Nathanail Stephanie K, Gyenes Gabor T, Van Damme Andrea, Meyer Tara C, Parent Eric C, Kennedy Michael D
Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada.
Jim Pattison Centre for Heart Health, Mazankowski Alberta Heart Institute, Alberta Health Services, Edmonton, Alberta, Canada.
CJC Open. 2021 Dec 9;4(4):364-372. doi: 10.1016/j.cjco.2021.12.001. eCollection 2022 Apr.
A paucity of studies have investigated participant attendance in community-based and hybrid cardiac rehabilitation programs in the Canadian setting. We compared exercise-session attendance of community-based, bridging (hospital plus community-based), and hospital-based participants who attended a high-volume cardiac rehabilitation program in Alberta, Canada.
Exercise sessions attended and participant characteristics were collected and analyzed from 230 records of patients who attended cardiac rehabilitation between 2016 and 2019. Community-based ( = 74) and bridging ( = 41) program participants were age- and sex-matched in a 1:1 ratio to hospital-based participants. The number of exercise sessions attended was compared among program groups, between female and male patients, and for patients with vs without cardiac surgery. The percentage of exercise sessions attended was also compared among program groups.
Bridging participants attended the greatest number of exercise sessions (median = 10.0 sessions) and demonstrated a significantly higher percentage of sessions attended (91%, 25th and 75th percentile interquartile range [IQR] = 64, 100%) than matched hospital participants (median = 6.0 sessions; 63%, 25, 75 IQR = 13, 94%; = 0.01). Percentage of sessions attended did not differ for bridging and community-based participants ( = 0.30). Exercise-session attendance was similar for community-based participants (median = 6.0 sessions; 75%, 25, 75 IQR = 38%, 88%) vs their hospital matches (median = 6.0 sessions; 81%, 25, 75 IQR = 38%, 100%; ≥ 0.37), as well as for female vs male patients (median = 7.0 sessions for both sexes; = 0.66), and for surgical vs nonsurgical patients (median = 7.0 sessions; = 0.48). Female patients in the bridging program attended significantly more exercise sessions in the community, compared with male patients in the bridging program ( = 0.02).
Bridging participants attended the most exercise sessions overall and demonstrated a higher percentage attendance than hospital-based participants. These results suggest that a hybrid program consisting of hospital and community-based exercise was favourable for exercise-session attendance. Given modern approaches to de-medicalize cardiac rehabilitation, our findings further support the provision of community program offerings, without detriment to patient session attendance.
在加拿大的背景下，很少有研究调查基于社区和混合心脏康复项目中的参与者出勤率。我们比较了加拿大艾伯塔省参加高容量心脏康复项目的社区、过渡（医院加社区）和医院参与者的锻炼课程出勤率。
收集并分析了2016年至2019年期间参加心脏康复的230名患者的记录中的锻炼课程出勤情况和参与者特征。基于社区（n = 74）和过渡（n = 41）项目的参与者与医院参与者按1:1的比例进行年龄和性别匹配。比较了项目组之间、女性和男性患者之间以及接受心脏手术和未接受心脏手术的患者的锻炼课程数量。还比较了项目组之间的锻炼课程出勤百分比。
过渡参与者参加的锻炼课程数量最多（中位数 = 10.0节），并且出勤百分比显著高于匹配的医院参与者（91%，第25和75百分位数四分位间距[IQR] = 64，100%）（中位数 = 6.0节；63%，25，75 IQR = 13，94%；P = 0.01）。过渡和基于社区的参与者的出勤百分比没有差异（P = 0.30）。基于社区的参与者（中位数 = 6.0节；75%，25，75 IQR = 38%，88%）与其医院匹配者（中位数 = 6.0节；81%，25，75 IQR = 38%，100%；P ≥ 0.37）、女性和男性患者（两性中位数均为7.0节；P = 0.66）以及手术和非手术患者（中位数 = 7.0节；P = 0.48）的锻炼课程出勤情况相似。与过渡项目中的男性患者相比，过渡项目中的女性患者在社区参加的锻炼课程明显更多（P = 0.02）。
过渡参与者总体上参加的锻炼课程最多，并且出勤率高于医院参与者。这些结果表明，由医院和社区锻炼组成的混合项目有利于锻炼课程出勤。鉴于现代使心脏康复非医学化的方法，我们的研究结果进一步支持提供社区项目，而不会损害患者的课程出勤率。
