Alexander Helen, D'Silva Andrew, Tack Christopher, Cowie Aynsley
Physiotherapy Manager and Rehabilitation Services Lead Nuffield Health at St. Bartholomew's Hospital, 38 Giltspur Street, London, EC1A 7BS.
Consultant Cardiologist Guy's and St. Thomas' NHS Foundation Trust, St. Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH.
Br J Cardiol. 2023 Oct 10;30(4):31. doi: 10.5837/bjc.2023.031. eCollection 2023.
Remote delivery of cardiovascular rehabilitation (CR) has been vital during the COVID pandemic when restrictions have been placed on face-to- face services. In the future, CR services are likely to offer alternatives to centre- based CR, including digital options. However, little is known about the digital access and confidence of CR service users, or their CR delivery preferences. A telephone survey was conducted of those referred for CR in the London boroughs of Lambeth and Southwark (n=60) in which questions were asked about digital access and confidence, as well as current and future delivery preferences for their CR. Between March and July 2021, 60 service-users met the inclusion criteria and were recruited for a telephone survey (mean age 60 ± 11.2 years). Of those, 82% had regular access to a smartphone, 60% to a computer or laptop and 43% to a tablet device. A high proportion of service users perceived themselves to be 'extremely' or 'somewhat' confident to use their devices. Thirty-nine (65%) service users would currently prefer a face-to- face assessment, rising to 82% once the perceived COVID-19 threat and restrictions are less. Preferences for accessing exercise were equally split between face-to-face and remotely supported independent exercise, with low interest in digital options. Delivery preferences for education, relaxation and peer support were more heterogeneous with interest in all delivery options. In conclusion, digital access and confidence in CR service users was good. Redesigning CR services to offer more rehabilitation delivery options, aligned with patient choice may increase uptake and further trials are needed to assess the impact.
在新冠疫情期间，当面对面服务受到限制时，心血管康复（CR）的远程提供至关重要。未来，CR服务可能会提供基于中心的CR服务的替代方案，包括数字选项。然而，对于CR服务使用者的数字接入情况和信心，以及他们对CR服务提供方式的偏好，我们知之甚少。对伦敦兰贝斯区和南华克区被转诊接受CR治疗的患者（n = 60）进行了电话调查，询问了他们的数字接入情况和信心，以及他们目前和未来对CR服务提供方式的偏好。在2021年3月至7月期间，60名服务使用者符合纳入标准并被招募进行电话调查（平均年龄60 ± 11.2岁）。其中，82%的人经常使用智能手机，60%的人经常使用电脑或笔记本电脑，43%的人经常使用平板电脑设备。很大一部分服务使用者认为自己“非常”或“有些”有信心使用这些设备。39名（65%）服务使用者目前更喜欢面对面评估，一旦认为新冠疫情威胁和限制减少，这一比例将升至82%。在获取锻炼的方式上，面对面和远程支持的自主锻炼的偏好各占一半，对数字选项的兴趣较低。在教育、放松和同伴支持方面，服务提供方式的偏好更为多样化，对所有提供方式都有兴趣。总之，CR服务使用者的数字接入情况良好且信心充足。重新设计CR服务以提供更多符合患者选择的康复服务提供方式，可能会提高接受度，还需要进一步的试验来评估其影响。
