Department of Occupational Therapy and Physiotherapy, Zealand University Hospital Roskilde, Roskilde, Sjaelland, Denmark
Department of Occupational Therapy and Physiotherapy, Zealand University Hospital Roskilde, Roskilde, Sjaelland, Denmark.
BMJ Open. 2022 Nov 29;12(11):e064660. doi: 10.1136/bmjopen-2022-064660.
Despite documented benefits of cardiac rehabilitation (CR), attrition rates remain relatively high. Insights on patient perspectives concerning dropout during transition phases are deficient. This deeper understanding may help to inform on the perceived benefits and barriers in CR. This qualitative study explores the reasons why patients' dropout during the transition from a hospital-based CR programme to local healthcare facilities.
A Danish hospital and seven local healthcare centres.
Twelve patients, who had dropped out of exercise-based cardiac rehabilitation (exCR) during the transition from hospital-based rehabilitation to local healthcare centres, were recruited to semistructured interviews based on a purposeful sampling.
Important patient needs during rehabilitation was the ability to identify and reflect oneself in a group of peers in a safe, specialised hospital-based environment. At the transition point, the meaningfulness of continuation of CR was revaluated. Findings showed that reasons for discontinuation varied within individuals. It encompassed on a balanced choice of reassessing benefits against competing agendas as work demands versus expectations of benefits in a changed exercise environment and own exercise capabilities.
The study indicated that patient needs as timely relevance, a specialised safe environment and peer support are significant for participation in exCR. These needs may change during the transition stage due to competing agendas as work obligations and assessment of own ability to take control themselves. Perceived meaningfulness may be a major motivational driver for both initiating and making a judiciously choice of leaving an exCR programme.
尽管有心脏康复（CR）的益处的相关记录，但退出率仍然相对较高。关于患者在过渡阶段退出的观点缺乏深入了解。这种更深入的了解可能有助于了解 CR 中的感知益处和障碍。本定性研究探讨了患者在从基于医院的 CR 计划过渡到当地医疗机构期间退出的原因。
丹麦一家医院和七家当地医疗机构。
根据目的抽样，从 12 名在从医院康复过渡到当地医疗机构期间退出基于运动的心脏康复（exCR）的患者中招募了 12 名患者参加半结构化访谈。
康复期间患者的重要需求是在安全、专门的基于医院的环境中，在一群同龄人中识别和反思自己的能力。在过渡点，重新评估了继续进行 CR 的意义。研究结果表明，退出的原因因人而异。它包括在重新评估收益与竞争议程之间进行平衡选择，例如工作需求与改变的运动环境和自身运动能力的预期收益。
该研究表明，患者的需求如及时性、专门的安全环境和同伴支持对于参与 exCR 很重要。由于工作义务和自身控制能力的评估等竞争议程，这些需求可能会在过渡阶段发生变化。感知意义可能是启动和明智选择退出 exCR 计划的主要动机驱动因素。
