Campbell N C, Grimshaw J M, Ritchie L D, Rawles J M
Department of General Practice, University of Aberdeen.
J R Coll Physicians Lond. 1996 Nov-Dec;30(6):514-9.
to give a comprehensive description of the practice of outpatient cardiac rehabilitation in Scotland.
an identifying survey of 1,270 individuals in hospital, general practice and community sources nationally, followed by computer-assisted telephone interviews about programme characteristics with key personnel from identified cardiac rehabilitation schemes.
patient provision, referral criteria and programme features.
65 programmes provided outpatient cardiac rehabilitation for 4,980 patients in one year, representing 17% of the 29,180 patients who survived admission to hospital with coronary heart disease. Cardiac rehabilitation practice varied widely: 53 (82%) programmes included exercise, although only 19 (29%) at the most beneficial level; 40 (62%) included relaxation training, although only three (5%) at a level shown to give benefit; 47 (72%) included education, although only 16 (25%) in a manner with reported benefits in randomised trials.
outpatient cardiac rehabilitation was provided to a minority of patients with coronary heart disease. Programmes varied widely, and were often more limited than those reporting mortality and morbidity benefits in randomised trials. There is a substantial gap between current provision and practice of cardiac rehabilitation and that advocated in published guidelines.
全面描述苏格兰门诊心脏康复的实施情况。
对全国范围内医院、全科医疗及社区渠道的1270人进行识别性调查，随后对已识别的心脏康复计划的关键人员进行关于项目特征的计算机辅助电话访谈。
患者供给情况、转诊标准及项目特点。
65个项目在一年内为4980名患者提供了门诊心脏康复服务，占因冠心病入院存活的29180名患者的17%。心脏康复实践差异很大：53个（82%）项目包括运动，尽管只有19个（29%）达到最有益的水平；40个（62%）项目包括放松训练，尽管只有3个（5%）达到显示有益的水平；47个（72%）项目包括教育，尽管只有16个（25%）采用了随机试验中报告有获益的方式。
只有少数冠心病患者接受了门诊心脏康复服务。各项目差异很大，且通常比随机试验中报告有死亡率和发病率获益的项目更有限。目前心脏康复的供给和实践与已发表指南中所倡导的存在很大差距。
