基于技术的交付方式,但现在及时审查远程护理模式、使用的工具并计划如何将其与传统的面授项目整合是很重要的。