Mechanisms and drivers of social inequality in phase <scp>II</scp> cardiac rehabilitation attendance: A convergent mixed methods study

Pedersen, Maria; Overgaard, Dorthe; Andersen, Ingelise; Baastrup, Marie; Egerod, Ingrid

doi:10.1111/jan.13715

Cited by 15 publications

(18 citation statements)

References 38 publications

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“…Traveling time to and from the CR site is a known cause for CR dropout ( 20 , 21 ). However, in this audit, traveling time was not a frequently identified drop-out cause.…”

Section: Discussionmentioning

confidence: 99%

Why Do Patients With Ischaemic Heart Disease Drop Out From Cardiac Rehabilitation in Primary Health Settings. A Qualitative Audit of Patient Charts

Ravn¹,

Uhd²,

Svendsen³

et al. 2022

Front. Rehabilit. Sci.

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BackgroundCardiac rehabilitation (CR) and medical treatment are integrated parts of the intervention for cardiac patients and are a class 1A recommendation. However, CR dropout is reported to be relatively high and little is known about the reasons for CR dropout in primary health settings.AimThis study investigates causes for CR dropout through a qualitative audit of medical charts among patients with ischaemic heart disease.MethodsThis was a qualitative retrospective audit of patient's medical charts. Patients who dropped out from CR between 1 January and 31 December 2018 in five primary health settings were included. Local patient charts provided information related to causes and formed the basis of the analysis. Data were analyzed using thematic analysis.ResultsA total of 690 patients were referred for and commenced CR and 199 (29%) dropped out. Twenty-five (12.6%) patients finished CR but were excluded due to standards of ≥180 days between CR meetings, leaving 118 patients included. Four themes as causes for patient's dropout were identified: (1) CR-programmes, (2) logistical, (3) intrapersonal and (4) clinical factors.ConclusionThis study identified new focus areas to which health professionals may attend in reducing drop-out from CR. Organisation of CR, challenges with combining labor market attachment and CR, focus on patient education and comorbidities. The results underline the importance of health professionals emphasizing the benefits of CR and explains that CR enhances long-term labor market attachment. Furthermore, health professionals should encourage participation in patient education and adapt exercise to the individual patient's potential.

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“…Traveling time to and from the CR site is a known cause for CR dropout ( 20 , 21 ). However, in this audit, traveling time was not a frequently identified drop-out cause.…”

Section: Discussionmentioning

confidence: 99%

Why Do Patients With Ischaemic Heart Disease Drop Out From Cardiac Rehabilitation in Primary Health Settings. A Qualitative Audit of Patient Charts

Ravn¹,

Uhd²,

Svendsen³

et al. 2022

Front. Rehabilit. Sci.

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show abstract

“…This can be supported through a course of cardiac rehabilitation offered through the national health service (NHS), though uptake is low [18]. Whilst there are many reasons why this may be the case [19][20][21][22], some of it may be due to inadequate levels of health literacy.…”

Section: Health Literacy and Cardiovascular Diseasementioning

confidence: 99%

Establishing the efficacy of interventions to improve health literacy and health behaviours: a systematic review

et al. 2020

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Background: The primary aim of this review was to establish whether health literacy interventions, in adults, are effective for improving health literacy. Two secondary aims assessed the impact of health literacy interventions on health behaviours and whether health literacy interventions have been conducted in cardiovascular patients. Methods: A systematic review (Prospero registration: CRD42018110772) with no start date running through until April 2020. Eligible studies were conducted in adults and included a pre/post measure of health literacy. Medline,

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“…Pedersen et al 14 also implemented comprehensive case analysis differently after separate analysis of the qualitative and quantitative data. They explored how anxiety and depression affect cardiac rehabilitation attendance using both qualitative ( n = 24) and quantitative ( n = 302) data.…”

Section: Data Sourcesmentioning

confidence: 99%

Practical strategies to identify and address discordant findings in mixed methods research

Younas

Pedersen

Inayat

2022

Research Methods in Medicine & Health Sciences

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Integration of qualitative and quantitative data in mixed methods research generates confirmed, discordant, and expanded findings. Guidance is available about the methods and strategies for the meaningful integration of data. However, little has been written about strategies for managing discordant findings in mixed methods. This paper describes and illustrates practical strategies for managing and integrating discordant findings in mixed methods analyses based on researchers reflections and experiences of managing and integrating discordant findings in convergent and sequential exploratory mixed methods studies. Two strategies, namely, comprehensive case and variable analysis and sociocultural exploration are proposed. Comprehensive case analysis involves identifying discordant findings in quantitative data, identifying supportive data in qualitative data, and selecting variables for mixed analysis and interpretation. Sociocultural exploration comprises qualitative code and quantitative data matrix for themes, identification of discordant findings under each theme, and development of sociocultural profile. Identifying and addressing discordant findings in mixed methods is an essential step of rigorous mixed methods analysis. The comprehensive case and variable analysis and sociocultural exploration strategies emphasize the need to examine discordance in data at an early stage of analysis. Further use and evaluation of these strategies are warranted to expand the body of knowledge about practical methods of mixed methods data analysis.

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Mechanisms and drivers of social inequality in phase II cardiac rehabilitation attendance: A convergent mixed methods study

Cited by 15 publications

References 38 publications

Why Do Patients With Ischaemic Heart Disease Drop Out From Cardiac Rehabilitation in Primary Health Settings. A Qualitative Audit of Patient Charts

Why Do Patients With Ischaemic Heart Disease Drop Out From Cardiac Rehabilitation in Primary Health Settings. A Qualitative Audit of Patient Charts

Establishing the efficacy of interventions to improve health literacy and health behaviours: a systematic review

Practical strategies to identify and address discordant findings in mixed methods research

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