Koenders Niek, van Oorsouw Roel, Conijn Daniëlle, Verbakel Mariëtte, Eijsvogels Thijs M H, van der Wees Philip J
Department of Rehabilitation Radboud University Medical Center Nijmegen the Netherlands.
Royal Dutch Society of Physical Therapy Amersfoort the Netherlands.
J Am Heart Assoc. 2025 Sep 16;14(18):e040588. doi: 10.1161/JAHA.124.040588. Epub 2025 Sep 11.
To improve uptake and completion of cardiac rehabilitation, it is important to identify needs and tailor cardiac rehabilitation accordingly. Therefore, the aim of this study was to synthesize the needs of patients with coronary heart disease, heart failure, or thoracic aortic dissection regarding cardiac rehabilitation.
We performed a systematic review and meta-ethnographic synthesis of qualitative studies. We synthesized lines of argument and assessed the confidence of evidence using the Grading of Recommendations Assessment, Development and Evaluation Confidence in Evidence From Reviews of Qualitative Research approach. Ultimately, we integrated our findings into a conceptual model with recommendations for cardiac rehabilitation professionals.
Ninety-four studies were included and provided data from 1731 patients, 185 significant others (eg, partners or family members), and 105 cardiac rehabilitation professionals. We have synthesized 5 lines of argument that explained the needs of patients: (1) Patients need safety but not overprotection (high confidence); (2) patients need significant others to be involved (high confidence); (3) patients need support from people with whom they can identify (moderate confidence); (4) patients need personalized care (moderate confidence); and (5) patients need help to redesign a meaningful future (high confidence).
There is a need for innovation of current cardiac rehabilitation programs. Overprotection of significant others must be addressed within a safe environment and by thorough involvement of significant others. Cardiac rehabilitation professionals can begin adapting cardiac rehabilitation by organizing peer support, providing personalized care, and helping to redesign a meaningful future. Meeting patients' needs may improve uptake and completion of cardiac rehabilitation.
为提高心脏康复的参与率和完成率，识别需求并据此量身定制心脏康复方案非常重要。因此，本研究的目的是综合冠心病、心力衰竭或胸主动脉夹层患者在心脏康复方面的需求。
我们对定性研究进行了系统评价和元民族志综合分析。我们综合了论证思路，并采用《定性研究综述证据的推荐分级、制定与评价》方法评估证据的可信度。最终，我们将研究结果整合到一个概念模型中，并为心脏康复专业人员提供了建议。
纳入了94项研究，提供了来自1731名患者、185名重要他人（如伴侣或家庭成员）和105名心脏康复专业人员的数据。我们综合了5条解释患者需求的论证思路：（1）患者需要安全但不需要过度保护（高可信度）；（2）患者需要重要他人参与（高可信度）；（3）患者需要来自他们能够认同的人的支持（中等可信度）；（4）患者需要个性化护理（中等可信度）；（5）患者需要帮助重新设计有意义的未来（高可信度）。
当前的心脏康复项目需要创新。必须在安全的环境中解决重要他人过度保护的问题，并让重要他人充分参与。心脏康复专业人员可以通过组织同伴支持、提供个性化护理以及帮助重新设计有意义的未来来开始调整心脏康复方案。满足患者需求可能会提高心脏康复的参与率和完成率。
