Lieberman L, Meana M, Stewart D
Toronto Hospital, Women's Health Program, University of Toronto, Canada.
J Womens Health. 1998 Aug;7(6):717-23. doi: 10.1089/jwh.1998.7.717.
This study investigates gender differences in the barriers and incentives that are most influential in the coronary patient's decision to participate in cardiac rehabilitation programs (CRPs) and suggests strategies to counter these barriers. Patient surveys were administered to consecutive English-speaking attenders and referred nonattenders to a cardiac rehabilitation center at a university healthcare system in Toronto, Canada. A survey questionnaire, constructed from a literature review and advice from key informants, examined potential factors affecting decisions to engage in CRPs. One hundred twenty-nine attenders at a CRP and 61 referred nonattenders completed the questionnaire. Physician recommendation was reported to be the most important factor influencing both women's and men's decisions to participate in CRPs, followed by encouragement from family members. For women who had attended CRP, encouragement from their adult children was significantly more influential than it was for men. Attention to health promotion was also a significantly more powerful motivator for women than it was for men. For CRP nonattenders, concomitant illness, transportation problems, and inconvenient timing of the program were stated to be the three most important barriers to CRP participation in both sexes, although women rated concomitant illness as a significantly more powerful barrier than did men. The decision to participate in CRPs involves several factors, some of which are different or more important for women. As physician recommendations continue to be the single most important factor in motivating both men and women to attend, strengthened and increased physician endorsement will likely encourage higher levels of participation in CRPs. For women, permission should be sought to discuss the advantages of CRPs with adult children who are apparently influential in the decision. As women nonattenders are more concerned than men about the effects of concomitant illnesses, reassurance should be provided about customized programs and exercise targets that consider the needs and limitations of individuals with other health conditions.
本研究调查了在冠心病患者参与心脏康复计划（CRP）的决策中最具影响力的障碍和激励因素的性别差异，并提出了应对这些障碍的策略。对加拿大多伦多一所大学医疗系统的心脏康复中心连续的英语使用者和转介的未参与者进行了患者调查。根据文献综述和关键信息提供者的建议构建了一份调查问卷，以检查影响参与CRP决策的潜在因素。129名CRP参与者和61名转介的未参与者完成了问卷。据报告，医生的建议是影响女性和男性参与CRP决策的最重要因素，其次是家庭成员的鼓励。对于参加CRP的女性来说，成年子女的鼓励比男性更具影响力。对健康促进的关注对女性也是比男性更有力的动机。对于未参加CRP的人来说，合并症、交通问题和项目时间不便被认为是男女参与CRP的三个最重要障碍，尽管女性认为合并症是比男性更有力的障碍。参与CRP的决策涉及多个因素，其中一些因素对女性来说不同或更重要。由于医生的建议仍然是激励男性和女性参与的最重要单一因素，加强和增加医生的认可可能会鼓励更高水平的CRP参与。对于女性，应寻求许可与显然在决策中有影响力的成年子女讨论CRP的好处。由于未参加CRP的女性比男性更担心合并症的影响，应提供关于考虑到其他健康状况个体的需求和限制的定制计划和运动目标的保证。
